Socio-demographic factors and reasons associated with delay in breast cancer presentation: A study in Nigerian women

Abstract

We evaluated the effects of selected socio-demographic factors on late presentation and reasons why our breast cancer patients delay reporting for treatment. All female breast cancer patients referred to one of the general surgery out-patient clinics of Lagos State University Teaching Hospital between January 2009 and December 2010 were interviewed. Relevant socio-demographic and clinical data were obtained and reasons for patient delay documented. Univariate and multivariate logistic regression analyses were conducted to calculate odd ratio for delay. A total of 201 patients were enrolled. Mean duration of symptoms was 12.12 months (SD ± 5.18). Delay for more than 3 months before initial medical consultation was observed in 164 patients (81.6%). Increased risk of late presentation was associated with single women (OR=2.054), primary level of education (OR=3.059), negative history of benign breast disease (OR=1.648) and pre-menopause (OR=1.861). Ignorance of the nature of illness, belief in spiritual healing, fear of mastectomy and belief in herbal treatment were the leading reasons for delay. Women with higher risk of late presentation should be the target group during interventions aimed at raising breast cancer awareness. Reasons for patient delay should also be addressed.

Delay in diagnosis of breast cancer in a developing country: a single centre observational study in a tertiary care hospital in North Kerala, India

“…[10][11][12] This needs to be corrected with proactive steps taken by the health system and media to bring out scientific information into the public domain so that patients do not rely on hearsay for medical information. Moreover, establishment of breast cancer support groups in the community will help patients in overcoming their fears and doubts regarding treatment and rehabilitation.…”

Factores asociados con el tratamiento oportuno en mujeres con cáncer de mama apoyadas por una organización no gubernamental en Bogotá

“…En el contexto latinoamericano, en otros trabajos como el de Trufelli, et al, llevado a cabo en un hospital público brasilero, se encontró que la mediana del tiempo que trascurría entre la sospecha de tumor detectado por mamografía y la biopsia, era de 72 días (17), lo que se aproxima a lo hallado en cuanto al T 2 en este estudio. En lo concerniente a los factores que determinan estas demoras, en diversos estudios a nivel internacional se han detectado problemas sociales que pueden generar barreras de acceso y demoras en el proceso de atención (18,19). De hecho, algunos investigadores colombianos han podido establecer que la atención oportuna del cáncer está determinada por la inequidad social (12,13,20).…”

Mammogram history in Nigerian women: Age-related risk factors for breast cancer and educational implications

“…Again, this arguably depicts efforts by health providers to increase breast cancer awareness or deliberate efforts by the women themselves to seek mammography (given their elevated risk) in response to the health promotion jingles. Previous studies show low or modest knowledge of risk factors for breast cancer in Nigerian women, 15,19,20 which in turn is blamed for low levels of mammography uptake. 15 Although the present findings suggest women of younger menarche age were motivated to request mammograms, presumably in response to the public awareness jingles, it is still necessary for health campaigns to address the patriarchal aspects of Nigerian society, where women are less able to take the initiative for their own health care.…”

“…16 Thus, Nigerian health workers may fail to offer mammography screening to women with negative age-related risk factors. Furthermore, Nigerian women may delay or decline mammograms partly because of knowledge deficits on breast cancer, 19 including age-related risk factors. 20 Even amongst women who are more knowledgeable about breast cancer (e.g.…”

“…Although knowledge of breast cancer risk factors in Nigerian women is low, and this has been implicated in low levels of mammography uptake, 15 the positive relationship between chronological age and mammography history suggests older women were motivated to seek mammograms as a result of awareness of age-related risk factors. 19 The public awareness jingles used by health workers seemed particularly helpful in this context. Even women younger than 50 years should be specifically targeted by such health promotion campaigns, given the lower age of breast cancer onset in Nigerian women.…”