Breast cancer patient delay in Fukushima, Japan following the 2011 triple disaster: a long-term retrospective study

BMC Cancer

Research Article

Shuhei Nomura¹  Yukio Kanazawa²  Tsuyoshi Nemoto³  Tetsuya Tanimoto⁴  Tomohiro Morita⁵  Sae Ochi⁵  Shigehira Saji⁶  Masaharu Tsubokura⁷  Claire Leppold⁸  Toyoaki Sawano⁹  Takeru Yokota⁹  Manabu Tsukada⁹  Hiromichi Ohira⁹  Akihiko Ozaki^1,10  Masahiro Kami^1,11  Shigeaki Kato^1,12 

[1] Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, SW7 2AZ, London, UK;Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Minamisoma, 113-0033, Tokyo, Japan;Department of Gastroenterology, Minamisoma Municipal General Hospital, Minamisoma, 975-0033, Fukushima, Japan;Department of Home Medical Care, Minamisoma Municipal General Hospital, Minamisoma, 975-0033, Fukushima, Japan;Department of Internal Medicine, Jyoban Hospital of Tokiwa Foundation, Iwaki, 972-8322, Fukushima, Japan;Department of Internal Medicine, Soma Central Hospital, Soma, 976-0016, Fukushima, Japan;Department of Medical Oncology, Fukushima Medical University, 960-1295, Fukushima, Japan;Department of Radiation Protection, Minamisoma Municipal General Hospital, Minamisoma, 975-0033, Fukushima, Japan;Department of Research, Minamisoma Municipal General Hospital, Minamisoma, 975-0033, Fukushima, Japan;Department of Surgery, Minamisoma Municipal General Hospital, 2-54-6 Takamicho, Haramachi, Minamisoma, 975-0033, Fukushima, Japan;Department of Surgery, Minamisoma Municipal General Hospital, 2-54-6 Takamicho, Haramachi, Minamisoma, 975-0033, Fukushima, Japan;Department of Epidemiology and Biostatistics, Teikyo University Graduate School of Public Health, Minamisoma, 173-8605, Tokyo, Japan;Medical Governance Research Institute, Minato-ku, 108-0074, Tokyo, Japan;Research Institute of Innovative Medicine, Jyoban Hospital of Tokiwakai Group, Iwaki, 972-8322, Fukushima, Japan;

关键词: Breast cancer;    Patient delay;    Social support;    Psychosocial stress;    Health service;    Fukushima;    Minamisoma;    Nuclear power plant;    Disaster;   

DOI  :  10.1186/s12885-017-3412-4

 received in 2016-08-28, accepted in 2017-06-08,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundLittle information is available concerning how patient delay may be affected by mass disasters. The main objectives of the present study are to identify whether there was a post-disaster increase in the risk of experiencing patient delay among breast cancer patients in an area affected by the 2011 triple disaster in Fukushima, Japan, and to elucidate factors associated with post-disaster patient delay. Sociodemographic factors (age, employment status, cohabitant status and evacuation status), health characteristics, and health access- and disaster-related factors were specifically considered.MethodsRecords of symptomatic breast cancer patients diagnosed from 2005 to 2016 were retrospectively reviewed to calculate risk ratios (RRs) for patient delay in every year post-disaster compared with the pre-disaster baseline. Total and excessive patient delays were respectively defined as three months or more and twelve months or more from symptom recognition to first medical consultation. Logistic regression analysis was conducted for pre- and post-disaster patient delay in order to reveal any factors potentially associated with patient delay, and changes after the disaster.ResultsTwo hundred nineteen breast cancer patients (122 pre-disaster and 97 post-disaster) were included. After adjustments for age, significant post-disaster increases in RRs of experiencing both total (RR: 1.66, 95% Confidence Interval (CI): 1.02–2.70, p < 0.05) and excessive patient delay (RR: 4.49, 95% CI: 1.73–11.65, p < 0.01) were observed. The RRs for total patient delay peaked in the fourth year post-disaster, and significant increases in the risk of excessive patient delay were observed in the second, fourth, and fifth years post-disaster, with more than five times the risk observed pre-disaster. A family history of any cancer was the only factor significantly associated with total patient delay post-disaster (odds ratio: 0.38, 95% CI: 0.15–0.95, p < 0.05), while there were no variables associated with delay pre-disaster.ConclusionsThe triple disaster in Fukushima appears to have led to an increased risk of patient delay among breast cancer patients, and this trend has continued for five years following the disaster.

【 授权许可】

CC BY   
© The Author(s). 2017