Korean J Psychosom Med.  2014 Jun;22(1):13-22.

Psychosocial Factors Predicting Delayed Diagnosis of Breast Cancer: The Role of Marital Relationship Functioning

• Kim JY
• Woo J
• Lee SS
• Kim HW
• Khang D
• Rim HD

Abstract

OBJECTIVES
Breast cancer has been the most prevalent female cancer in South Korea since 2001. Early detection of this disease is the most effective strategy for reducing mortality. The objective of this study was to identify factors which could predict advanced stage at diagnosis of breast cancer.
METHODS
Participants who were initially diagnosed with breast cancer and referred to the Stress Clinic of the Breast Cancer Center at Kyungpook National University Hospital were included. Through a semi-structured interview, the authors investigated psychosocial variables such as the extent of marital and family functioning and emotional-economic family burden as well as sociodemographic and health behavior-, health characteristic- and cancer-related variables.
RESULTS
Data were collected from 219 participants. One hundred and twenty(54.8%) subjects were diagnosed with advanced-stage breast cancer. Variables that were significantly different between the advanced-stage and early-stage groups included : monthly breast self examination(p<0.000), annual mammographic screening(p< 0.000), mode of tumor detection(p<0.000), nature of the first symptoms(p<0.000), time to treatment after di-agnosis(p<0.000), overloaded economic and family burden(p=0.018), marital functioning(p<0.000) and family functioning(p<0.00). Logistic regression analysis indicated that irregular annual mammography screening(OR=7.431 ; 95% CI 2.407-22.944) or a lack of screening(OR=25.299 ; 95% CI 7.855-81.482) and a dysfunctional marital relationship(OR=4.772 ; 95% CI 2.244-10.145) were significantly associated with advanced stage at diagnosis of breast cancer.
CONCLUSIONS
We reconfirmed screening behavior to be a risk factor for delayed diagnosis of breast cancer. Our findings also emphasized the importance of psychosocial factors such as marital functioning in early detection of breast cancer. Psychiatric consultation in the area of martial functioning could be beneficial for increasing early detection in breast cancer.

Keyword

Advanced stage at diagnosis of breast cancer; Psychosocial factor; Marital functioning

MeSH Terms

Breast
Breast Neoplasms*
Delayed Diagnosis*
Diagnosis
Female
Gyeongsangbuk-do
Humans
Korea
Logistic Models
Mammography
Marriage*
Mass Screening
Mortality
Psychology*
Risk Factors
Time-to-Treatment