Social barriers to diagnosis and treatment of breast cancer in patients presenting at a teaching hospital in Ibadan, Nigeria

Pruitt, Liese C.C.; Mumuni, Tolulope; Raikhel, Eugene; Ademola, Adeyinka; Ogundiran, Temidayo O.; Adenipekun, A; Morhason-Bello, Imran O.; Ojengbede, Oladosu; Olopade, Olufunmilayo I.

doi:10.1080/17441692.2014.974649

Cited by 68 publications

(89 citation statements)

References 31 publications

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“…Our findings that, among those reasons, make the priority for financial obstacles is consistent with a preceding Sudanese study (Alawad et al, 2013). Also it is shared by a couple of studies from two countries at the extremes of economic prosperity, Nigeria and US (Pruitt et al, 2015;Ruddy et al, 2014). Many studies have addressed the role of lack of knowledge in deterring presentation (Memon et al, 2013;Bodapati and Babu, 2013).…”

Section: Discussionmentioning

confidence: 99%

Factors Delaying Presentation of Sudanese Breast Cancer Patients: an Analysis Using Andersen's Model

Salih

Alfaki²,

Alam-Elhuda³

et al. 2016

Asian Pacific Journal of Cancer Prevention

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Purpose: A multicenter, observational, cross-sectional study was conducted to assess factors delaying presentation of breast cancer cases. Materials and Methods: Data were collected from a pair of highly specialized referral centers, both located in the center of the Sudanese capital, Khartoum. For a total of 153 eligible respondents, durations of delay, clinicodemographic factors and reasons of referral were collected from our respondents through self-administered questionnaires. Logistic regression analysis and ANOVA were used to test the relation between periods of delay and different factors. Odd ratios (OR's) and their correspondent Confidence intervals (95% CI's). Delay periods were studied with Andersen's model. Results: The average duration of delay in our study was 11.9 (±11.2) months. Only a quarter of our patients presented early within the first 3 months after onset of their symptoms. About 47.7% arrived later during the course of the first year, while it took beyond that for the last 27% to come. A prior diagnosis of BC was the only predictor of early presentation (for 3-12 months OR=9.6 (p<0.00), 95% CI 9.55-9.75; for >12 months OR=9.3 (p<0.00), 95% CI 9.33-9.33). Out of the 12 different reasons for delay given by our respondents, none showed a significant difference between patients presenting early or late. Financial incapacity (17.5%), ignorance about BC (14.3), and misinterpreting symptoms (12.7%) were the top three whys of delay. Conclusions: Our findings support existence of a non-uniform pattern of delay among Sudanese BC patients. Changing currently adopted awareness elevating strategies into much more inclusive approaches is strongly recommended.

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Section: Discussionmentioning

confidence: 99%

Factors Delaying Presentation of Sudanese Breast Cancer Patients: an Analysis Using Andersen's Model

Salih

Alfaki²,

Alam-Elhuda³

et al. 2016

Asian Pacific Journal of Cancer Prevention

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“…I talked to my husband who said that I have nothing and that I talk too much.' (Patient 5) Use of traditional medicine and low level of breast cancer knowledge among breast cancer patients [17][18][19]23] have been reported in different studies from sub-Saharan Africa. Also, low breast cancer awareness among the general female population [24] and among female health care workers [25] were reported.…”

Section: Appraisal Interval: From Symptom Recognition To Perceiving Amentioning

confidence: 99%

“…That's why I am using traditional medicine.' (Woman 5, Group 1) Financial hardship [18,22] and the possibility to easily access a health care practitioner [19] were reported elsewhere to influence immediate medical care among breast cancer patients in sub-Saharan Africa.…”

Section: Help Seeking Interval: Perceiving a Reason To Discuss Symptomentioning

confidence: 99%

“…Only a number of studies have used qualitative methods to capture the patients' internal processes (individual perception and interpretation through social interaction) during the different time intervals [15]. Studies analyzing the pathway of women with breast [17][18][19] and cervical [20] cancer in sub-Saharan Africa were published only recently. Most studies are limited by the fact that they only include diagnosed patients.…”

