Armauer Hansen Research Institute (AHRI), Communicable and Non-Communicable Disease Directorate, Addis Ababa, Ethiopia.
College of Medicine and Health Science, Arsi University, Asella, Ethiopia.
JCO Glob Oncol. 2024 Nov;10:e2400263. doi: 10.1200/GO-24-00263. Epub 2024 Nov 21.
Low breast cancer survival rates are often linked to late-stage diagnosis. The patient interval, the time between symptom detection and the first health care visit, is a key indicator of early diagnosis. This study aimed to assess the prevalence of patient delay and its associated factors in Ethiopia.
This systematic review used a combined approach of meta-analysis and meta-synthesis of quantitative and qualitative data, respectively. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline.
Eleven studies that satisfied the eligibility criteria were included in the review. More than half (58.48%) of the patients with breast cancer delayed seeking medical help at health facilities, with a median delay time of 120 days. Presence of a painful breast ulcer/wounded mass (odds ratio [OR], 0.23 [95% CI, 0.09 to 0.58]), having swelling or a lump in the armpit (OR, 0.27 [95% CI, 0.15 to 0.46]), residing in urban area (OR, 0.27 [95% CI, 0.15 to 0.49]), and having a secondary school education or higher (OR, 0.28 [95% CI, 0.12 to 0.64]) were less likely to delay in seeking formal health care. However, patients who travel more than 5 km (OR, 6.33 [95% CI, 4.10 to 9.75]) were more likely to delay in our meta-analysis. Moreover, the meta-synthesis showed that the nature and progression of symptoms, symptom disclosure, social support, emotional responses, use of alternative therapies, misconceptions about breast cancer, financial limitations, accessibility issues, and other personal-environmental factors were associated with patient delay.
Nearly three fifths of patients with breast cancer delayed seeking health care at health facilities. Inaccessibility, low awareness, cultural beliefs, and socioeconomic factors contributed to these delays. Increasing public awareness, especially in rural areas, and improving health care access could encourage earlier presentation.
乳腺癌存活率低通常与晚期诊断有关。患者就诊间隔，即从出现症状到首次就诊的时间，是早期诊断的一个关键指标。本研究旨在评估埃塞俄比亚患者就诊延迟的流行率及其相关因素。
本系统评价采用了荟萃分析和定性数据荟萃综合的结合方法，分别。我们遵循系统评价和荟萃分析的首选报告项目指南。
符合纳入标准的 11 项研究被纳入综述。超过一半（58.48%）的乳腺癌患者延迟到医疗机构寻求医疗帮助，中位延迟时间为 120 天。存在乳房疼痛溃疡/创伤性肿块（优势比[OR]，0.23 [95%可信区间，0.09 至 0.58]）、腋窝肿胀或肿块（OR，0.27 [95%可信区间，0.15 至 0.46]）、居住在城区（OR，0.27 [95%可信区间，0.15 至 0.49]）和具有中学或更高学历（OR，0.28 [95%可信区间，0.12 至 0.64]）不太可能延迟寻求正规医疗保健。然而，我们的荟萃分析显示，患者出行超过 5 公里（OR，6.33 [95%可信区间，4.10 至 9.75]）更有可能延迟就诊。此外，荟萃综合表明，症状的性质和进展、症状披露、社会支持、情绪反应、替代疗法的使用、对乳腺癌的误解、经济限制、可及性问题以及其他个人环境因素与患者就诊延迟有关。
近五分之三的乳腺癌患者延迟到医疗机构寻求医疗帮助。不可及性、低意识、文化信仰和社会经济因素导致了这些延迟。提高公众意识，特别是在农村地区，并改善医疗保健的可及性，可以鼓励更早的就诊。
