Why women with breast cancer presented late to health care facility in North-west Ethiopia? A qualitative study

PLoS One. 2020 Dec 4;15(12):e0243551. doi: 10.1371/journal.pone.0243551. eCollection 2020.

Abstract

Background: Although early diagnosis is a key determinant factor for breast cancer survival, delay in presentation and advanced stage diagnosis are common challenges in low and middle income countries including Ethiopia. Long patient delays in presentation to health facility and advanced stage diagnosis are common features in breast cancer care in Ethiopia but the reasons for patient delays are not well explored in the country. Therefore we aimed to explore the reasons for patient delay in seeking early medical care for breast cancer in North-west Ethiopia.

Methods: A qualitative study was conducted from November to December 2019 using in-depth interviews from newly diagnosed breast cancer patients in the two comprehensive specialized hospitals in North West Ethiopia. Verbal informed consent was taken from each participant before interviews. A thematic content analysis was performed using Open Code software version 4.02.

Results: Lack of knowledge and awareness about breast cancer, cultural and religious beliefs, economic hardships, lack of health care and transportation access, fear of surgical procedures and lack of trusts on medical care were the major reasons for late presentation of breast cancer identified from the patient's narratives.

Conclusions: The reasons for late presentation of patients to seek early medical care for breast cancer had multidimensional nature in Northwest Ethiopia. Health education and promotion programs about breast cancer should be designed to increase public awareness to facilitate early detection of cases before advancement on the existing health care delivery system.

MeSH terms

  • Adult
  • Breast Neoplasms / diagnosis
  • Breast Neoplasms / psychology*
  • Delayed Diagnosis / psychology
  • Delayed Diagnosis / trends*
  • Early Detection of Cancer / trends
  • Ethiopia / epidemiology
  • Female
  • Health Education / methods
  • Health Facilities / statistics & numerical data
  • Health Knowledge, Attitudes, Practice / ethnology
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Middle Aged
  • Patient Acceptance of Health Care / psychology*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Qualitative Research
  • Surveys and Questionnaires
  • Young Adult

Grants and funding

The author(s) received no specific funding for this work.