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Breast Cancer Management Timelines in a Tertiary Care Center During the COVID-19 Pandemic, Makkah City, Saudi Arabia:
Abdulrahman H Alhassani1, Abdulmohsen S Alqurashi2, Turki H Alhassani2
1General Surgery, Makkah Healthcare Cluster, Makkah, SAU.
Insights
Patient appointment adherence significantly impacts breast cancer treatment timelines. Missed or canceled appointments in Saudi Arabia led to delays in initiating therapy for breast cancer (BC) patients.
Area of Science:
- Oncology
- Public Health
- Healthcare Management
Background:
- Breast cancer (BC) is a major global health concern, particularly for women.
- In Saudi Arabia, BC represented 31.8% of female cancer cases in 2018.
- The COVID-19 pandemic disrupted healthcare, potentially delaying BC management.
Purpose of the Study:
- To determine diagnostic and management timelines for breast cancer patients.
- To identify factors contributing to treatment delays in Saudi Arabia.
- To address the lack of regional research on breast cancer care intervals.
Main Methods:
- Observational retrospective study at King Abdullah Medical City (KAMC), Makkah, Saudi Arabia.
- Included female patients diagnosed with or referred for BC between January 2020 and August 2021.
- Data collected via centralized electronic chart review.
Main Results:
- 76 female patients were analyzed (mean age 50 ± 11 years).
- 36.8% of patients exceeded 60 days for management completion.
- Patient non-attendance and appointment cancellations were significantly associated with treatment delays (p=0.033, p<0.001, p=0.03).
Conclusions:
- Patient adherence to appointments is critical for timely breast cancer treatment initiation.
- Strategies to improve appointment attendance are needed to mitigate delays.
- Further research on COVID-19's impact on other cancers is recommended.
Background:
Breast cancer (BC) is a prevalent form of cancer and a leading cause of death among women worldwide. In Saudi Arabia, it accounted for 31.8% among females of all new cancer cases reported in 2018. Following the declaration of COVID-19 as a global pandemic, there was a complete redistribution of healthcare resources to face this crisis, which caused a significant delay in the management of various diseases, including BC. There is currently a lack of research in our region on the facility time interval in BC management. Therefore, this study aimed to fill this gap by determining the timelines of diagnosis, management, and factors influencing the delay.
Methods:
This observational retrospective study included all female patients diagnosed with BC at or referred to King Abdullah Medical City (KAMC) in Makkah, Saudi Arabia, between January 2020 and August 2021. The data for this study were obtained from a centralized electronic chart review of all included patients at the KAMC center.
Results:
A total of 76 patients were included in the study, with a mean age of 50 ± 11 years. In terms of the disease management duration, 20 patients (26.3%) completed their management within 30 days, 28 patients (36.8%) had a management duration between 31 and 60 days, and the management duration of 28 patients (36.8%) exceeded 60 days. Patient deposition showed a significant association with delay (p = 0.033). A higher incidence of delays at the initiation of treatment was observed in patients who failed to attend appointments (p < 0.001). Among patients who skipped two or more appointments, 12 individuals (80%) experienced a delay of more than 60 days. Moreover, appointment cancellation was associated with delayed treatment initiation (p = 0.03). Patients' age and comorbidity showed no significant association (p = 0.49, p = 0.24, respectively).
Conclusion:
Our findings highlight the significant impact of patient deposition and canceled or skipped appointments on delayed initiation of therapy for BC patients. Further research should be conducted to evaluate the impact of COVID-19 on other malignancies.
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