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Zheng J, Guo AH, Xue BW, Wu SY, Wang XX, Jing YJ, Zhai LJ, Liu R. Exploring patient delay in people with chronic kidney disease: A cross-sectional study. Medicine (Baltimore) 2024; 103:e37077. [PMID: 38363926 PMCID: PMC10869059 DOI: 10.1097/md.0000000000037077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/05/2024] [Indexed: 02/18/2024] Open
Abstract
To examine the factors that contribute to patient delays among individuals with chronic kidney disease (CKD) and offer insights to help develop specific risk management strategies. Conducted as a cross-sectional study between September 2021 and April 2022, this study used a convenient sampling technique to select 245 individuals diagnosed with CKD from a Grade 3 Class A hospital located in Shanxi Province. These individuals were chosen as the subjects of the study. The research participants underwent an investigation using several assessment tools, including socio-demographic information questionnaire, medical behavior, the social support rating scale, the simplified coping style questionnaire, and the General Self-efficacy Scale. The study revealed that 35.4% of individuals with CKD experienced patient delay (the interval between the initial onset and the time of seeking medical attention being longer than or equal to 3 months). Through a multifactorial logistic regression analysis, it was determined that various factors independently influenced patient delay in patients with CKD. These factors included the level of knowledge about CKD, educational level, frequency of attending physical examinations, severity of initial symptoms, social support, self-efficacy, positive coping, and negative coping. Numerous factors contribute to the Patient Delay. To effectively enhance awareness and coping abilities regarding CKD in high-risk groups, it is essential to implement focused and continuous interventions throughout the medical seeking process.
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Affiliation(s)
- Jie Zheng
- Nursing College of Shanxi Medical University, Shanxi, China
| | - Ao-Han Guo
- Nursing College of Shanxi Medical University, Shanxi, China
| | - Bo-Wen Xue
- Nursing College, Hangzhou Normal University, Hangzhou, China
| | - Shu-Yan Wu
- Nursing College of Shanxi Medical University, Shanxi, China
| | | | - Yue-Juan Jing
- The Second Hospital of Shanxi Medicine University, Shanxi, China
| | - Lin-Jun Zhai
- Nursing College of Shanxi Medical University, Shanxi, China
| | - Rong Liu
- Nursing College of Shanxi Medical University, Shanxi, China
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2
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Alhassani AH, Alqurashi AS, Alhassani TH, Fageeh SM, Almatrafi MI, Alsharif EK, Alzahrani AM, Attieh RA. Breast Cancer Management Timelines in a Tertiary Care Center During the COVID-19 Pandemic, Makkah City, Saudi Arabia: A Retrospective Study. Cureus 2023; 15:e42893. [PMID: 37664289 PMCID: PMC10474793 DOI: 10.7759/cureus.42893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND Breast cancer (BC) is a prevalent form of cancer and a leading cause of death among women worldwide. In Saudi Arabia, it accounted for 31.8% among females of all new cancer cases reported in 2018. Following the declaration of COVID-19 as a global pandemic, there was a complete redistribution of healthcare resources to face this crisis, which caused a significant delay in the management of various diseases, including BC. There is currently a lack of research in our region on the facility time interval in BC management. Therefore, this study aimed to fill this gap by determining the timelines of diagnosis, management, and factors influencing the delay. METHODS This observational retrospective study included all female patients diagnosed with BC at or referred to King Abdullah Medical City (KAMC) in Makkah, Saudi Arabia, between January 2020 and August 2021. The data for this study were obtained from a centralized electronic chart review of all included patients at the KAMC center. RESULTS A total of 76 patients were included in the study, with a mean age of 50 ± 11 years. In terms of the disease management duration, 20 patients (26.3%) completed their management within 30 days, 28 patients (36.8%) had a management duration between 31 and 60 days, and the management duration of 28 patients (36.8%) exceeded 60 days. Patient deposition showed a significant association with delay (p = 0.033). A higher incidence of delays at the initiation of treatment was observed in patients who failed to attend appointments (p < 0.001). Among patients who skipped two or more appointments, 12 individuals (80%) experienced a delay of more than 60 days. Moreover, appointment cancellation was associated with delayed treatment initiation (p = 0.03). Patients' age and comorbidity showed no significant association (p = 0.49, p = 0.24, respectively). CONCLUSION Our findings highlight the significant impact of patient deposition and canceled or skipped appointments on delayed initiation of therapy for BC patients. Further research should be conducted to evaluate the impact of COVID-19 on other malignancies.
