Nowadays, breast cancer remains a serious disease, associated with heavy treatments and long-term sequelae that represent high costs of care (Maghous et al., 2016). As a result, systematic screening and improved treatment and management have been required to reduce breast cancer mortality over the past 20 years (Park, Anderson & Gail, 2015; Basu et al., 2018). However, the role of screening is currently controversial in terms of improving treatment (Gatzsche & Jargensen 2013).
The prognosis of breast cancer is strongly linked to biology (hormonal receptors, Her2, proliferation, immune infiltrate…), but also to its stage at diagnosis. An earlier diagnosis is synonymous with a better chance of cure, but also with less burdensome treatments (Mandelblatt et al. , 2016). While early diagnosis improves the prognosis and is a decisive step in the process of breast cancer management, the current state of breast cancer care in Morocco is marred by a number of observations that may constitute obstacles to improving the quality of its management (Mimouni et al., 2018). Indeed, several studies have shown that delay in diagnosis and access to treatment remains a major problem (Rutqvist, 2006; Hansen et al., 2011; Chintamani et al., 2011), which has led to an awareness of the lengthy delays in access to care (Maghous et al., 2016). These waiting times depend both on the patient himself and on the health system in general. They may vary by country, region, patient characteristics, type of cancer and management strategy (Pourcel et al., 2013). As a result, timeliness of care and access to care services has become a priority in public health policy at the international (Revaux et al., 2014) and national (Basu et al., 2018) levels, and is an important component of quality and continuity of care. It is also an indicator of healthcare system performance and a tracer of inequalities in access to healthcare (Molinié et al., 2013).
Some countries have committed themselves to the evaluation and quantified reduction of the time taken to treat cancers and have made this an objective of their cancer plans (Pourcel et al., 2013). As for Morocco, to date there is very little data available on the various consultation, diagnosis and treatment access times (Mimouni et al., 2018). Hence the objective of this retrospective epidemiological study spread over one and a half years (starting in 2017) is to determine the consultation, referral and histological diagnosis times of women with breast cancer admitted to the Reference and reproductive health center of Tetouan (RRHT) and to analyze the factors likely to influence the duration. The goal of our research is to suggest the development of strategies to target barriers to access to diagnosis for women with breast cancer at the provincial and national level.