Knowledge of symptoms, time to presentation and barriers to medical help-seeking among Omani women diagnosed with breast cancer: a cross-sectional study

Abstract

ObjectiveTo identify knowledge of breast cancer (BC) symptoms, time taken to consult a doctor and factors contributing to delays in medical help-seeking.DesignA cross-sectional study of Omani women diagnosed with BC.SettingThe two main teaching hospitals in Oman: Royal Hospital and Sultan Qaboos University Hospital.ParticipantsAdult Omani women recently diagnosed with BC.ToolsThe Breast Module of the Cancer Awareness Measure and the International Cancer Benchmarking Partnership questionnaire were used to collect data.ResultsA total of 300 women with BC participated (response rate: 91.0%). The mean age at diagnosis was 43.0±12.50 years and 33.5% were diagnosed at stage III or IV. Although most women (74.4%) recognised breast/armpit lumps to be a symptom of BC, less than half identified other symptoms, including breast/armpit pain (44.0%), changes in the position of the nipple (36.2%), redness (31.7%), fatigue (26.3%), weight loss (23.4%) and loss of appetite (20.8%). While most (91.6%) were aware that BC could be cured if detected early, only 66.4% sought medical help within a month of developing symptoms. Initial responses to symptoms included informing husbands (40.2%) or family members (36.5%). Barriers to seeking medical help included feeling scared (68.9%) and worried about what the doctor might find (62.8%). Highly educated women were more likely to recognise the following as BC symptoms: changes in nipple position (OR: 0.16, 95% CI 0.03 to 0.81), breast pain (OR: 0.10, 95% CI 0.01 to 0.86) and unexplained weight loss (OR: 0.18, 95% CI 0.04 to 0.88) (all p<0.05).ConclusionsAlthough many Omani women with BC were aware of the importance of early diagnosis, most demonstrated inadequate knowledge of symptoms, did not prioritise seeking medical help and reported emotional barriers to help-seeking. More educational measures are needed to improve symptom recognition and address help-seeking barriers to minimise delays in diagnosis.

Effectiveness of an Educational Program on Awareness of Breast Cancer Risk Factors, Symptoms, and Barriers to Seeking Medical Help among Adolescent Omani School Students—An Interventional Study

“…To our knowledge, this is the first interventional study conducted in Oman to evaluate the effectiveness of a cancer education program in enhancing awareness of BC risk factors and symptoms and reducing barriers to seeking medical help among female Omani adolescent students. In Oman, BC has been ranked as the most commonly diagnosed cancer, with affected women being diagnosed at a younger age and presenting at relatively advanced stages (i.e., stages III or IV) at the time of diagnosis [ 17 , 18 ]. Awareness of evidence-based cancer risk factors has been considered an important component of cancer control strategies [ 25 ].…”

“…Previous studies have indicated that young Omani women have inadequate knowledge of BC symptoms [ 18 , 19 ]; moreover, such women do not prioritize seeking medical help and report several physical and emotional barriers to help-seeking despite awareness of the importance of an early BC diagnosis [ 18 , 20 , 21 ]. As such, researchers have concluded that there is an urgent need for cancer education programs to be included in local school curricula targeting female adolescents to improve their knowledge of BC symptoms and address help-seeking barriers to minimize delays in BC diagnosis.…”

High Number of Familial Breast Cancer Cases in the Arabian Gulf Countries: Investigating the Reasons

“…The lack of BC screening practices was attributed to the lack of a doctor’s recommendation, fear, and embarrassment. 33 - 35 El Hajj and Hamid 36 in 2013 pointed out that 88% of pharmacies in Qatar fail to provide education programs for BC, though 60% were eager to participate in the promotion for BC awareness.…”

A qualitative exploration of women's perspectives and acceptability of including new cancer awareness information in all‐clear breast or cervical screening results

“…Relating their 'affective attitude', women in this study mostly felt positive about the INCLUSION approach, but had concerns about its emotional implications in stimulating anxiety or fear which could impede their acceptance and use of new cancer information. Previous studies have also shown fear of diagnosis as a barrier to early presentation for suspected cancer symptoms (Al-Aziz et al, 2021;Macleod et al, 2009) or screening uptake (Bamidele et al, 2017), which highlights the importance of providing cancer information in a clear and reassuring way, to avoid women confusing it with an impending diagnosis.…”