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Affiliation(s)
| | | | | | - Sarah M Fageeh
- Faculty of Medicine, Umm Al-Qura University, Makkah, SAU
| | | | - Emad K Alsharif
- Division of Breast and Endocrine Surgery, Specialized Surgical Unit, King Abdullah Medical City, Makkah, SAU
| | - Abdulaziz M Alzahrani
- Division of Breast and Endocrine Surgery, Specialized Surgical Unit, King Abdullah Medical City, Makkah, SAU
| | - Roaa A Attieh
- Division of Breast and Endocrine Surgery, Specialized Surgical Unit, King Abdullah Medical City, Makkah, SAU
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3
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Khan S, Jalees S, Jabeen Z, Khan M, Qadri RH, Adnan H, Khan BS, Khan AH. Myths and Misconceptions of Breast Cancer in the Pakistani Population. Cureus 2023; 15:e40086. [PMID: 37425603 PMCID: PMC10327610 DOI: 10.7759/cureus.40086] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
Background Breast cancer is one of the most prevalent types of cancer in the female population. The cultural diversity, religious beliefs, myths, and misinformation regarding the disease contribute to diagnostic delays and enhanced burden on the healthcare system. This study aimed to ascertain the extent of knowledge and prevalence of erroneous beliefs and misconceptions regarding breast cancer among Pakistani women belonging to diverse socioeconomic and educational backgrounds. Methodology This cross-sectional study was performed in a tertiary care hospital in Karachi, Pakistan. A total of 350 women were enrolled in the study as a representative female population, and 300 participants were included who met the inclusion criteria. Participants were conveniently interviewed using a pre-piloted questionnaire designed to assess the prevalent myths and misconceptions about breast cancer. The data were analyzed by SPSS version 23 (IBM Corp., Armonk, NY, USA) using descriptive statistics. Results The study findings point to a significant prevalence of erroneous beliefs and a lack of accurate information on breast cancer. The mean age of the participants was 20.8 ± 10.4 years. The majority of the participants belonged to a middle socioeconomic status (70%) and were undergraduates (61.4%). The participants' friends and family members were the most frequent sources of information regarding breast cancer. The most common myth was "breast-feeding offers immunity to breast cancer completely" (76.6%), followed by "breast cancer spreads after biopsy" (63.8%). Participants also believed that breast tissue biopsy can lead to the spread of cancer (63.4%) and that faith healers and alternative medicine can cure breast cancer (47.5%). One-third (33.3%) of the participants considered all lumps to be breast cancer; however, approximately half (41.6%) of the participants thought that only painful lumps were associated with breast cancer. A significant number of participants believed breast cancer to be a result of God's curse (31.4%) or evil eye (38.7%). Conclusions The findings suggest a critical need for community-based breast health education initiatives that take into account Pakistani women's distinctive cultural and societal attitudes and work to dispel common misconceptions about the condition.
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Affiliation(s)
- Sulhera Khan
- Dermatology, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK
- Internal Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Sumeen Jalees
- Internal Medicine, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK
| | - Zohra Jabeen
- Community Medicine, Karachi Medical and Dental College, Karachi, PAK
| | - Marium Khan
- Internal Medicine, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK
| | - Rafia H Qadri
- Internal Medicine, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK
| | - Haneya Adnan
- Internal Medicine, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK
| | - Bareerah S Khan
- Internal Medicine, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK
| | - Amir H Khan
- Internal Medicine, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK
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Araujo JM, Gómez AC, Jongh WZD, Ausejo J, Córdova I, Schwarz LJ, Bretel D, Fajardo W, Saravia-Huarca LG, Barboza-Meca J, Morante Z, Guillén JR, Gómez H, Cárdenas NK, Hernández L, Melo W, Villarreal-Garza C, Caglevic C, Palacio C, García H, Mejía G, Flores C, Vallejos C, Pinto JA. A nationwide pilot study on breast cancer screening in Peru. Ecancermedicalscience 2023; 17:1494. [PMID: 36816782 PMCID: PMC9937072 DOI: 10.3332/ecancer.2023.1494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction A high prevalence of advanced breast cancer (BC) is a common scenario in Latin America. In Peru, the frequency of BC at Stages III/IV is ≈50% despite implementation of a programme for breast cancer screening (BCS) along the country. We carried out a study to assess the feasibility and develop an instrument to evaluate the knowledge, barriers and perception about BCS in a nationwide pilot study in Peru among candidates for BCS. Methods We conducted a systematic review of 2,558 reports indexed in PubMed, Scopus, Web of Science, Medline-Ovid and EMBASE, regarding to our study