Factors associated with late diagnosis of breast cancer among women in Botswana.

PurposeIn order to deliver appropriate and timely care planning and minimise avoidable late diagnoses, clinicians need to be aware of which patients are at higher risk of receiving a late cancer diagnosis. We aimed to determine which demographic and clinical factors are associated with receiving a ‘late’ cancer diagnosis (within the last 12 weeks of life).MethodRetrospective cohort study of 2,443 people who died from cancer (‘cancer decedents’) in 2013–2015. Demographic and cancer registry datasets linked using patient-identifying Community Health Index numbers. Analysis used binary logistic regression, with univariate and adjusted odds ratios (SPSS v25).ResultsOne third (n = 831,34.0%) received a late diagnosis. Age and cancer type were significantly associated with late cancer diagnosis (p < 0.001). Other demographic factors were not associated with receiving a late diagnosis. Cancer decedents with lung cancer (Odds Ratios presented in abstract are the inverse of those presented in the main text, where lung cancer is the reference category. Presented as 1/(OR multivariate)) were more likely to have late diagnosis than those with bowel (95% Confidence Interval [95%CI] Odds Ratio (OR)1.52 (OR1.12 to 2.04)), breast or ovarian (95%CI OR3.33 (OR2.27 to 5.0) or prostate (95%CI OR9.09 (OR4.0 to 20.0)) cancers. Cancer decedents aged > 85 years had higher odds of late diagnosis (95%CI OR3.45 (OR2.63 to 4.55)), compared to those aged < 65 years.ConclusionsCancer decedents who were older and those with lung cancer were significantly more likely to receive late cancer diagnoses than those who were younger or who had other cancer types.

Purpose: In Tanzania, women are diagnosed at advanced breast cancer stages. The reasons for this are multifactorial and have not been systematically investigated in the Kilimanjaro Region. This study aimed to identify reasons for advanced stage breast cancer at time of diagnosis. Methods: Four focus group discussions and 8 semi- structured in-depth interviews were conducted among health care providers (HCP) and traditional healers from five health care facilities (1 regional and 2 district hospitals) and two urban and rural communities in Kilimanjaro, Tanzania. Thematic coding via grounded theory technique was done by two independent reviewers. Results: Twenty HCP (10 doctors and 10 nurses) and 8 traditional healers participated in the study. The average ages for doctors were 38, nurses 33, and traditional healers 50. Among HCP, the most common reasons for advanced stage breast cancer at time of diagnosis were patients initially seeking care from traditional healers, and patient distrust of conventional medicine. Among traditional healers, the most common reasons were: delayed initiation of biomedical treatment due to long turnaround of pathology results, inability to pay for diagnostic workup and treatment, and transportation issues. Both groups stated lack of patient breast cancer knowledge. Conclusions: There was agreement that lack of adequate breast cancer knowledge and awareness as a very common reason for advanced disease presentation among HCP and traditional healers. Community health education must be designed to adopt socio-cultural and religious doctrines to alleviate the misconceptions and knowledge gap. Health system interventions are also needed to facilitate access to timely, affordable, and quality breast cancer diagnosis and treatment Citation Format: Elizabeth F. Msoka, Lily Gutnik, Agnes M. Cyril, Brenda C. Kitali, Vivian F. Saria, Jackline C. Kwayu, Adellaida A. Kavishe, Perry C. Msoka, Ayesiga Herman, Furaha Serventi, Gilleard G. Masenga, Oluwadamilola Fayanju, Laura Fish, Blandina Th. Mmbaga. Health Care Providers and Traditional Healers Perspectives on Late Diagnosis of Breast Cancer in Tanzania: A Qualitative Study [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 77.

BackgroundMost women with breast cancer in Ethiopia are diagnosed at an advanced stage of the disease, but the reasons for this have not been systematically investigated. This study, therefore, aimed to explore the main reasons for diagnosis of advanced stage breast cancer from the perspective of patients, family members, and health care providers.MethodsA qualitative study with in-depth interviews was conducted with 23 selected participants at Tikur Anbessa Specialized Hospital, Oncology Clinic using a semi-structured interview guide. These participants were 13 breast cancer patients, 5 family members, and 5 health care providers. Data were transcribed into English, coded and analyzed using thematic analysis.ResultsAwareness about the causes, risk, initial symptoms, early detection methods, and treatment of breast cancer were uncommon, and misconceptions about the disease prevailed among breast cancer patients and family members. There was a sense of hopelessness and uncertainty about the effectiveness of conventional medicine amongst patients and family members. Consequently, performing spiritual acts (using holy water) or seeking care from traditional healers recurred amongst the interviewees. Not taking initial symptoms of breast cancer seriously by the patients, reliance on traditional medicines, competing priorities, financial hardship, older age, fear of diagnosis of cancer, and weak health systems (e.g., delay in referral and long waiting period for consultation) were noted as the main contributors to late diagnosis. In contrast, persuasion by family members and friends, higher educational attainment, and prior experience of neighboring women with breast cancer were mentioned to be facilitators of early diagnosis of breast cancer.ConclusionsThe causes of late diagnosis of breast cancer in Ethiopia are multi-factorial and include individual, cultural, and health system factors. Interventions targeting these factors could alleviate the misconceptions and knowledge gap about breast cancer in the community, and shorten waiting time between symptom recognition and diagnosis of breast cancer.

