Sociodemographic Factors Associated with Delays in Breast Cancer

Gueye, Mamour; Guèye, Serigne; Diallo, Moussa; Thiam, Ousmane; Mbodji, Aïssatou; Diouf, Abdoulaye; Fall, Khalifa; Toure, Youssou; Daff, Hadja Maïmouna Barro; Moreau, Jean Charles

doi:10.4236/ojog.2017.74047

Cited by 16 publications

(22 citation statements)

References 12 publications

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“…This might be because the delay time may give enough time for progression and growth of the disease to advanced stages. A similar finding is reported in studies conducted in Rwanda [19], Senegal [26], Iran [35] and India [36] in which the longer delay time is a significant contributor for advanced-stage diagnosis of breast cancer.…”

Section: Discussionsupporting

confidence: 89%

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Factors associated with advanced stage diagnosis of breast cancer in North West Ethiopia. a cross-sectional study

Tesfaw

Tiruneh

Tamire

et al. 2021

ecancer

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Background: Breast cancer tumours are the most common malignant tumours among women in Ethiopia. Although advanced-stage diagnosis of breast cancer is a common problem, evidence-based information is lacking about the magnitude and determinants of advanced-stage presentation in north-west Ethiopia.Methods: An institution-based, cross-sectional study was conducted at the oncology units of the University of Gondar and Felege Hiwot specialised hospitals. Stages III and IV were considered advanced stage, whereas stages I and II were considered early stages. Data were collected prospectively on newly diagnosed breast cancer patients and entered using the EPI Info version 7.2 and analysed using Statistical Package for the Social Sciences version 23. Multivariable logistic regression was used to identify the determinants of advanced-stage diagnosis of breast cancer. A p-value < 0.05 was used as the cut-off point to select the determinants of the advanced stage.Result: About 71.2% of breast cancer patients presented with advanced-stage disease. The median age of patients was 40 years. Rural residence (adjusted odds ratio (AOR) = 1.7; 95% confidence interval (CI): 1.02, 2.96), painless breast lump/wound (AOR = 2.5; 95% CI: 1.45, 4.13), travel distance ≥5 km (AOR = 3.2; 95% CI: 1.72, 5.29), not practising breast self-examination (BSE) (AOR = 2.9; 95% CI: 1.30, 6.52), time to presentation ≥3 months (AOR = 1.4; 95% CI: 1.02, 2.37) and misdiagnosed at first visit (AOR = 1.9; 95% CI: 1.09, 3.59) were determinants of advanced-stage breast cancer. Conclusion:Nearly three-quarters of the patients were diagnosed with advanced-stage breast cancer. Not practising BSE, travel distance ≥5 km, rural residence, painless breast wound/lump and being misdiagnosed at first visit were important determinants of advanced-stage diagnosis of breast cancer. Focused awareness creation programmes for the public and increasing cancer diagnostic centres in the country are crucial to downstage breast cancer at presentation.

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Section: Discussionsupporting

confidence: 89%

“…Most breast cancer patients in developing countries suffer very long delays and are diagnosed at advanced stages and have high mortality rates [ 21 , 24 , 25 ]. Several studies classify factors contributing to advanced-stage diagnosis into patient-mediated factors and healthcare system-related factors [ 19 , 20 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with advanced stage diagnosis of breast cancer in North West Ethiopia. a cross-sectional study

Tesfaw

Tiruneh

Tamire

et al. 2021

ecancer

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“…The finding is in line with a multi-national analysis survey 32 and other studies conducted in low and middle income countries like Mali, Rwanda, and Senegal. 21,25,33 However, it was shorter than studies in Nigeria and Libya 26,34 which is 17 months and 7.5 months respectively. In contrast, it is longer than studies conducted in Brazil, China, and Egypt.…”

Section: Discussionmentioning

confidence: 67%

“…The proportion of patient delay accounts for 103 (50.3%), which is higher than studies in Pakistan, Iran, and South Africa, 16 , 37 , 38 however, lower than Senegal, Tanzania, and Nigeria. 18 , 33 , 39 The difference might be due to the difference in sample size of the studies and different use of the cut-off point for classifying patient delay. Besides, large proportions (65.69%) of women with breast cancer were presented at an advanced stage.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Delay in Breast Cancer Presentation at the Only Oncology Center in North East Ethiopia: A Cross-Sectional Study