theme. In total, 111 were selected and a 51-items survey was developed (eight items about sociodemographic characteristics). Patients were recruited in public hospitals or private clinics, in rural and urban areas of nine departments of Peru. Results We surveyed 488 women from: Lima (150), Cajamarca (93), Ica (59), Arequipa (56), Loreto (48), Ancash (38), Junín (15), Puerto Maldonado (15) and Huancavelica (14); 27.9% of them were from rural areas. The mean of age was 53.3 years (standard deviation ± 9.1). Regarding education level, 29.8% had primary, 33.2% secondary and 37.0% higher education. In total, 28.7% of women did not know the term 'mammogram' and 47.1% reported never receiving a BCS (36.9% from urban and 73.5% from rural population). In women that underwent BCS, only 67% knew it is for healthy women. In total, 54.1% of patients had low levels of knowledge about risk factors for BC (i.e. 87.5% of women respond that injuries in the breast produce cancer). Cultural, economic and geographic barriers were significantly associated with having a mammogram where 56.9% of participants considered a cost ≤ 7 USD as appropriate. Mammogram was perceived as too painful for 54.9% of women. In addition, women with a self-perception of low-risk for BC and a fatalistic perception of cancer were less likely to have a BCS. Conclusion We found that it is feasible to conduct a large-scale study in Peru. The results of this pilot study highlight an urgent need of extensive education and awareness about BCS in Peru.
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Affiliation(s)
- Jhajaira M Araujo
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru,Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Chorrillos, Lima 15067, Peru
| | - Andrea C Gómez
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru
| | - Winston Zingg-De Jongh
- Department of Molecular and Cellular Medicine, Texas A&M University, TX 77843, E.E.U.U., USA
| | - Jhon Ausejo
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Iván Córdova
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Luis J Schwarz
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Denisse Bretel
- Grupo de Estudios Clínicos Oncológicos Peruano (GECOPERU), Santiago de Surco, Lima 15038, Peru
| | - Williams Fajardo
- Servicio de Medicina Interna, Hospital Nacional Dos de Mayo, Lima 15003, Peru
| | | | | | - Zaida Morante
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru
| | - Juan R Guillén
- Hospital Félix Torrealva Gutiérrez- ESSALUD, Ica 11001, Peru
| | - Henry Gómez
- Grupo de Estudios Clínicos Oncológicos Peruano (GECOPERU), Santiago de Surco, Lima 15038, Peru
| | - Nadezhda K Cárdenas
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Lady Hernández
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Walter Melo
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Cynthia Villarreal-Garza
- Centro de Cáncer de Mama, Hospital Zambrano Hellion, Tecnológico de Monterrey, 66278 San Pedro Garza García, Monterrey, México
| | - Christian Caglevic
- Cancer Research Department, Fundacion Arturo Lopez Perez, Santiago de Chile 7500921, Chile
| | - Carolina Palacio
- Departamento de Oncología Clínica, Instituto de Cancerología Las Américas - AUNA, Medellín 050022, Colombia
| | - Héctor García
- Facultad de Medicina, Universidad de Antioquia, Medellín 050010, Colombia
| | - Gerson Mejía
- Departamento de Oncología Médica, Hospital Clínico VIEDMA, Cochabamba 0304, Bolivia
| | - Claudio Flores
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru
| | - Carlos Vallejos
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru
| | - Joseph A Pinto
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru,Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
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Petrova D, Garrido D, Špacírová Z, Fernández-Martínez NF, Ivanova G, Rodríguez-Barranco M, Pollán M, Barrios-Rodríguez R, Sánchez MJ. Duration of the patient interval in breast cancer and factors associated with longer delays in low-and middle-income countries: A systematic review with meta-analysis. Psychooncology 2023; 32:13-24. [PMID: 36345154 PMCID: PMC10100001 DOI: 10.1002/pon.6064] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 10/02/2022] [Accepted: 10/31/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Breast cancer survival is lower in low- and middle-income countries (LMICs) partially due to many women being diagnosed with late-stage disease. The patient interval refers to the time elapsed between the detection of symptoms and the first consultation with a healthcare provider and is considered one of the core indicators for early diagnosis and treatment. The goal of the current research was to conduct a meta-analysis of the duration of the patient interval in LMICs and investigate the socio-demographic and socio-cultural factors related to longer delays in presentation. METHODS We conducted a systematic review with meta-analysis (pre-registered protocol CRD42020200752). We searched seven information sources (2009-2022) and included 50 articles reporting the duration of patient intervals for 18,014 breast cancer patients residing in LMICs. RESULTS The longest patient intervals were reported in studies from the Middle