Patient Delay and Contributing Factors Among Breast Cancer Patients at Two Cancer Referral Centres in Ethiopia: A Cross-Sectional Study
Journal – Journal of Multidisciplinary Healthcare
Publication date – Nov – 2020
Authors – Tesfaw A, Demis S, Munye T, Ashuro Z
Keywords – Breast Cancer, Ethiopia, patient delay, Predictors
Open access – Yes
Speciality – Surgical oncology
World region Eastern Africa
Language – English
Submitted to the One Surgery Index on November 9, 2020 at 10:18 am
Background: Unlike developed countries, there is high mortality of breast cancer in low- and middle-income countries associated with prolonged patient delays and advanced stage presentations. However, evidence-based information about patient delay in presentation and contributing factors to diagnosis of breast cancer in Ethiopia is scarce.
Methods: Institution-based cross-sectional study was conducted at oncology units of the University of Gondar and Felege Hiwot specialized hospitals. A total of 371 female breast cancer patients who were newly diagnosed from September 2019 to April 30, 2020 were included. Data were entered using EPI info version 7.2 and analyzed in SPSS version 23. Descriptive statistics was used to summarize socio-demographic and clinical characteristic of the patients. Multivariable logistic regression at a P-value< 0.05 significance level was used to identify predictors of patient delay.
Results: A total of 281 (75.7%) patients had long patient delay of ≥ 90 days (3 months) with the average patient delay time of 8 months, and advanced stage diagnosis was found on 264 (71.2%) of patients. The median age of patients was 40 years. Rural residence (AOR=3.72; 95% CI=1.82– 7.61), illiterate (AOR=3.8; 95% CI=1.71– 8.64), having a painless wound (AOR=3.32; 95% CI=1.93, 5.72), travel distance ≥ 5 km (AOR=1.66; 95% CI=1.09– 3.00), having no lump/swelling in the armpit (AOR=6.16; 95% CI=2.80– 13.54), and no history of any breast problem before (AOR=2.46; 95% CI=(1.43– 4.22) were predictors for long patient delay.
Conclusion: Long patient delay and advanced stage diagnosis of breast cancer are higher in our study. Travel distance ≥ 5 km, rural residence, no history of any breast problem before, having no lump/swelling in the arm pit, a painless lump in the breast, and being illiterate were important predictors for patient delay. Therefore, public awareness programs about breast cancer should be designed to prevent patient delay in presentation and to promote early detection of cases before advancement.
OSI Number – 20736