The J-Delay scale: a measure of the likelihood of patient delay in breast cancer.

Patient delay in seeking treatment for breast cancer is a major contributing factor to morbidity and mortality. No instruments have previously been developed to predict the likelihood of patient delay. This report describes the development and testing of the J-Delay scale, designed to estimate a woman's risk of making the judgment to delay versus to seek immediate evaluation of self-discovered breast symptoms that might signal breast cancer. The J-Delay scale items were developed in four qualitative studies (28 focus groups, combined N = 147 women). The J-Delay scale was tested in 2 large, community-based samples varying across age, income, and ethnicity (combined N = 1,290). Content validity was supported by narrative analysis. Criterion validity was supported by the correct prediction of patient delay in 69%-86% of surveyed and interviewed women with symptoms of 3 months' or more duration. Internal consistency reliability was .83 in English samples (n = 596 and 352) and .81 in a Spanish sample (n = 222). Test-retest reliability after 3-4 months (n = 251) was supported by consistent assignment in 88.8% of cases. The J-Delay is a valid and reliable tool to identify women at risk for patient delay. Women identified as likely to delay medical attention must be targeted for early detection interventions focused on patient delay.