East (3-4 months), followed by South-East Asia (2 months), Africa (1-2 months), Latin America (1 month), and Eastern Europe (1 month). Older age, not being married, lower socio-economic status, illiteracy, low knowledge about cancer, disregarding symptoms or not attributing them to cancer, fear, negative beliefs about cancer, and low social support were related to longer delays across most regions. Longer delays were also related to use of alternative medicine in the Middle East, South-East Asia, and Africa and distrust in the healthcare system in Eastern Europe. CONCLUSIONS There is large variation in the duration of patient intervals across LMICs in different geographical regions. Patient intervals should be reduced and, for this purpose, it is important to explore their determinants taking into account the social, cultural, and economic context.
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Affiliation(s)
- Dafina Petrova
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Escuela Andaluza de Salud Pública (EASP), Granada, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Dunia Garrido
- Department of Developmental and Educational Psychology, University of Granada, Granada, Spain
| | - Zuzana Špacírová
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Escuela Andaluza de Salud Pública (EASP), Granada, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Nicolás Francisco Fernández-Martínez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Escuela Andaluza de Salud Pública (EASP), Granada, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Interlevel Clinical Management Unit for Prevention, Promotion and Health Surveillance, Reina Sofía University Hospital, Córdoba, Spain
| | - Ganka Ivanova
- Department of Applied Psychology, College of Education, Social Sciences and Humanities, Al-Ain University, Abu Dhabi, United Arab Emirates
| | - Miguel Rodríguez-Barranco
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Escuela Andaluza de Salud Pública (EASP), Granada, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Marina Pollán
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,National Center for Epidemiology, Health Institute Carlos III, Madrid, Spain
| | - Rocío Barrios-Rodríguez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Maria José Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Escuela Andaluza de Salud Pública (EASP), Granada, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Afaya A, Ramazanu S, Bolarinwa OA, Yakong VN, Afaya RA, Aboagye RG, Daniels-Donkor SS, Yahaya AR, Shin J, Dzomeku VM, Ayanore MA, Alhassan RK. Health system barriers influencing timely breast cancer diagnosis and treatment among women in low and middle-income Asian countries: evidence from a mixed-methods systematic review. BMC Health Serv Res 2022; 22:1601. [PMID: 36587198 PMCID: PMC9805268 DOI: 10.1186/s12913-022-08927-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 12/05/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Globally, breast cancer is the most common cancer type and the leading cause of cancer mortality among women in developing countries. A high prevalence of late breast cancer diagnosis and treatment has been reported predominantly in Low- and Middle-Income Countries (LMICs), including those in Asia. Thus, this study utilized a mixed-methods systematic review to synthesize the health system barriers influencing timely breast cancer diagnosis and treatment among women in Asian countries. METHODS We systematically searched five electronic databases for studies published in English from 2012 to 2022 on health system barriers that influence timely breast cancer diagnosis and treatment among women in Asian countries. The review was conducted per the methodology for systematic reviews and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, while health system barriers were extracted and classified based on the World Health Organization (WHO)'s Health Systems Framework. The mixed-methods appraisal tool was used to assess the methodological quality of the included studies. RESULTS Twenty-six studies were included in this review. Fifteen studies were quantitative, nine studies were qualitative, and two studies used a mixed-methods approach. These studies were conducted across ten countries in Asia. This review identified health systems barriers that influence timely breast cancer diagnosis and treatment. The factors were categorized under the following: (1) delivery of health services (2) health workforce (3) financing for health (4) health information system and (5) essential medicines and technology. Delivery of health care (low quality of health care) was the most occurring barrier followed by the health workforce (unavailability of physicians), whilst health information systems were identified as the least barrier. CONCLUSION This study concluded that health system factors such as geographical accessibility to treatment, misdiagnosis, and long waiting times at health facilities were major barriers to early breast cancer diagnosis and treatment among Asian women in LMICs. Eliminating these barriers will require deliberate health system strengthening, such as improving training for the health workforce and establishing more healthcare facilities.
