Diagnostic delay in breast cancer diagnosis: the role of health practitioners

Abstract

Breast cancer is a significant health concern for women in Pakistan, with one in nine women facing a high lifetime risk of being diagnosed with the disease. Accessing timely and appropriate healthcare services for breast cancer patients can be challenging in Pakistan, and understanding the role of different health practitioners is essential to understand the functioning of the informal referral system. Therefore, this study aimed to explore the different aspects of patients' consultations with various health practitioners for diagnosing breast cancer symptoms. Data were collected from 168 breast cancer patients who had consulted local health practitioners before being diagnosed with breast cancer. Descriptive statistics, the Kruskal‒Wallis H test, and post hoc tests were used to analyze the data. The study found that most patients consulted general practitioners (59.52%) and pir (56.55%) for their health-related concerns. Consultants referred most patients to diagnostic centers, while pir and hakim referred no patients. Patients visited pir and general practitioners the most, but the average number of visits to pir and hakim was higher than that to other health practitioners (p < 0.05). Moreover, pir (130 days) and hakim (120 days) had longer treatment periods than other health practitioners, with hakim charging the highest consultation fees [i.e., Pakistani rupees (PKR) 18,000] and patients incurring the highest travel expenses to visit pir (p < 0.05). Our study highlights the challenges faced by breast cancer patients in seeking timely and effective healthcare services. The absence of a formal referral system resulted in prolonged diagnosis times, extensive travel, and financial burdens on the patients. The findings suggest the need to improve general public awareness regarding breast cancer symptoms and establish an active cancer referral system to achieve early diagnosis, timely treatment, and improved quality of life for breast cancer patients, especially those with a lower socioeconomic status.