Background: Breast cancer, like many other noncommunicable diseases, remains a public health problem today. Although the disease is more common in people over 50, younger women are also affected. The chances of following this disease depend on the stage at which it is diagnosed, since the earlier the diagnosis, the greater the chances of survival. The aim of this study was to determine the factors associated with late diagnosis of breast cancer among women in hospital settings in Ouagadougou (Burkina Faso) in 2024. Methods: This was a cross-sectional analytical study that took place over a period of six months, from February 2 to July 31, 2024, in university hospitals in the city of Ouagadougou. The study included women with confirmed breast cancer. Data were analyzed using Statistical Package for Social Sciences (SSP) software. Results: The study involved 226 women. Among them, the 40-49 age group was the most represented at 39.3%. In addition, 33.63% had a secondary education. More than half (79.65%) lived in urban areas. The frequency of late diagnosis was 32.74% [IC95% (0.674-0.914)]. The factors associated with late diagnosis of breast cancer were the environment in which the patient lived (OR=0.08; p=0.001), The first resort, including traditional medicine (OR=106; p&lt;0.001) and insufficient symptom awareness (OR=4.63; p=0.001). Conclusions: These results reflect a constructive dialogue between traditional and modern medicine, enabling traditional practitioners to be trained to recognize the early signs of breast cancer and to refer patients rapidly to the appropriate health centers for treatment.

INTRODUCTION: Breast cancer is the first cancer of women in Burkina Faso. There remains a relatively late diagnosis and a reserved prognosis. The main aim of this study is to study the causes, therapeutic and prognostic impacts of late diagnosis of breast cancer at Yalgado Ouédraogo University Hospital. MATERIALS AND METHODS: This was a descriptive and prospective study from May 1st to October 31, 2013. The departments of surgery, gynecology and anatomy-pathology served as a framework for our study. All consenting breast cancer patients with a height greater than at least 5 cm (&gt;T2), suspicious or metastatic satellite lymphadenopathy was included. The data analysis was done using Epi-info© software version 7.2.2.6, with the use of the Khi2, Fisher-exact and Student tests. RESULTS: We collected 70 patients with an average age of 46.1 years. In 95.7% of cases, our patients had consulted a traditional therapist or at least one medical center before being referred to the Yalgado Ouédraogo University Hospital. The consultation was less than 6 months in 52.9% of cases. Diagnostic time was statistically associated with source and monthly income with a p-value of 0.03 and 0.05 respectively. Stage III accounted for 62.8% of cases. Surgery was performed in 48.6% of cases, including 23.5% palliative surgery. Chemotherapy was neo-adjuvant in 22%, adjuvant in 48.8% and palliative in 14.6%. The average duration of follow-up was 2.7 months. We had found 20.6% of recidivism and 22% of deaths. CONCLUSION: Poverty, ignorance, socio-cultural constraints and lack of staff reduce patients' access to early diagnosis, which is responsible for expensive complex treatment and a poor prognosis. Equitable financial and geographic access will reduce diagnostic delays and mortality from breast cancer. KEYWORDS: Breast cancer; Late diagnosis; Causes; Treatment; Prognosis.

