Factors influencing diagnosis delay of advanced breast cancer in Moroccan women

Abstract

BackgroundDelay in the diagnosis of breast cancer in symptomatic women of 3 months or more is associated with advanced stage and low survival. We conducted this study to learn more about the extent and reasons behind diagnosis delay of advanced breast cancer in Moroccan women.MethodsA group of patients with advanced breast cancer were interviewed at the National Institute of Oncology in Rabat during the period from February to December 2014. Diagnosis delay was devised into patient delay and system delay. Patient delay was defined as time from first symptoms until first medical consultation. System delay was defined as time from first presentation to a health care provider until definite diagnosis or treatment. Prospective information and clinical data were collected on a form during an interview with each patient and from medical records.ResultsIn all, 137 patients were interviewed. The mean age of women was 48.3 ± 10.4 years. The median of consultation time was 6[4,12] months and the median of diagnosis time was 1[1,3] months. Diagnosis delay was associated to a personal reason in 96 (70.1 %) patients and to a medical reason in 19 (13.9 %) patients. A number of factors predicted diagnosis delay: symptoms were not considered serious in 66 (55.9 %) patients; traditional therapy was applied in 15 (12.7 %) patients and fear of cancer diagnosis and/or treatment in 14 (11.9 %) patients. A use of traditional methods was significantly associated with rural residence and far away from basic health center (p = 0.000). Paradoxically, a family history of breast cancer was significantly higher in who report a fear of cancer diagnosis and/or treatment to diagnosis delay (p < 0.001). Also, a significantly higher risk of more than 6 months delay was found among rural women (P = 0.035) and women who live far away from specialized care center (P = 0.001).ConclusionsDiagnosis delay is very serious problem in Morocco. Diagnosis delay was associated with complex interactions between several factors and with advanced stages. There is a need for improving breast cancer information in our populations and training of general practitioners to reduce advanced breast cancer by promoting early detection.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2394-y) contains supplementary material, which is available to authorized users.

Barriers and Explanatory Mechanisms of Delays in the Patient and Diagnosis Intervals of Care for Breast Cancer in Mexico

“…The known relevance of breast cancer awareness in the patients’ medical‐seeking behavior is confirmed in our findings. The association identified between the patients’ initial interpretations of breast symptoms as “not cancer” and “not worrisome” and postponement of seeking care has been described in previous studies . The results of the PA reveal that these initial interpretations are associated with higher cancer awareness indicators like knowing someone who had cancer, knowledge of mammography, and knowledge of BC symptoms.…”

Use of traditional and complementary medicines by cancer patients at a national cancer referral facility in a low‐income country

“…Starting use of T&CM before seeking care at biomedical facilities potentially delays health seeking. Other studies have shown that patients with cancer who take recourse to T&CM often delay by several months to be diagnosed and are often in advanced stage disease at presentation (Broom et al, ; De Boer, Niyonzima, Orem, Bartlett, & Zafar, ; Kerdpon & Sriplung, ; Maghous et al, ). These findings have important implications for interventions to promote early detection of cancers by targeting the THPs who are visited earlier on in the disease trajectory.…”

Factors influencing delay in symptomatic presentation of breast cancer in Brazilian women

“…The observed time interval was shorter in countries such as Thailand (Poum et al, ), Estonia (Innos et al, ) and Jordan (Abu‐Helalah et al, ) than observed herein, with medians of 12, 16, and 30 days, respectively. In Morocco (Maghous et al, ), Niger (Pace et al, ), China (Yau et al, ) and Uganda (Odongo et al, ), the delay exceeds 90 days. The largest time intervals described in the literature were 5 months in Niger (median), 6 months in Morocco (median), 13 months in Uganda (median) and 13.1 weeks in China (mean).…”

“…In a systematic review (Walter et al, ), demographic, psychological and social factors are mentioned as some of the reasons contributing to the delay in this step (Andersen & Cacioppo, ). Women's liability concerning delays in breast cancer evaluation must be questioned and broadly discussed, due to social, political and economic barriers (Lim, Potrata, & Simonella, ; Maghous et al, ; Pace et al, ; Unger‐Saldaña, ; Unger‐Saldaña & Infante‐Castañeda, ).…”

“…Women's liability concerning delays in breast cancer evaluation must be questioned and broadly discussed, due to social, political and economic barriers (Lim, Potrata, & Simonella, 2015;Maghous et al, 2016;Pace et al, 2015;Unger-Saldaña, 2014;Unger-Saldaña & Infante-Castañeda, 2009).…”