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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Main Authors: Debisa Eshatu Wendimu, Mosisa Bekele Degefa, Daniel Legese Achalu, Biniyam Tedla Mamo, Derese Bekele Daba, Solomon Getnet Meshesha
Format: Article
Language:English
Published: American Society of Clinical Oncology 2024-11-01
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.
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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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