PURPOSE In Tanzania, women are diagnosed at an advanced stages of breast cancer. The aim of this study is to identify reasons for this finding from the patient perspective. METHODS Semi-structured in-depth interviews were conducted in inpatient and outpatient settings in the Kilimanjaro Cancer Care Center. Thematic coding via grounded theory technique was done by two independent reviewers. RESULTS Ten 10 patients (five rural and five urban) participated in the study. The average ages was 48. Seven (70.0%) were Christian. Eight (80.0%) patients had primary education, six (60.0%) were married, and eight (80.0%) were not employed. Two women (20.0%) had stage 2, four women (40.0%) had stage 3, and 4 (40.0%) had stage 4. The most common reasons reported by patients for advanced stage breast cancer at time of diagnosis are initially seeking care from traditional healers (n = 6, 60.0%), lack of breast cancer sign and symptoms knowledge (n = 8, 80.0%), misconceptions about breast cancer treatment especially mastectomy (n = 5, 50.0%), distrust of conventional medicine (n = 4, 40.0, seeking support from the religious leaders (n = 6, 60.0%). Furthermore, we found that, almost all (n = 9, 90.0%) of the patients express their concern regarding financial challenges to access care and treatment for cancer. For example (n = 3, 30.0%) said payment for cancer treatment is too costly and six patients (60.0%) stated that lack of money for transportation. CONCLUSION Lack of adequate breast cancer knowledge and awareness, patient provider relationships, and access to care are the most common mentioned reasons for advanced disease at time of diagnose among breast cancer patients. Engagement with the community through cultural sensitive public health campaigns and interventions must be designed to alleviate the misconceptions and knowledge gap in these communities. System level change is needed to improve access to care.

Purpose: In Tanzania, women often present with advanced stage breast cancer leading to treatment delays and poor outcomes. Factors influencing late hospital presentation of breast cancer have not been investigated. In this study, we aimed to explore patient perception of factors contributing to the late diagnosis of breast cancer. Methods: Women diagnosed with late- stage breast cancer in an outpatient cancer care center were identified by clinic nurses and recruited for study participation. Semi-structured interviews were conducted by a single proctor. Interviews were recorded, transcribed verbatim, and coded by three independent reviewers using NVivo 12. Themes were identified using a grounded theory approach. Results: Twenty patients (10 rural and 10 urban) participated in the interviews. The average age was 56; 11 (55%) completed primary education, 10 (50%) were unemployed, and 5 (25%) were married. Fourteen (70 %) of the patients had stage 4 breast cancer, 3 (15%) had stage 3, and 3 (15%) had stage 2. Nineteen (95%) of our respondents misunderstood the etiology of breast cancer as well as its causes, signs, and symptoms. Misconceptions led to experiences of stigma in 19 (95%) participants. One participant stated: “…I failed to tell people because… once I tell them that I have problem they will start to run away from me and even if you ask for assistance they think that I cannot pay them back because they think they might help me today and I die tomorrow before I pay them back…” Fifteen (75%) of the participants experienced rejection from their partners. Thirteen (65%) participants expressed financial concerns and eighteen (90%) participants were initially treated by a traditional healer, both of which lead to delays in hospital presentation. Conclusion: Lack of knowledge about breast cancer among patients, societal stigma, lack of spousal support, financial barriers, and initial treatment by traditional healers all contribute to delays in diagnosis and treatment of breast cancer in Northern Tanzania. Stigma reduction and educational interventions may reduce these delays, and further research is needed to improve access to cancer care in this population. Citation Format: Elizabeth Msoka-Bright, Mackenzie Abraham, Polina Zmijewski, Furaha Serventi, Perry Cyril, Brenda Kitali, Vivian Saria, Jackline Kwayu, Adelide Kavishe, Gileard Masenga, Blandina Mmbaga, Lily Gutnik. Perceived Factors for Late Diagnosis in Women With Advanced Breast Cancer in Northern Tanzania [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 67.

Cancer survival rates make big headlines. Recently the government has used survival rates as part of the case for the major NHS structural reforms, and it is estimated that up...

Breast cancer is leading the cancer incidence and mortality ranks worldwide. Currently, breast cancer represents 30.1% of all cancers occurring in women in Congo. In sub-Saharan Africa, breast cancer is diagnosed delayed in 70% of cases. The purpose of this work is to study the epidemiological aspects of patients with late diagnosis of breast cancer at the Brazzaville University Hospital, Congo. We carried out a cross-sectional analytic study in the medical oncology service of the University Hospital of Brazzaville. We used systematic, exhaustive sampling. Logistic regression was used for data analysis, and P values ≤5% were considered significant. Data for 182 patients were collected. Delay in diagnosis represented 91.21% of cases. Delay in diagnosis was significantly associated with lack of finance (P = 0.011) and with breast cancer stages greater than 2 (P < 0.001), but the proximity to the center was suggestive. Multivariate analysis revealed an association between diagnostic delay and proximity to the center (P = 0.025) as well as with breast cancer stages greater than 2 (P < 0.001). The delay in breast cancer diagnosis widely discussed in the literature remains relevant in Congo. Routine screening, the construction of a cancer center and its optimal equipment, and the subsidy of care are all critical factors for battling delayed breast cancer diagnosis in Congo.

