유방암 환자에서 생활사건 스트레스가 치료지연에 미치는 영향
The Effect of Stressful Life Events on the Patient Delay in Breast Cancer Patients
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Objectives：As breast cancer has become prevalent, its disease-related burden has been on the rise and a matterof great concern. Delayed presentation of symptomatic breast cancer has an association with lower survival rate. Theobjective of this study was to understand the effect of stressful life events on delayed presentation of patients with breastcancer. Methods：A group of newly diagnosed breast cancer patients were interviewed and were asked about patient delayand stressful-life events. Variables related stressful-life events were investigated through Social readjustment ratingscale. We divided two groups depending on 3 months of patients delay and analyzed the effect of stressful-life eventson patients delay. Results：Among the patients, 73.6% presented to clinician within 3 months. There was a significant association betweenpatient delay and late cancer stage(p=0.035). In multivariate regression analysis, there were risk factors for longerpatient delay in patients with severe stress(OR 2.541, p=0.038), with the first symptom as other than lump(OR 3.614,p=0.014) and patients who did not monthly breast self-examination(irregular : OR 3.802, p=0.024 ; never done : OR3.196, p=0.052). Conclusion：The findings suggest that the delayed presentation was associated with late stage diagnosis and wasaffected by stressful life events significantly. The consideration for stress-related factors would be indispensable for establishingthe strategy for early detection.
Abstract
Objectives：As breast cancer has become prevalent, its disease-related burden has been on the rise and a matterof great concern. Delayed presentation of symptomatic breast cancer has an association with lower survival rate. Theobjective of this study was to understand the effect of stressful life events on delayed presentation of patients with breastcancer. Methods：A group of newly diagnosed breast cancer patients were interviewed and were asked about patient delayand stressful-life events. Variables related stressful-life events were investigated through Social readjustment ratingscale. We divided two groups depending on 3 months of patients delay and analyzed the effect of stressful-life eventson patients delay. Results：Among the patients, 73.6% presented to clinician within 3 months. There was a significant association betweenpatient delay and late cancer stage(p=0.035). In multivariate regression analysis, there were risk factors for longerpatient delay in patients with severe stress(OR 2.541, p=0.038), with the first symptom as other than lump(OR 3.614,p=0.014) and patients who did not monthly breast self-examination(irregular : OR 3.802, p=0.024 ; never done : OR3.196, p=0.052). Conclusion：The findings suggest that the delayed presentation was associated with late stage diagnosis and wasaffected by stressful life events significantly. The consideration for stress-related factors would be indispensable for establishingthe strategy for early detection.
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