Section: Introductionmentioning

confidence: 99%

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Why Do Women with Breast Cancer Get Diagnosed and Treated Late in Sub-Saharan Africa Perspectives from Women and Patients in Bamako, Mali

et al. 2018

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Background: Breast cancer, the most common cancer among women worldwide, has a high mortality rate in low-income countries. In sub-Saharan Africa, most breast cancer patients are diagnosed with advanced disease. Some studies have quantified the time delay to diagnosis in sub-Saharan Africa, but very few have used qualitative methods to understand barriers leading to delay. This study analyses barriers throughout a breast cancer patient's pathway from symptom recognition to treatment in Mali. Method: Three focus group discussions were conducted. The model of pathways to treatment was used to structure the results into 4 time intervals: appraisal, help-seeking, diagnosis, and treatment, with a focus on barriers during each interval. Results: The main barriers during the appraisal interval were a low level of breast cancer knowledge among women, their families, and medical professionals, and during the help-seeking interval, mistrust in the community health care centers and economic hardship. Barriers during the diagnosis interval were low quality of health care services and lack of social support, and during the pretreatment interval high costs and lack of specialized services. Conclusion: Multilevel interventions are needed to ensure access, availability, and affordability of a minimum standard of care for breast cancer patients in sub-Saharan Africa.

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“…The cancer burden in low-middle-income countries is growing, with the survival rates much poorer than those in high-income countries 4,5 . In low-middle-income countries like Nigeria, advanced stage of the disease at diagnosis and delayed treatment represent notable problems [6][7][8][9] . Compounding the problem of late stage diagnosis of breast cancer in developing countries are lack of healthcare infrastructure and resources necessary to implement early detection, diagnosis and treatment of breast cancer.…”

Section: Introductionmentioning

confidence: 99%

COMMENTARY: Promoting Early Detection of Breast Cancer and Care Strategies for Nigeria

Ogunkorode

Holtslander

Anonson

et al. 2017

Afr J Reprod Health

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Breast cancer is the most common cancer in women particularly in developing countries like Nigeria, with high mortality, and economic costs. Worldwide, it is predicted that more than one million women are diagnosed with breast cancer, and more than 400,000 will die from the disease every year. A comparative integrative review of the literature from Nigeria and Canada showed that in Canada, there is positive association between wide spread education, early detection, the disease stage at diagnosis, and survival rates. In Nigeria, presentation with the advanced stage of the disease makes survival very low. The primary factors responsible for the late presentations are lack of awareness, misconceptions about breast cancer causes, and treatment outcomes. It is recommended that guidelines and policies about breast cancer early detection, care strategies, and ongoing management pathways be produced, disseminated, and adopted. The guidelines will assist practitioners and patients in making informed decisions and choices about the most appropriate health care for their specific clinical situations. The implementation of evidence-based guidelines will most likely help to improve care processes, the quality of clinical decisions and patient treatment outcome. RésuméLe cancer du sein est le cancer le plus commun chez les femmes, surtout dans les pays en développement comme le Nigeria, avec une mortalité élevée et des coûts économiques. Dans le monde entier, on prévoit que plus d'un million de femmes sont diagnostiquées avec un cancer du sein et plus de 400 000 mourront de la maladie chaque année. Un examen comparatif des documents venant du Nigéria et du Canada ont montré qu'au Canada, il existe une association positive entre l'éducation largement répandue, le dépistage précoce, le stade de la maladie au moment du diagnostic et les taux de survie. Au Nigéria, la présentation au stade avancé de la maladie rend la survie très faible. Les principaux facteurs responsables des présentations tardives sont le manque de sensibilisation, les idées fausses sur les causes du cancer du sein et les résultats du traitement. Il est recommandé de produire, de diffuser et d'adopter des lignes directrices et des politiques sur la détection précoce du cancer du sein, les stratégies de soins et les parcours de gestion en cours. Les lignes directrices aideront les praticiens et les patients à prendre des décisions et des choix éclairés sur les soins de santé les plus appropriés pour leurs situations cliniques spécifiques. La mise en oeuvre de lignes directrices fondées sur des données probantes contribuera vraisemblablement à améliorer les processus de soins, la qualité des décisions cliniques et les résultats du traitement de la patiente. (Afr J Reprod Health 2017; 21[2]: 18-25).

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Social barriers to diagnosis and treatment of breast cancer in patients presenting at a teaching hospital in Ibadan, Nigeria

Cited by 68 publications

References 31 publications

Factors Delaying Presentation of Sudanese Breast Cancer Patients: an Analysis Using Andersen's Model

Factors Delaying Presentation of Sudanese Breast Cancer Patients: an Analysis Using Andersen's Model

Why Do Women with Breast Cancer Get Diagnosed and Treated Late in Sub-Saharan Africa Perspectives from Women and Patients in Bamako, Mali

COMMENTARY: Promoting Early Detection of Breast Cancer and Care Strategies for Nigeria

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