Department of Public Health, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia.
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-Wittenberg, Germany.
Clin Breast Cancer. 2021 Feb;21(1):e112-e119. doi: 10.1016/j.clbc.2020.08.011. Epub 2020 Oct 1.
Breast cancer is a leading cause of cancer death in women in low- and middle-income countries, largely because of late-stage diagnosis. Yet studies are very limited in the Ethiopian context. Therefore, we determined the occurrence of late-stage disease and associated factors in selected public hospitals in south and southwest Ethiopia.
A 5-year retrospective cross-sectional study was conducted on breast cancer patient medical records from January 2013 to December 2017 in 6 hospitals. Multivariable logistic regression was performed to identify factors associated with late-stage disease (stage III and IV). Adjusted odds ratios (AOR) with 95% confidence intervals were used. P < .05 was considered statistically significant.
Overall, 426 breast cancer patients were identified, and 72.5% were diagnosed with late-stage disease. The mean ± standard deviation patient age was 42.8 ± 13.4 years. Factors associated with late diagnosis were patient delay in seeking care (AOR = 2.50; 95% confidence interval [CI], 1.51-4.16); health system delays (AOR = 1.62; 95% CI, 1.02-2.59); female sex (AOR = 3.46; 95% CI, 1.50-7.98); rural residence (AOR = 2.37; 95% CI, 1.45-3.86); chief complaint of breast lump (AOR = 3.01; 95% CI, 1.49-6.07); and history of comorbidities (AOR = 1.72; 95% CI, 1.02-2.91).
The majority of patients were diagnosed with late-stage diagnosis of breast cancer. Patient delays in seeking care, health system delays, being female, rural residence, and patient comorbidities were associated factors. These findings provide evidence that efforts to increase public and health provider awareness to promote early breast cancer diagnosis, particularly in rural areas, are needed in south and southwest Ethiopia.
乳腺癌是中低收入国家女性癌症死亡的主要原因，主要是因为诊断较晚。然而，在埃塞俄比亚的背景下，相关研究非常有限。因此，我们确定了在埃塞俄比亚南部和西南部的几家公立医院中晚期疾病的发生情况及其相关因素。
对 2013 年 1 月至 2017 年 12 月期间 6 家医院的 426 例乳腺癌患者病历进行了 5 年回顾性横断面研究。采用多变量逻辑回归分析与晚期疾病（III 期和 IV 期）相关的因素。采用调整后的优势比（AOR）和 95%置信区间进行分析。P<.05 被认为具有统计学意义。
总体而言，共发现 426 例乳腺癌患者，其中 72.5%的患者被诊断为晚期疾病。患者的平均年龄（±标准差）为 42.8 ± 13.4 岁。与晚期诊断相关的因素包括患者寻求医疗护理的延迟（AOR=2.50；95%置信区间[CI]，1.51-4.16）；卫生系统的延迟（AOR=1.62；95%CI，1.02-2.59）；女性（AOR=3.46；95%CI，1.50-7.98）；农村居住（AOR=2.37；95%CI，1.45-3.86）；主要抱怨为乳房肿块（AOR=3.01；95%CI，1.49-6.07）；合并症史（AOR=1.72；95%CI，1.02-2.91）。
大多数患者被诊断为乳腺癌晚期。患者寻求医疗护理的延迟、卫生系统的延迟、女性、农村居住和患者合并症是相关的因素。这些发现表明，需要努力提高公众和卫生保健提供者的认识，以促进在埃塞俄比亚南部和西南部特别是农村地区的早期乳腺癌诊断。
