Factors influencing time to seeking medical advice and onset of treatment in women who are diagnosed with breast cancer in Serbia

Stamatovic, L.; Vasovic, S.; Trifunović, Jasna; Boskov, Nedeljka; Gajic, Zoran; Parezanovic, A.; Icevic, M.; Ćirković, Andja; Milić, Nataša

doi:10.1002/pon.4551

Cited by 8 publications

(8 citation statements)

References 32 publications

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“…Similarly, compared with studies in sub-Saharan African countries, the median patient interval in our study (30 days) was considerably shorter than those reported from Rwanda (150 days)24 and Mali (144 days),34 but comparable with that reported from South Africa (23 days) 35. As expected, compared with findings from countries outside of sub-Saharan Africa, however, our finding of median patient interval is generally longer 36 37…”

Section: Discussionsupporting

confidence: 79%

Time intervals experienced between first symptom recognition and pathologic diagnosis of breast cancer in Addis Ababa, Ethiopia: a cross-sectional study

et al. 2019

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ObjectivesThis study aimed to estimate the magnitude of patient and diagnostic delays and associated factors among women with breast cancer in Addis Ababa.DesignThis is a cross-sectional study.Settings and participantsAll women newly diagnosed with breast cancer in seven major healthcare facilities in Addis Ababa (n=441) were included in the study.Main outcomes and measuresPatient interval (time from recognition of first symptom to medical consultation) and diagnostic interval (time from first consultation to diagnosis). Patient intervals >90 days and diagnostic intervals >30 days were considered delays, and associated factors were determined using multivariable Poisson regressions with robust variance.ResultsThirty-six percent (95% CI [31.1%, 40.3%]) of the patients had patient intervals of >90 days, and 69% (95% CI [64.6%, 73.3%]) of the patients had diagnostic intervals of >30 days. Diagnostic interval exceeded 1 year for 18% of patients. Ninety-five percent of the patients detected the first symptoms of breast cancer by themselves, with breast lump (78.0%) as the most common first symptom. Only 8.0% were concerned about cancer initially, with most attributing their symptoms to other factors. In the multivariable analysis, using traditional medicine before consultation was significantly associated with increased prevalence of patient delay (adjusted prevalence ratio (PR) = 2.13, 95% CI [1.68, 2.71]). First consultation at health centres (adjusted PR = 1.19, 95% CI [1.02, 1.39]) and visiting ≥4 facilities (adjusted PR = 1.24, 95% CI [1.10, 1.40]) were associated with higher prevalence of diagnostic delay. However, progression of symptoms before consultation (adjusted PR = 0.73, 95% CI [0.60, 0.90]) was associated with decreased prevalence of diagnostic delay.ConclusionsPatients with breast cancer in Addis Ababa have prolonged patient and diagnostic intervals. These underscore the need for public health programme to increase knowledge about breast cancer symptoms and the importance of early presentation and early diagnosis among the general public and healthcare providers.

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Section: Discussionsupporting

confidence: 79%

Time intervals experienced between first symptom recognition and pathologic diagnosis of breast cancer in Addis Ababa, Ethiopia: a cross-sectional study

et al. 2019

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“…To reduce this interval, it would be important to remember that women with lower educational levels were more susceptible to have longer intervals, which is consistent with results from other studies 21,25,26 . Lower educational levels are also associated with lower levels of awareness and recognition of breast cancer warning signs 27,28 .…”

Section: Discussionsupporting

confidence: 83%

Factors associated with time interval between the onset of symptoms and first medical visit in women with breast cancer

et al. 2020

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Women presenting with advanced breast cancer tumors are common in Brazil. Little is known about factors contributing to the delay in seeking care. The aim of this study was to identify factors associated with longer time intervals between the onset of breast cancer symptoms and the first medical visit in the Federal District, Brazil. The analysis included 444 symptomatic women with incident breast cancer, interviewed between September, 2012 and September, 2014, during their admission for breast cancer treatment in nine public hospitals in the Federal District. Patients with metastatic disease at diagnosis were not included in this study. The outcome was time interval between symptom onset and the first medical visit, whether > 90 (34% of patients) or ≤ 90 days. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95%CI). In the multivariate analysis, the > 90 day interval was significantly associated with patients not performing mammography and/or breast ultrasound in the two years prior to breast cancer diagnosis (OR = 1.97; 95%CI: 1.26-3.08), and with more advanced stages (OR = 1.72; 95%CI: 1.10-2.72). Furthermore, there was a lower chance of delay in patients with higher levels of education (OR = 0.95; 95%CI: 0.91-0.99). A relatively high proportion of breast cancer patients in the Brazilian Federal District experienced delay to attend the first medical consultation after the symptoms onset. Increasing breast cancer awareness, especially among women with low educational levels and those not participating in mammography screening programs could contribute to reduce this delay.

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“…A semistructured interview guide was used for the interview. The guiding questions were based on previous similar publications 6,10,[15][16][17][18][19][20] and were adapted for use in the Ghana context. Section 1 of the interview guide (Supplementary Data) was semistructured, and it was based on the Model of Pathways to Treatment framework.…”

Section: Data Collectionmentioning

confidence: 99%

Pathways to Breast Cancer Diagnosis and Treatment Among Women in Ghana: A Qualitative Study

Mburu

Mensah

Virnig

et al. 2021

Women's Health Reports

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Background: Breast cancer is the leading cause of cancer death among Ghanaian women and most women are identified once they develop symptoms. Women then must navigate a complex health care system to get diagnosed and receive orthodox medicine. We describe Ghanaian women's pathways of care from breast cancer-related symptom detection to treatment receipt. Methods: We conducted a qualitative study using an empirical phenomenological approach. We used a purposive sampling technique to recruit 31 women with breast cancer who were receiving treatment at Komfo Anokye Teaching Hospital in Kumasi, Ghana. They participated in semistructured in-depth interviews between November 2019 and March 2020. All interviews were transcribed verbatim and analyzed using a deductive coding approach. Results: Women navigate approximately nine steps from symptom detection to receiving orthodox breast cancer treatment. The breast cancer care pathway is not linear and women frequently move among different management approaches, including alternative therapy (faith healing and traditional herbal healing). All the women detected the symptoms themselves. Some of the women sought orthodox medicine due to information from the media. Conclusions: Alternative therapy providers play a critical role in the breast cancer diagnosis and care pathways in Ghana underscoring the need to formally integrate them into the health care system. Breast cancer awareness programs through the media and educational programs aimed at alternative therapy providers may reduce the time from symptom detection to receipt of orthodox medicine.

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Factors influencing time to seeking medical advice and onset of treatment in women who are diagnosed with breast cancer in Serbia

Cited by 8 publications

References 32 publications

Time intervals experienced between first symptom recognition and pathologic diagnosis of breast cancer in Addis Ababa, Ethiopia: a cross-sectional study

Time intervals experienced between first symptom recognition and pathologic diagnosis of breast cancer in Addis Ababa, Ethiopia: a cross-sectional study

Factors associated with time interval between the onset of symptoms and first medical visit in women with breast cancer

Pathways to Breast Cancer Diagnosis and Treatment Among Women in Ghana: A Qualitative Study

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