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Affiliation(s)
- Agani Afaya
- grid.15444.300000 0004 0470 5454Mo-Im Nursing Research Institute, College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea ,grid.449729.50000 0004 7707 5975Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Sheena Ramazanu
- grid.4280.e0000 0001 2180 6431Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Obasanjo Afolabi Bolarinwa
- grid.127050.10000 0001 0249 951XDepartment of Global Public Health, Canterbury Christ Church University, Canterbury, UK
| | - Vida Nyagre Yakong
- grid.442305.40000 0004 0441 5393Department of Preventive Health Nursing, School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
| | - Richard Adongo Afaya
- grid.442305.40000 0004 0441 5393Department of Midwifery and Women’s Health, School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
| | - Richard Gyan Aboagye
- grid.449729.50000 0004 7707 5975Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Silas Selorm Daniels-Donkor
- grid.8241.f0000 0004 0397 2876Department of Nursing, School of Health Sciences, University of Dundee, Scotland Dundee, UK
| | - Ahmed-Rufai Yahaya
- Hariri School of Nursing, American University of Beruit, Beirut, Lebanon ,grid.460777.50000 0004 0374 4427Department of Internal Medicine, Tamale Teaching Hospital, Tamale, Ghana
| | - Jinhee Shin
- grid.412965.d0000 0000 9153 9511Woosuk University, College of Nursing, Wanju, Republic of Korea
| | - Veronica Millicent Dzomeku
- grid.9829.a0000000109466120Department of Nursing, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Martin Amogre Ayanore
- grid.449729.50000 0004 7707 5975Department of Health Policy Planning and Management, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Robert Kaba Alhassan
- grid.449729.50000 0004 7707 5975Centre for Health Policy and Implementation Research. Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
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Sarfraz M, Waqas H, Ahmed S, Rurush-Asencio R, Mushtaque I. Cancer-Related Stigmatization, Quality of Life, and Fear of Death Among Newly Diagnosed Cancer Patients. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221140650. [PMID: 36409065 DOI: 10.1177/00302228221140650] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
The purpose of the study is to investigate the gender differences among newly diagnosed cancer patients from the cultural perspective of Pakistan. The data comprised two equal groups: men (50%) and women (50%). Most participants were 31-45 years old, and the duration of the cancer diagnosis was less than 6 months (74.6%). The data was collected on the following scales: the discrimination and stigma scale, the internalized stigma scale, the WHO-quality of life scale, and the fear of death scale. Data was analyzed using SPSS v.25; descriptive statistics, an independent sample t-test, and simple linear regression were applied to the data. The results revealed that men and women are both experiencing cancer-related stigmatization in Pakistan. However, women face a higher level of stigmatization, lower quality of life, and higher fear of death than men. Furthermore, the regression analysis result confirms that the cancer-related stigma faced by the diagnosed patients decreases the patient's quality of life and induces the fear of death.
