Journal – Psycho‐Oncology
Article type – Journal research article – Systematic review
Publication date – Nov – 2022
Authors – Dafina Petrova, Dunia Garrido, Zuzana Špacírová, Nicolás Francisco Fernández-Martínez, Ganka Ivanova, Miguel Rodríguez-Barranco, Marina Pollán, Rocío Barrios-Rodríguez, Maria José Sánchez
Keywords – Breast Cancer, illiteracy, low- and middle-income countries (LMICs), lower socio-economic status
Open access – Yes
Speciality – Other, Surgical oncology
World region Global

Language – English
Submitted to the One Surgery Index on December 3, 2022 at 1:59 am
Abstract:

Objective
Breast cancer survival is lower in low- and middle-income countries (LMICs) partially due to many women being diagnosed with late-stage disease. The patient interval refers to the time elapsed between the detection of symptoms and the first consultation with a healthcare provider and is considered one of the core indicators for early diagnosis and treatment. The goal of the current research was to conduct a meta-analysis of the duration of the patient interval in LMICs and investigate the socio-demographic and socio-cultural factors related to longer delays in presentation.

Methods
We conducted a systematic review with meta-analysis (pre-registered protocol CRD42020200752). We searched seven information sources (2009–2022) and included 50 articles reporting the duration of patient intervals for 18,014 breast cancer patients residing in LMICs.

Results
The longest patient intervals were reported in studies from the Middle East (3–4 months), followed by South-East Asia (2 months), Africa (1–2 months), Latin America (1 month), and Eastern Europe (1 month). Older age, not being married, lower socio-economic status, illiteracy, low knowledge about cancer, disregarding symptoms or not attributing them to cancer, fear, negative beliefs about cancer, and low social support were related to longer delays across most regions. Longer delays were also related to use of alternative medicine in the Middle East, South-East Asia, and Africa and distrust in the healthcare system in Eastern Europe.

Conclusions
There is large variation in the duration of patient intervals across LMICs in different geographical regions. Patient intervals should be reduced and, for this purpose, it is important to explore their determinants taking into account the social, cultural, and economic context.

OSI Number – 21831

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