Abstract

The objectives of this study is to identify potential predictors of long delay and to examine the association between breast cancer patient delay and stage at diagnosis. Breast cancer stage represents an important prognostic factor and advanced stage is associated with decreased time of disease-free survival and increased mortality rates. Thus, reducing these delays is believed to be of high importance. For the period of this study, February 2017 to January 2018, 171 pa­tients were interviewed, Predictors of breast cancer stage at time of diagnosis was determined by bivariate analysis using ordinal logistic regression. The relationship between each of the independent variables with breast cancer stage was determined. A greater percentage of the study participants were below 50 years of age (52%) and the mean ±SD age was 49.5±11.3 years. The percentage of premenopausal women among the study population was 48.2% while postmenopausal women was 51.8%. BMI of <25 is 32%, 25-29 is 47% while >30 was 20. The odds for advanced breast cancer stage is 2.75 for women who had 1-2 months diagnosis delay compared to women who had below 1 month delay. Those with >2 months diagnosis delay also had higher odds compared to those who had below 1 month delay (OR = 2.05, 95% CI = 1.04 – 4.06). The final ordinal logistic model revealed that variables that remained significant were having moderately differentiated tumour histology grade (aOR = 0.11, 95% CI = 0.04 – 0.28), well differentiated tumour histology grade (aOR = 0.35, 95% CI = 0.13 – 0.92) and bra cup size C (aOR = 0.41, 95% CI = 0.17 – 0.98). Improved screening, awareness and education programs are required by the health care professionals and health policy makers in order to promote early detection of breast cancer to avoid diagnosis at advanced stages.

Highlights

  • The incidence of breast cancer in developing countries including Nigeria is lower compared to developed countries, with 31.3 new cases per 100000 women in comparison to the 74.1 new cases per 100000 observed in developed regions

  • The reasons adduced for the differences in mortality rates include advanced stages at presentation, worse biologic behavior, poor treatment facilities and poor patient acceptance of recommended treatments which have been linked to ignorance, superstition, self denial, fear of mastectomy and unavailability of treatment facilities [2]

  • Popoola Abiodun et al.: Factors Associated with Advanced Disease Stage at Diagnosis in a Study of Patients with Newly Diagnosed Breast Cancer countries are diagnosed at stages I and II, whereas in low and middle-income countries, only 20-60% of patients are diagnosed in early stages of the disease

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Summary

Introduction

The incidence of breast cancer in developing countries including Nigeria is lower compared to developed countries, with 31.3 new cases per 100000 women in comparison to the 74.1 new cases per 100000 observed in developed regions. More than 70% of breast cancer patients in developed. Popoola Abiodun et al.: Factors Associated with Advanced Disease Stage at Diagnosis in a Study of Patients with Newly Diagnosed Breast Cancer countries are diagnosed at stages I and II, whereas in low and middle-income countries, only 20-60% of patients are diagnosed in early stages of the disease. Breast cancer stage represents an important prognostic factor and advanced stage is associated with decreased time of disease-free survival and increased mortality rates. Reducing these delays is believed to be of high importance. The Nonattribution of symptoms to cancer, fear of the disease and treatment and low educational level were the most frequent causes of patient delay [3]

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