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Affiliation(s)
| | - Hamid Waqas
- School of Business and Management, Westminster International Universityin Tashkent, Uzbekistan
| | - Saba Ahmed
- Fatima Jinnah Women University, Rawalpindi, Pakistan
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8
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Abo Al-Shiekh SS, Alajerami YS, Abushab KM, Najim AA, AlWaheidi S, Davies EA. Factors affecting delay in the presentation of breast cancer symptoms among women in Gaza, occupied Palestinian territory: a cross-sectional survey. BMJ Open 2022; 12:e061847. [PMID: 36270752 PMCID: PMC9594579 DOI: 10.1136/bmjopen-2022-061847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To identify factors related to women's delay in presenting with breast cancer symptoms to improve diagnosis in the occupied Palestinian territory (oPt). DESIGN Cross-sectional. SETTING Two government cancer hospitals. PARTICIPANTS A consecutive sample of 130 Palestinian women living in Gaza with newly diagnosed breast cancer were approached in the waiting rooms of cancer hospitals in Gaza between 1 January 2017 and 31 December 2017. 120 women took part and returned the completed questionnaire. PRIMARY AND SECONDARY OUTCOME MEASURES Clinical information about breast cancer was collected from hospital cancer records. An interval of 3 months or more between women's self-discovery of symptoms and their first presentation to a medical provider was considered as a delay. RESULTS 94% (122/130) of women attending cancer hospitals in Gaza agreed to take part in the study. Their mean age was 51 years (range: 23-72), 33.6% (31/122) had a family history of breast cancer and 74.5% (41/55) of those whose cancer stage was known had been diagnosed at stage III or IV. Around one-half (62/122) said they had not recognised the seriousness of their breast changes but only 20% (24/122) of women delayed seeking healthcare by 3 months and more. The two only factors associated to late presentation were that the woman considered their symptoms not serious (p<0.001) and lack of pain (p=0.012). Lower socioeconomic status, older age, lower education and negative family history of breast cancer were not statistically associated with women's delay. CONCLUSIONS Women's awareness about the seriousness of breast changes and the critical importance of seeking prompt diagnosis needs to be improved using context-relevant and evidence-based awareness campaigns. This should be accompanied with training of female nurses on promoting early detection and improvement in diagnostic facilities to ensure timely diagnosis of cancer in the oPt.
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Affiliation(s)
| | | | - Khaled M Abushab
- Department of Medical Imaging, Al-Azhar University, Gaza, Palestine
| | - Ahmed A Najim
- Nursing Department, Al-Azhar University, Gaza, Palestine
| | | | - Elizabeth A Davies
- Health and Social Care Research, King's College London, London, UK
- Knowledge and Intelligence, Public Health England, London, UK
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9
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Momenimovahed Z, Momenimovahed S, Allahqoli L, Salehiniya H. Factors Related to the Delay in Diagnosis of Breast Cancer in the Word: A Systematic Review. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2022. [DOI: 10.1007/s40944-022-00632-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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10
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Rehman S, Nagarajan JS, Ghafoor B, Qureshi MH, Shahrukh S. Invasive Lobular Carcinoma in Premenopausal Woman: A Delayed Diagnosis Due to Socio-Cultural Factors Prevalent in Pakistan. Cureus 2022; 14:e24766. [PMID: 35677012 PMCID: PMC9167430 DOI: 10.7759/cureus.24766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 12/03/2022] Open
Abstract
A 41-year-old premenopausal woman presented to the outpatient department with a diagnosis of invasive lobular carcinoma. She noticed a lump a year back but did not seek medical attention due to many socio-cultural factors prevalent in Pakistan that prevent her from seeking medical attention earlier. She came in for a check-up after increasing in size of the lump. The bilateral mammogram showed large areas of asymmetrical density in the left upper quadrant. It was followed by an ultrasound-guided biopsy which confirmed the diagnosis of invasive lobular carcinoma. Due to stage 3, it was recommended to have CT and an MRI of the breast to assess the extent of the disease. Tissue immunohistochemistry was also requested, which came back as ER-positive, PR-positive, and HER2/neu negative. MRI of the breast revealed a 4.2 x 3.3cm heterogeneously enhancing asymmetric mass-like enhancement area within the left breast outer quadrant with an adjacent spiculated nodular lesion measuring 2.2 cm. CT chest/abdomen/pelvis with contrast showed left breast with minimal parenchymal asymmetry and a small 9 mm node seen in the left axilla. There was no evidence of metastasis. The patient was started on neoadjuvant therapy to minimize systemic disease, followed by mastectomy. This case highlights socio-cultural factors prevalent in Pakistan that lead to delays in the diagnosis and treatment of invasive lobular carcinoma. The outcome had been better if the patient sought medical attention sooner at an earlier stage. We also propose strategies to raise awareness in Pakistan for the timely diagnosis and treatment of breast cancer.
