Ulrike Annette Anja Fritz1, Holger Pfaff2, Lena Roth1, Micheal Swora2, Sophie Elisabeth Groß2,3. 1. Medizinische Fakultät, Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft (IMVR) der Humanwissenschaftlichen Fakultät und der Medizinischen Fakultät der Universität zu Köln. 2. Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft (IMVR) der Humanwissenschaftlichen Fakultät und der Medizinischen Fakultät der Universität zu Köln. 3. LVR-Institut für Versorgungsforschung, LVR-Klinik Köln.
Abstract
This study examines the influence of sociodemographic factors on the type of and stage at diagnosis in breast cancer in Germany. METHOD: As part of the certification of the breast cancer centers by the German Cancer Society (DGK), the Institute of Medical Sociology, Health Services and Rehabilitation Science (IMVR) conducted nationwide post-stationary postal patient surveys (n=852). The influence of sociodemographic factors on the type of diagnosis and on the stage at diagnosis were each analyzed using a multinomial logistic regression. RESULTS: 45.5% palpated the tumor by themselves, 33.4% were diagnosed by mammography screening and 16.6% by gynecological check-up. Being diagnosed by screening was associated with an early stage cancer. Furthermore, breast cancer patients without private health insurance or with a low educational level were less likely to be diagnosed by a gynecological check-up. Patients within screening age (50-69) had higher odds for an early stage breast cancer. Patients with a low educational level had lower odds for an early stage breast cancer. CONCLUSION: Fifty percent of the breast cancer patients were not diagnosed by screening. Mammography screening appears to be more sensitive in detecting early stage cancer, since we found an association between diagnosis by screening and an early stage cancer. Age outside of the screening range and a low educational level might be risk factors for an advanced stage breast cancer. High screening rates, especially for these risk groups, seem to be important for early detection of breast cancer. Thieme. All rights reserved.
This study examines the influence of sociodemographic factors on the type of and stage at diagnosis in breast cancer in Germany. METHOD: As part of the certification of the breast cancer centers by the German Cancer Society (DGK), the Institute of Medical Sociology, Health Services and Rehabilitation Science (IMVR) conducted nationwide post-stationary postal patient surveys (n=852). The influence of sociodemographic factors on the type of diagnosis and on the stage at diagnosis were each analyzed using a multinomial logistic regression. RESULTS: 45.5% palpated the tumor by themselves, 33.4% were diagnosed by mammography screening and 16.6% by gynecological check-up. Being diagnosed by screening was associated with an early stage cancer. Furthermore, breast cancer patients without private health insurance or with a low educational level were less likely to be diagnosed by a gynecological check-up. Patients within screening age (50-69) had higher odds for an early stage breast cancer. Patients with a low educational level had lower odds for an early stage breast cancer. CONCLUSION: Fifty percent of the breast cancer patients were not diagnosed by screening. Mammography screening appears to be more sensitive in detecting early stage cancer, since we found an association between diagnosis by screening and an early stage cancer. Age outside of the screening range and a low educational level might be risk factors for an advanced stage breast cancer. High screening rates, especially for these risk groups, seem to be important for early detection of breast cancer. Thieme. All rights reserved.