Timeliness of Breast Cancer Patients' Presentation to Health Care Facilities in Ethiopia: A Systematic Review and Meta-Analysis
PURPOSELow breast cancer survival rates are often linked to late-stage diagnosis. The patient interval, the time between symptom detection and the first health care visit, is a key indicator of early diagnosis. This study aimed to assess the prevalence of patient delay and its associated factors in...
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| Format: | Article |
| Language: | English |
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American Society of Clinical Oncology
2024-11-01
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| Series: | JCO Global Oncology |
| Online Access: | https://ascopubs.org/doi/10.1200/GO-24-00263 |
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| author | Debisa Eshatu Wendimu Mosisa Bekele Degefa Daniel Legese Achalu Biniyam Tedla Mamo Derese Bekele Daba Solomon Getnet Meshesha |
| author_facet | Debisa Eshatu Wendimu Mosisa Bekele Degefa Daniel Legese Achalu Biniyam Tedla Mamo Derese Bekele Daba Solomon Getnet Meshesha |
| author_sort | Debisa Eshatu Wendimu |
| collection | DOAJ |
| description | PURPOSELow breast cancer survival rates are often linked to late-stage diagnosis. The patient interval, the time between symptom detection and the first health care visit, is a key indicator of early diagnosis. This study aimed to assess the prevalence of patient delay and its associated factors in Ethiopia.METHODSThis systematic review used a combined approach of meta-analysis and meta-synthesis of quantitative and qualitative data, respectively. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline.RESULTSEleven studies that satisfied the eligibility criteria were included in the review. More than half (58.48%) of the patients with breast cancer delayed seeking medical help at health facilities, with a median delay time of 120 days. Presence of a painful breast ulcer/wounded mass (odds ratio [OR], 0.23 [95% CI, 0.09 to 0.58]), having swelling or a lump in the armpit (OR, 0.27 [95% CI, 0.15 to 0.46]), residing in urban area (OR, 0.27 [95% CI, 0.15 to 0.49]), and having a secondary school education or higher (OR, 0.28 [95% CI, 0.12 to 0.64]) were less likely to delay in seeking formal health care. However, patients who travel more than 5 km (OR, 6.33 [95% CI, 4.10 to 9.75]) were more likely to delay in our meta-analysis. Moreover, the meta-synthesis showed that the nature and progression of symptoms, symptom disclosure, social support, emotional responses, use of alternative therapies, misconceptions about breast cancer, financial limitations, accessibility issues, and other personal-environmental factors were associated with patient delay.CONCLUSIONNearly three fifths of patients with breast cancer delayed seeking health care at health facilities. Inaccessibility, low awareness, cultural beliefs, and socioeconomic factors contributed to these delays. Increasing public awareness, especially in rural areas, and improving health care access could encourage earlier presentation. |
| format | Article |
| id | doaj-art-879d8ffb93d04390a86e218036baf285 |
| institution | Kabale University |
| issn | 2687-8941 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | American Society of Clinical Oncology |
| record_format | Article |
| series | JCO Global Oncology |
| spelling | doaj-art-879d8ffb93d04390a86e218036baf2852024-11-21T20:59:59ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412024-11-011010.1200/GO-24-00263Timeliness of Breast Cancer Patients' Presentation to Health Care Facilities in Ethiopia: A Systematic Review and Meta-AnalysisDebisa Eshatu Wendimu0Mosisa Bekele Degefa1Daniel Legese Achalu2Biniyam Tedla Mamo3Derese Bekele Daba4Solomon Getnet Meshesha5Armauer Hansen Research Institute (AHRI), Communicable and Non-Communicable Disease Directorate, Addis Ababa, EthiopiaCollege of Medicine and Health Science, Arsi University, Asella, EthiopiaArmauer Hansen Research Institute (AHRI), Clinical Trial Directorate, Addis Ababa, EthiopiaOhio State Global One Health LLC, Addis Ababa, EthiopiaCollege of Medicine and Health Science, Ambo University, Ambo, EthiopiaEthiopian Food and Drug Authority, Addis Ababa, EthiopiaPURPOSELow breast cancer survival rates are often linked to late-stage diagnosis. The patient interval, the time between symptom detection and the first health care visit, is a key indicator of early diagnosis. This study aimed to assess the prevalence of patient delay and its associated factors in Ethiopia.METHODSThis systematic review used a combined approach of meta-analysis and meta-synthesis of quantitative and qualitative data, respectively. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline.RESULTSEleven studies that satisfied the eligibility criteria were included in the review. More than half (58.48%) of the patients with breast cancer delayed seeking medical help at health facilities, with a median delay time of 120 days. Presence of a painful breast ulcer/wounded mass (odds ratio [OR], 0.23 [95% CI, 0.09 to 0.58]), having swelling or a lump in the armpit (OR, 0.27 [95% CI, 0.15 to 0.46]), residing in urban area (OR, 0.27 [95% CI, 0.15 to 0.49]), and having a secondary school education or higher (OR, 0.28 [95% CI, 0.12 to 0.64]) were less likely to delay in seeking formal health care. However, patients who travel more than 5 km (OR, 6.33 [95% CI, 4.10 to 9.75]) were more likely to delay in our meta-analysis. Moreover, the meta-synthesis showed that the nature and progression of symptoms, symptom disclosure, social support, emotional responses, use of alternative therapies, misconceptions about breast cancer, financial limitations, accessibility issues, and other personal-environmental factors were associated with patient delay.CONCLUSIONNearly three fifths of patients with breast cancer delayed seeking health care at health facilities. Inaccessibility, low awareness, cultural beliefs, and socioeconomic factors contributed to these delays. Increasing public awareness, especially in rural areas, and improving health care access could encourage earlier presentation.https://ascopubs.org/doi/10.1200/GO-24-00263 |
| spellingShingle | Debisa Eshatu Wendimu Mosisa Bekele Degefa Daniel Legese Achalu Biniyam Tedla Mamo Derese Bekele Daba Solomon Getnet Meshesha Timeliness of Breast Cancer Patients' Presentation to Health Care Facilities in Ethiopia: A Systematic Review and Meta-Analysis JCO Global Oncology |
| title | Timeliness of Breast Cancer Patients' Presentation to Health Care Facilities in Ethiopia: A Systematic Review and Meta-Analysis |
| title_full | Timeliness of Breast Cancer Patients' Presentation to Health Care Facilities in Ethiopia: A Systematic Review and Meta-Analysis |
| title_fullStr | Timeliness of Breast Cancer Patients' Presentation to Health Care Facilities in Ethiopia: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Timeliness of Breast Cancer Patients' Presentation to Health Care Facilities in Ethiopia: A Systematic Review and Meta-Analysis |
| title_short | Timeliness of Breast Cancer Patients' Presentation to Health Care Facilities in Ethiopia: A Systematic Review and Meta-Analysis |
| title_sort | timeliness of breast cancer patients presentation to health care facilities in ethiopia a systematic review and meta analysis |
| url | https://ascopubs.org/doi/10.1200/GO-24-00263 |
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