Aim: The purpose of this study is to examine the research hypothesis that there are differences in determinant factors that depend on the income level in seeking medical care of breast cancer patients who delayed getting medical care.
Methods: A cross-sectional survey was carried out at breast clinics in Japan, from February to May, 2016. The survey was conducted among 61 breast cancer patients who delayed seeking care at a hospital for more than 3 months after noticing a breast abnormality. The survey was asked about Problem Definition, Affective Responses, Health service utilization habits, Social Context, Beliefs, and Health services system variables. In the analysis, the annual family income level was classified into two groups, high-income group (≧3,000,000 JPY) and low-income group (＜3,000,000 JPY), and group comparisons were performed.
Results: The lower-income group experienced a significantly higher level of fear (p＝0.001) and anxiety (p＝0.008) compared with the higher-income group, when patients notice a breast abnormality. There were significantly differences between lower and higher-income group among 4 out of 20 items on the Modified J-Delay scale. The percentage of those who answered yes in the following questions were significantly high in the lower-income group : “Choose not to take any action” (p＝0.01), “Nuisance about thinking and acting” (p＝0.003), or “Consideration to people around” (p＝0.046). On the other hand, the percentage of those who answered yes in the following question was significantly high in the higher-income group answered “prioritized attending a hospital examination than other important things” (p＝0.03).
Conclusion: Our finding showed that there were differences in related factors that depend on the income level in seeking medical care of breast cancer patients who delayed getting medical care. Therefore, it was important to consider income level when constructing methods for reducing delayed seeking medical care.