Sex bias in diagnostic delay in bronchiectasis: An analysis of the Spanish Historical Registry of Bronchiectasis

Chron Respir Dis. 2017 Nov;14(4):360-369. doi: 10.1177/1479972317702139. Epub 2017 Apr 10.

Abstract

Diagnostic delay is common in most respiratory diseases, particularly in bronchiectasis. However, sex bias in diagnostic delay has not been studied to date.

Objective: Assessment of diagnostic delay in bronchiectasis by sex.

Methods: The Spanish Historical Registry of Bronchiectasis recruited adults diagnosed with bronchiectasis from 2002 to 2011 in 36 centres in Spain. From a total of 2113 patients registered we studied 2099, of whom 1125 (53.6%) were women.

Results: No differences were found for sex or age (61.0 ± 20.6, p = 0.88) or for localization of bronchiectasis ( p = 0.31). Bronchiectasis of unknown aetiology and secondary to asthma, childhood infections and tuberculosis was more common in women (all ps < 0.05). More men than women were chronic obstructive pulmonary disease-related bronchiectasis and colonized by Haemophilus influenzae ( p < 0.001 for both). Onset of symptoms was earlier in women. The diagnostic delay for women with bronchiectasis was 2.1 years more than for men ( p = 0.001).

Discussion: We recorded a substantial delay in the diagnosis of bronchiectasis. This delay was significantly longer in women than in men (>2 years). Independent factors associated with this sex bias were age at onset of symptoms, smoking history, daily expectoration and reduced lung function.

Keywords: Bronchiectasis; diagnostic delay; gender bias; gender gap; sex bias.

MeSH terms

  • Adult
  • Age of Onset
  • Aged
  • Aged, 80 and over
  • Asthma / complications
  • Bias
  • Bronchi / microbiology
  • Bronchiectasis / diagnosis*
  • Bronchiectasis / etiology*
  • Bronchiectasis / physiopathology
  • Delayed Diagnosis / statistics & numerical data*
  • Female
  • Haemophilus influenzae / isolation & purification
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive / complications
  • Registries
  • Sex Factors
  • Smoking
  • Spain
  • Sputum
  • Time Factors
  • Tuberculosis, Pulmonary / complications