My altered self: cancer

Breast cancer is a major health problem for women. This cancer is most often diagnosed and the leading cause of cancer deaths in women worldwide. Breast cancer in young women is associated with late diagnosis, aggressive biological characteristics, and poor prognosis. The objective of the study is to determine the prevalence and characteristics of young age breast cancer in Haji Adam Malik General Hospital Medan in 2013-2017. The study design was observational descriptive design with a cross-sectional approach. The study samples were medical records of young women diagnosed with breast cancer who were treated at Haji Adam Malik General Hospital Medan. The prevalence of breast cancer in young age women in Haji Adam Malik General Hospital Medan in 2013-2017 was 234 patients (15.2%). In this study, the samples that fulfilled the inclusion criteria were 153, with the majority characteristics of patients were 35-39 years old, stage III, histopathological type of invasive carcinoma of no special type, grade II, and clinical subtype of triple-negative. The prevalence of young age breast cancer is lower than old age breast cancer. Young women tend to be diagnosed with breast cancer in advanced stage and intermediate grade with aggressive biological characteristics.

Salivary biomarkers in the diagnosis of breast cancer: A review.

No Brasil, a cada ano, são registrados quase 60 mil novos casos de câncer de mama. Entretanto, das mais de 10 milhões de mamografias esperadas em mulheres na faixa etária dos 50 aos 69 anos, apenas 2,5 milhões foram realizadas em 2013. O rastreamento populacional por meio da mamografia vem se mostrando uma estratégia eficaz na redução de mortes em mulheres principalmente acima dos 50 anos. O objetivo deste estudo foi avaliar os fatores socioeducacionais associados ao diagnóstico tardio do câncer de mama e a valorização do rastreamento por meio da mamografia em mulheres assintomáticas. Entre janeiro de 2000 a dezembro de 2014, 26 artigos foram selecionados em todo o território nacional e revisados. A população do estudo foi de mulheres na faixa-etária entre 25 a 69 anos. Observou-se que 68,2% dos casos avaliados eram mulheres de baixa renda, 94,1%, com baixa escolaridade, e 72,7 % demonstraram total dependência do SUS. Os dados ainda indicaram que 61,2% do diagnóstico para o câncer de mama encontravam-se em estádios avançados (lll e lV). O diagnóstico tardio e, por vezes, a terapêutica inadequada contribuem para que o câncer de mama continue sendo a principal causa de morte entre as mulheres brasileiras. Deve-se considerar a educação para autonomia e corresponsabilidade do público feminino nos cuidados de sua saúde na expectativa de minimizar o tempo prolongado entre a suspeita da anormalidade nas mamas e a confirmação diagnóstica por falta de realização da mamografia e a adesão de mulheres assintomáticas aos programas de prevenção

PURPOSE Breast cancer is the leading cause of cancer-related death among women, and ovarian cancer has the highest case fatality rate of all gynecologic cancers. In Nigeria, approximately 80% of breast and ovarian cancer cases are diagnosed at advanced stages. Genetic testing has the potential to reduce the morbidity and mortality associated with late cancer diagnosis. The introduction of genetic testing for cancer risk assessment at University College Hospital (UCH), Ibadan will serve as a model for the rest of Nigeria. The objective of this study was to introduce genetic testing for cancer risk assessment in patients with breast and ovarian cancer in Ibadan, Nigeria and to determine the demographics of women undergoing testing and their perceptions concerning the benefits of and barriers to genetic testing. METHODS Patients with breast or ovarian cancer were recruited at UCH. All patients received genetic counseling and had the opportunity to consent to the Color Genomics Hereditary Cancer Panel Test, free of charge, after due ethical approval. Patients were tested for 30 gene mutations with known associations to eight hereditary cancers. After testing, patients completed a semistandardized questionnaire assessing their sociodemographic information, family cancer history, and perceived benefits and barriers to genetic testing. RESULTS Seven patients with ovarian cancer and 40 patients with breast cancer received genetic counseling, and all chose to undergo subsequent genetic testing. The average age at testing was 49 years, and the average age at cancer diagnosis was 47 years. Eight women reported a known family cancer history, and there were more perceived benefits than barriers to genetic testing. The genetic test results revealed 27 negative mutations, 16 variants of unknown significance, and four pathogenic mutations. CONCLUSION Patients with breast and ovarian cancer at UCH associate genetic testing with benefits for their care. These results suggest potential for growth and sustainability of genetic testing for cancer risk management in Nigeria.

Providers Respond to USPSTF Report on Screening for Breast Cancer