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11
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Nnaji CA, Ezenwankwo EF, Kuodi P, Walter FM, Moodley J. Timeliness of diagnosis of breast and cervical cancers and associated factors in low-income and middle-income countries: a scoping review. BMJ Open 2022; 12:e057685. [PMID: 35121607 PMCID: PMC8819798 DOI: 10.1136/bmjopen-2021-057685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Addressing the barriers to early breast and cervical cancer diagnosis in low and middle-income countries (LMICs) requires a sound understanding and accurate assessment of diagnostic timeliness. This review aimed to map the current evidence on the time to breast and cervical cancer diagnosis and associated factors in LMICs. DESIGN Scoping review. SOURCES MEDLINE (via PubMed), Cochrane Library, Scopus and CINAHL. ELIGIBILITY CRITERIA Studies describing the time to diagnosis and associated factors in the context of breast and cervical cancer in LMICs published from 1 January 2010 to 20 May 2021. STUDY SELECTION AND DATA SYNTHESIS Two reviewers independently screened all abstracts and full texts using predefined inclusion criteria. The review was reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Evidence was narratively synthesised using predefined themes. RESULTS Twenty-six studies conducted across 24 LMICs were included in the review, most (24/26) of which focused on breast cancer. Studies varied considerably in their conceptualisation and assessment of diagnostic time, events, intervals and delays, with a minority of the studies reporting the use of validated methods and tools. Patient-related intervals and delays were more frequently evaluated and reported than provider-related and health system-related intervals and delays. Across studies, there were variations in the estimated lengths of the appraisal, help-seeking, patient and diagnostic intervals for both cancers and the factors associated with them. CONCLUSIONS Despite the significant burden of breast and cervical cancer in LMICs, there is limited information on the timeliness of diagnosis of these cancers. Major limitations included variations in conceptualisation and assessment of diagnostic events and intervals. These underscore the need for the use of validated and standardised tools, to improve accuracy and translation of findings to better inform interventions for addressing diagnostic delays in LMICs.
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Affiliation(s)
- Chukwudi A Nnaji
- Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South Africa
- Cancer Research Initiative, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South Africa
| | - Elochukwu F Ezenwankwo
- Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South Africa
- Cancer Research Initiative, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South Africa
| | - Paul Kuodi
- Department of Public Health, Faculty of Health Sciences, Lira University, Lira, Uganda
| | - Fiona M Walter
- Wolfson Institute of Population Health, Queen Mary University of London Barts and The London School of Medicine and Dentistry, London, UK
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Jennifer Moodley
- Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South Africa
- Cancer Research Initiative, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South Africa
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12
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Shah A, Haider G, Abro N, Hashmat S, Chandio S, Shaikh A, Abbas K. Correlation Between Site and Stage of Breast Cancer in Women. Cureus 2022; 14:e22672. [PMID: 35386160 PMCID: PMC8967127 DOI: 10.7759/cureus.22672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction Breast cancer is a worldwide public health issue and a primary cause of death among women. The present study aimed to assess the correlation between site and stage of breast cancer with respect to age among females. Methods A prospective observational study was conducted at the Medical Oncology Department, Jinnah Postgraduate Medical Centre, Karachi, Pakistan from May 2020 to June 2021. Female patients of 18 years or older with a confirmed diagnosis of breast cancer were included in the study. Histopathological reports were evaluated for tumor characteristics such as histological type, laterality, location, tumor size, grade, lymph node status, and stage of the tumor. Results The majority of the patients presented with advanced stages of tumor. Among all stages of breast tumor, the upper outer quadrant was the most frequent location of the tumor. The majority of the patients with cancer in the upper inner quadrant were diagnosed with stage I (28.57%) (p = 0.011). In contrast, the majority of the upper outer quadrant lesions were identified as stage III and stage IV (p < 0.0001). In patients of age <40 years, statistically significant differences in proportions of tumor location with respect to the stage of the tumor were observed (p = 0.018). Conclusion The upper outer quadrant and stage III of tumor are the most common site and stage of breast tumor in our population. There is a significant relationship between site and stage of breast tumor. Younger-aged patients had a significantly higher rate of cancers located in the upper outer quadrant in advance stages as compared to other quadrants.
