Getachew Sefonias, Tesfaw Aragaw, Kaba Mirgissa, Wienke Andreas, Taylor Lesley, Kantelhardt Eva J, Addissie Adamu
Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University, Halle, Germany.
BMC Womens Health. 2020 Feb 27;20(1):38. doi: 10.1186/s12905-020-00909-7.
Early diagnosis is a key determinant of breast cancer prognosis and survival. More than half of breast cancer cases are diagnosed at an advanced stage in Ethiopia, and the barriers to early diagnosis in this country are not well understood. We aimed to identify the perceived barriers to early diagnosis of breast cancer from the perspective of patients and health care providers in south and southwestern Ethiopia.
A qualitative study was conducted from March to April 2018 using in-depth interviews of breast cancer patients and breast cancer health care providers from six public hospitals located in urban and rural areas of south and southwestern Ethiopia. All participants provided verbal consent before participating. A thematic analysis was performed using Open Code 4.02.
Twelve breast cancer patients and thirteen health care providers were included in the study. Patient and health-system related barriers to early diagnosis of breast cancer were identified. Patient-related barriers were lack of knowledge and awareness of breast cancer, belief in traditional medicine and religious practices for treatment, and lack of social and financial support to seek care at a medical facility. Health-system related barriers were misdiagnosis of breast cancer, long distance to referral facilities, high cost of diagnostic services, long waiting time for diagnostic tests, and lack of screening and diagnostic tests in local facilities.
Early diagnosis of breast cancer is affected by multiple barriers in south and southwestern Ethiopia. Awareness campaigns and education about the disease, prevention, and early detection are needed to increase early diagnosis of breast cancer. Opportunities exist to improve early diagnosis and timely treatment in rural areas.
早期诊断是乳腺癌预后和生存的关键决定因素。在埃塞俄比亚，超过一半的乳腺癌病例在晚期才被诊断出来，该国早期诊断的障碍尚不清楚。我们旨在从埃塞俄比亚南部和西南部患者及医疗服务提供者的角度，确定乳腺癌早期诊断中存在的可感知障碍。
2018年3月至4月进行了一项定性研究，对埃塞俄比亚南部和西南部城乡地区六家公立医院的乳腺癌患者和乳腺癌医疗服务提供者进行了深入访谈。所有参与者在参与前均提供了口头同意。使用Open Code 4.02进行了主题分析。
该研究纳入了12名乳腺癌患者和13名医疗服务提供者。确定了与患者和医疗系统相关的乳腺癌早期诊断障碍。与患者相关的障碍包括缺乏对乳腺癌的知识和认识、相信传统医学和宗教疗法、缺乏寻求医疗服务的社会和经济支持。与医疗系统相关的障碍包括乳腺癌误诊、到转诊机构距离远、诊断服务费用高、诊断检查等待时间长以及当地医疗机构缺乏筛查和诊断检查。
在埃塞俄比亚南部和西南部，乳腺癌的早期诊断受到多种障碍的影响。需要开展提高对该疾病、预防和早期检测认识的宣传活动和教育，以增加乳腺癌的早期诊断。在农村地区存在改善早期诊断和及时治疗的机会。