Hassen¹,

Hussien²,

Asfaw³

et al. 2021

JMDH

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Background: Female breast cancer is becoming an emerging public health problem which accounts for 33% of all cancers in women and 23% of all cancer cases in Ethiopia. The majority of women with breast cancer are diagnosed at later stages due to delayed presentation to seek treatment. Objective: To determine the prevalence and factors associated with patient delay at presentation among breast cancer patients at Dessie Referral Hospital, the only oncology center in North East Ethiopia. Methods: We conducted an institution-based cross-sectional study among 204 female patients with pathology-confirmed breast cancer at the only oncology center of North East Ethiopia from January to June 2020. An interviewer administered questionnaire and a medical record data extraction tool were used to address the objective of the study. Patients were said to be delayed for diagnosis if the time duration between first clinical presentations to first clinical consultation was more than 3 months. Then, bivariable and multivariable logistic regression was employed to analyze the association between dependent and independent variables. Results: Among a total of 209 eligible participants, 5 refused to participate with a response rate of 97.6%. The proportion of patients with delayed presentation was 103 (50.5%), with the median time taken to visit a healthcare provider after recognition of the first symptom was 4 months. Age above 40 years (AOR=4.81; 95% CI=1.26-18.65) P<0.024, college and above educational status (AOR=0.05; 95% CI=0.01-0.77) p<0.036, government employee (AOR=0.19, 95% CI=0.03-0.91) P<0.002, urban residence (AOR= 0.21; 95% CI=0.01-0.82) p<0.001, visit traditional healer (AOR=0.38; 95% CI=0.2-0.69) P<0.0037, and no lump in under armpit (AOR= 9.05; 95% CI=1.14-22.69) P<0.002 were associated with delayed presentation. Conclusion: Delays to seek treatment is generally high in our study. Age, educational status, occupation, residence, visiting traditional healer, and absence of lump in under armpit were significant factors for delayed presentation. Intervention programs focusing on reducing delayed presentation should be employed.

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“…Low income, low educational level, no family history of breast cancer and no help from family members, are among the most cited variables associated with PD [12][13][14][15][16]. Additionally, fear and poor knowledge about disease symptoms contribute to PD [13,14,17,18].…”

Section: Introductionmentioning

confidence: 99%

Long travel distance for health care and poor adherence to breast cancer screening programs as predictors of patient delay

Weller¹

2019

A Epidemiol Public Health

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Patient delay (PD) is a leading cause of advanced stage of disease and poor prognosis among Brazilian breast cancer patients. The present study addressed socio-demographic variables and their impact on PD. Odds Ratios (OR) and Confidence Intervals (CI) were determined using regression analysis. Data of 103 breast cancer patients were obtained from medical records and interviews. All patients detected first symptoms of breast cancer on their own. On average, patients were seeking for medical help 67.5 (s= 124.1) days after recognition of symptoms. More than 60 days between recognition of symptoms and first medical visit was defined as PD in 33 (32.0%) cases. Low and intermediate educational level increased chance of PD, 1.22 (95%CI: 0.33-4.48) and 1.92 (95%CI: 0.53-7.00) fold. Having no stable relationship increased chance of PD 2.04 (95%CI: 0.88-4.73) fold. Patients without a private health insurance had a 1.90 (95%CI: 0.49-7.32) increased chance of PD. Women, who had not at all, or rarely performed medical visits at their own living place, had a 6.25 (0.76-51.33) increased chance of PD (p< 0.05). Patients who had never performed mammography and CBE had a 1.78 (0.57-5.53) and 1.47 (0.44-4.89) increased chance of PD. Not having a health service at the own living place was the most prominent causal factor of PD. As tumours of patients were not discovered during medical exams, the negative association between adherence to prevention programs and PD, points to additional attitudes of participating women that reduced treatment delay.

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Sociodemographic Factors Associated with Delays in Breast Cancer

Cited by 16 publications

References 12 publications

Factors associated with advanced stage diagnosis of breast cancer in North West Ethiopia. a cross-sectional study

Factors associated with advanced stage diagnosis of breast cancer in North West Ethiopia. a cross-sectional study

Factors Associated with Delay in Breast Cancer Presentation at the Only Oncology Center in North East Ethiopia: A Cross-Sectional Study

Long travel distance for health care and poor adherence to breast cancer screening programs as predictors of patient delay

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