More than one in three young women with breast cancer taking part in a study carried out in China had accumulated a significant delay before receiving care. The work, published in Asia-Pacific Journal of Oncology Nursing, looks at which factors are associated with that delay and shows that those who experienced it reported worse quality of life across several domains.
What was known
Delay before diagnosis and the start of treatment is one of the points breast cancer programmes try hardest to correct, because it shapes how advanced the disease is when treatment begins. Its determinants in young women were not well characterised.
What this work adds
It is a cross-sectional study: 286 young women with breast cancer treated between October 2022 and March 2023 at four tertiary hospitals in Hunan, China. The analysis followed the Andersen behavioural model; determinants of delay were identified with logistic regression and the relationship with quality of life was examined with linear regression.
Main results
Of the 286 participants, 106 (37.06%) had experienced delay. The factors that most increased the likelihood were living in a rural area (odds ratio [OR] 3.676; 95% CI 1.468-9.206), having first attended a department other than the specialist one (OR 3.910; 95% CI 1.439-10.624) and, above all, having waited more than seven days for that first appointment (OR 11.350; 95% CI 3.450-37.345). Reducing the risk were detection during a routine physical examination (OR 0.208; 95% CI 0.045-0.967), higher critical health literacy (OR 0.676) and more support from friends (OR 0.921). Delay was associated with worse quality of life (FACT-B): overall score (t = -2.443; p = 0.015), physical well-being (t = -3.526), functional well-being (t = -2.077; p = 0.039) and additional concerns (t = -1.974; p = 0.049).
What it means
The most important finding is that the main factor associated with delay does not depend on the patient’s decision but on how the care pathway is organised: waiting more than a week for the first appointment multiplied the likelihood of delay more than elevenfold. The authors conclude that interventions should aim to improve access to health care, without neglecting patient information. These are data from a cross-sectional study in one specific health system: they describe associations, not causes.
A view from the breast unit
The pathway described — a first appointment outside the specialist service and a delay that accumulates — is recognisable in any health system. For a breast unit, the practical message is to measure time to first appointment and time to diagnosis as indicators of its own performance, to look after fast-track referral routes for young women with breast symptoms and to offer clear materials on when to seek care without waiting.
Reference: Peng Y, Ma J, Liu L, Xiao J, Gu C. Determinants of patient delay and its association with quality of life among young women with breast cancer in China: A cross-sectional study, Asia-Pacific Journal of Oncology Nursing, 2026. DOI: 10.1016/j.apjon.2025.100846
