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Showing content from https://pubmed.ncbi.nlm.nih.gov/28629330/ below:

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

Affiliations

• ¹ Department of Surgery, Minamisoma Municipal General Hospital, 2-54-6 Takamicho, Haramachi, Minamisoma, Fukushima, 975-0033, Japan. ozakiakihiko@gmail.com.
• ² Department of Epidemiology and Biostatistics, Teikyo University Graduate School of Public Health, Minamisoma, Tokyo, 173-8605, Japan. ozakiakihiko@gmail.com.
• ³ Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, SW7 2AZ, UK.
• ⁴ Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Minamisoma, Tokyo, 113-0033, Japan.
• ⁵ Department of Research, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, 975-0033, Japan.
• ⁶ Department of Radiation Protection, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, 975-0033, Japan.
• ⁷ Department of Internal Medicine, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, 972-8322, Japan.
• ⁸ Department of Surgery, Minamisoma Municipal General Hospital, 2-54-6 Takamicho, Haramachi, Minamisoma, Fukushima, 975-0033, Japan.
• ⁹ Department of Medical Oncology, Fukushima Medical University, Fukushima, 960-1295, Japan.
• ¹⁰ Department of Internal Medicine, Soma Central Hospital, Soma, Fukushima, 976-0016, Japan.
• ¹¹ Research Institute of Innovative Medicine, Jyoban Hospital of Tokiwakai Group, Iwaki, Fukushima, 972-8322, Japan.
• ¹² Medical Governance Research Institute, Minato-ku, Tokyo, 108-0074, Japan.
• ¹³ Department of Home Medical Care, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, 975-0033, Japan.
• ¹⁴ Department of Gastroenterology, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, 975-0033, Japan.

• PMID: 28629330
• PMCID: PMC5477136
• DOI: 10.1186/s12885-017-3412-4

Item in Clipboard

Akihiko Ozaki et al. BMC Cancer. 2017.

• ¹ Department of Surgery, Minamisoma Municipal General Hospital, 2-54-6 Takamicho, Haramachi, Minamisoma, Fukushima, 975-0033, Japan. ozakiakihiko@gmail.com.
• ² Department of Epidemiology and Biostatistics, Teikyo University Graduate School of Public Health, Minamisoma, Tokyo, 173-8605, Japan. ozakiakihiko@gmail.com.
• ³ Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, SW7 2AZ, UK.
• ⁴ Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Minamisoma, Tokyo, 113-0033, Japan.
• ⁵ Department of Research, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, 975-0033, Japan.
• ⁶ Department of Radiation Protection, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, 975-0033, Japan.
• ⁷ Department of Internal Medicine, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, 972-8322, Japan.
• ⁸ Department of Surgery, Minamisoma Municipal General Hospital, 2-54-6 Takamicho, Haramachi, Minamisoma, Fukushima, 975-0033, Japan.
• ⁹ Department of Medical Oncology, Fukushima Medical University, Fukushima, 960-1295, Japan.
• ¹⁰ Department of Internal Medicine, Soma Central Hospital, Soma, Fukushima, 976-0016, Japan.
• ¹¹ Research Institute of Innovative Medicine, Jyoban Hospital of Tokiwakai Group, Iwaki, Fukushima, 972-8322, Japan.
• ¹² Medical Governance Research Institute, Minato-ku, Tokyo, 108-0074, Japan.
• ¹³ Department of Home Medical Care, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, 975-0033, Japan.
• ¹⁴ Department of Gastroenterology, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, 975-0033, Japan.

• PMID: 28629330
• PMCID: PMC5477136
• DOI: 10.1186/s12885-017-3412-4

Item in Clipboard

Background: Little 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.

Methods: Records 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.

Results: Two 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.

Conclusions: The 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.

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

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Map of Minamisoma City and…

Map of Minamisoma City and its location within So-so District, Fukushima, with air…

Map of Minamisoma City and its location within So-so District, Fukushima, with air dose rate. Minamisoma Municipal General Hospital and Watanabe Hospital are located 23 km and 25 km north of Fukushima Daiichi Nuclear Power Plant, respectively, both of which are within the voluntary evacuation zone. The air dose rate of radiation as of April 2011 is also described in this map. Approval for re-use of the image has been granted from ESRI Japan Corporation

Process of participant inclusion

Process of participant inclusion

Process of participant inclusion

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• Two-Year-Span Breast Cancer Screening Uptake in Japan after the COVID-19 Pandemic and Its Association with the COVID-19 Vaccination.

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