Factors affecting delay in the presentation of breast cancer symptoms among women in Gaza, occupied Palestinian territory: a cross-sectional survey

Abstract

ObjectiveTo identify factors related to women’s delay in presenting with breast cancer symptoms to improve diagnosis in the occupied Palestinian territory (oPt).DesignCross-sectional.SettingTwo government cancer hospitals.ParticipantsA consecutive sample of 130 Palestinian women living in Gaza with newly diagnosed breast cancer were approached in the waiting rooms of cancer hospitals in Gaza between 1 January 2017 and 31 December 2017. 120 women took part and returned the completed questionnaire.Primary and secondary outcome measuresClinical information about breast cancer was collected from hospital cancer records. An interval of 3 months or more between women’s self-discovery of symptoms and their first presentation to a medical provider was considered as a delay.Results94% (122/130) of women attending cancer hospitals in Gaza agreed to take part in the study. Their mean age was 51 years (range: 23–72), 33.6% (31/122) had a family history of breast cancer and 74.5% (41/55) of those whose cancer stage was known had been diagnosed at stage III or IV. Around one-half (62/122) said they had not recognised the seriousness of their breast changes but only 20% (24/122) of women delayed seeking healthcare by 3 months and more. The two only factors associated to late presentation were that the woman considered their symptoms not serious (p<0.001) and lack of pain (p=0.012). Lower socioeconomic status, older age, lower education and negative family history of breast cancer were not statistically associated with women’s delay.ConclusionsWomen’s awareness about the seriousness of breast changes and the critical importance of seeking prompt diagnosis needs to be improved using context-relevant and evidence-based awareness campaigns. This should be accompanied with training of female nurses on promoting early detection and improvement in diagnostic facilities to ensure timely diagnosis of cancer in the oPt.

Barriers to Timely Seeking of Breast Cancer Care Among Palestinian Women: A Cross-Sectional Study

“…This model was determined a priori on the basis of previous studies. 10,13,[24][25][26][27][28][29] Consistent with the original BCAM, 8 barriers to early presentation were classified into three categories: emotional, service-related, and practical barriers. The reported barriers were described using frequencies and percentages, and were compared between participants recruited from the Gaza Strip and those recruited from the WBJ using Pearson chisquare test.…”

The influence of socio-democratic factors on the stage at which women’s breast cancer is diagnosed and treatment prescribed in the Gaza Strip, occupied Palestinian territory

“…Part of the problem is the late presentation by women with symptoms or late diagnosis by the local health services [ 10 ]. With regard to early detection, the Palestinian Ministry of Health recommends that women aged 40–50 years should be screened every 2 years and those who are over the age of 50 should be screened every year [ 11 ].…”