Dedey Florence, Nsaful Josephine, Brownson Kirstyn E, Laryea Ruth Y, Coleman Nathaniel, Tetteh John, Clegg-Lamptey Joe-Nat, Calys-Tagoe Benedict N L
Department of Surgery, University of Ghana Medical School, Korle Bu, PO Box GP 4236, Accra, Ghana.
Department of Surgery, Korle Bu Teaching Hospital, PO Box 77, Accra, Ghana.
Ecancermedicalscience. 2024 Sep 6;18:1756. doi: 10.3332/ecancer.2024.1756. eCollection 2024.
Breast cancer incidence rates are rising in Africa and mortality is highest in West Africa. Reasons for poor survival are multifactorial but delays in seeking appropriate health care result in late presentation which contributes significantly to poor outcomes. Total delays of more than 3 months have been associated with advanced stage at presentation and poorer survival.
A cross-sectional design was used to assess delays in health-seeking behaviour in consecutive breast cancer patients receiving treatment at Korle Bu Teaching Hospital (KBTH) from January to December 2022 using a structured, interviewer-administered questionnaire. Data were gathered to assess health-seeking behaviour in relation to delays in a presentation to a health care facility, and factors that may have influenced the delays. Statistical analysis was done using descriptive and inferential analyses.
The study involved 636 participants with a mean age and SD of 52.6 ± 12 years. Most participants were diagnosed with Stage 3 or 4 breast cancer (56.5%). Ninety percent of participants had visited at least one health facility prior to seeking care at KBTH. Forty-two percent of the participants sought care at a health facility less than a month after noticing symptoms of breast cancer while 34.4% did so greater than 3 months after noticing symptoms. Delays showed a significant association with age, marital status, educational level, average monthly income and cancer stage ( < 0.05). Common reasons for delays were lack of knowledge of breast cancer signs and/or symptoms (47%), advice from family and friends (15%), financial difficulties (9%), seeking alternate treatments (7%), competing priorities (6%) and indifference (5%).
Lack of knowledge about breast cancer was a major cause of delay in seeking health care in this study. Education should specifically target knowledge about breast cancer and the need for appropriate and timely health seeking.
非洲的乳腺癌发病率正在上升，而西非的死亡率最高。生存状况不佳的原因是多方面的，但寻求适当医疗保健的延迟导致就诊时间较晚，这对不良后果有很大影响。超过3个月的总延迟与就诊时的晚期阶段和较差的生存率相关。
采用横断面设计，使用结构化的、由访谈者管理的问卷，对2022年1月至12月在科勒布教学医院（KBTH）接受治疗的连续乳腺癌患者的就医延迟行为进行评估。收集数据以评估与前往医疗机构就诊延迟相关的就医行为，以及可能影响延迟的因素。使用描述性和推断性分析进行统计分析。
该研究涉及636名参与者，平均年龄为52.6±12岁，标准差为12岁。大多数参与者被诊断为3期或4期乳腺癌（56.5%）。90%的参与者在前往KBTH就医之前至少去过一家医疗机构。42%的参与者在注意到乳腺癌症状后不到一个月就去了医疗机构就诊，而34.4%的参与者在注意到症状后超过3个月才这样做。延迟与年龄、婚姻状况、教育水平、平均月收入和癌症分期显著相关（<0.05）。延迟的常见原因是对乳腺癌体征和/或症状缺乏了解（47%）、家人和朋友的建议（15%）、经济困难（9%）、寻求替代治疗（7%）、有其他优先事项（6%）和漠不关心（5%）。
在本研究中，对乳腺癌缺乏了解是延迟寻求医疗保健的主要原因。教育应特别针对乳腺癌知识以及及时寻求适当医疗的必要性。