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Affiliation(s)
- Aamera Shah
- Department of Oncology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Ghulam Haider
- Department of Oncology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Nargis Abro
- Department of Oncology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Sana Hashmat
- Department of Oncology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Sanam Chandio
- Department of Oncology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Abdulla Shaikh
- Department of Oncology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Kiran Abbas
- Department of Oncology, Jinnah Postgraduate Medical Centre, Karachi, PAK
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13
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Ali D, Zeeshan S, Farooqi N, Vohra L. Breast surgery super-specialization: Impact on advanced surgical training and research. Pak J Med Sci 2022; 38:2345-2349. [PMID: 36415238 PMCID: PMC9676618 DOI: 10.12669/pjms.38.8.6045] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 07/18/2022] [Accepted: 09/07/2022] [Indexed: 01/25/2023] Open
Abstract
The earliest records of breast cancer (BC) date back to 3,000 - 2,500 B.C., ever since multiple curative options have been explored. First known wide margin excision was performed around 1st Century AD and a prototype of the modern-day BC surgery, Halsted radical mastectomy, was performed in the 20th Century. BC is the most common cancer in Pakistan accounting for up to 14.5% of the total cancer incidences. Accredited breast surgery fellowships were established in the UK and USA in 2002 and 2003, respectively. In Pakistan, the movement was delayed and the two-year College of Physicians and Surgeons Pakistan (CPSP) accredited breast surgery fellowship program started in 2019. The increasing annual incidence and changes in demands have led to an increased percentage of General Surgery graduates taking up specialty training. PubMed search from 1990 to 2021 showed a rising trend in the number of breast cancer publications from Pakistan; from almost no papers before 1990 to 615 between 2012 to 2021. This remarkable surge in BC-related research can be explained by the commencement of fellowship programs in breast surgery and related fields. An increase in specialist training will yield better results in the management of patients, improve clinical trials and help produce more meaningful publications from the country.
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Affiliation(s)
- Danish Ali
- Dr. Danish Ali, MBBS. Dean’s Clinical Research Fellow, Aga Khan University Hospital, Karachi, Pakistan
| | - Sana Zeeshan
- Dr. Sana Zeeshan; MBBS, FCPS, FACS. Assistant Professor of Breast Surgery, Aga Khan University Hospital, Karachi, Pakistan,Correspondence: Dr. Sana Zeeshan Assistant Professor, Department of Surgery, Aga Khan University, Stadium Road, Karachi, Pakistan.
| | - Nifasat Farooqi
- Dr. Nifasat Farooqi, MBBS, FCPS. Senior Medical Officer, COVID ICU, Aga Khan University Hospital, Karachi, Pakistan
| | - Lubna Vohra
- Dr. Lubna Vohra, MBBS, FCPS, FACS. Assistant Professor of Breast Surgery, Aga Khan University Hospital, Karachi, Pakistan
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14
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Khan S, Khan S. Sporadic Creutzfeldt-Jakob Disease: Diagnosing Typical and Atypical Presentations under Limited Circumstances. Dement Geriatr Cogn Disord 2021; 50:36-42. [PMID: 34023835 DOI: 10.1159/000514470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/15/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Sporadic Creutzfeldt-Jakob disease (sCJD) is a transmissible disorder of the central nervous system caused by the transformation of normal prion protein into an abnormal misfolded form. The process begins spontaneously and runs a vicious cycle to cause spongiform encephalopathy, rapidly resulting in death. Amply described in the western literature, CJD is scarcely reported in Asia due to certain limitations including missed diagnosis, under-reporting, and rarity of the disease. Brain MRI, electroencephalogram, cerebrospinal fluid testing, and biopsy of the infected brain tissue support the diagnosis in cases of clinical suspicion. However, the diagnosis can still be made with limited available resources in developing countries. METHOD A review of CJD cases evaluated in the neurology department of a tertiary care hospital in Pakistan was done from 2002 to 2018. RESULTS Eleven cases labeled as sCJD are identified based on the European MRI-CJD consortium criteria. This is the first study on CJD from Pakistan, which includes both the typical and atypical presentations. CONCLUSION Even with limited testing available, the diagnosis of CJD can be made with confidence in the developing countries, provided the suspicion is kept high in cases of rapid onset dementia and acute behavioral changes.
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Affiliation(s)
- Shazma Khan
- Department of Neurology, Aga Khan University Hospital, Karachi, Pakistan.,Department of Neurology, Ziauddin University Hospital, Karachi, Pakistan
| | - Sara Khan
- Department of Neurology, Aga Khan University Hospital, Karachi, Pakistan
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15
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COVID 19 pandemic: Effect on management of patients with breast cancer; single center retrospective cohort study. INTERNATIONAL JOURNAL OF SURGERY OPEN 2021; 35:100386. [PMID: 34568622 PMCID: PMC8359567 DOI: 10.1016/j.ijso.2021.100386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 12/24/2022]
Abstract
Background (SARS-COV-2) infection, led to a pandemic affecting many countries, resulting in hospitals diverting most of their resources to fight the pandemic. Breast cancer, already a healthcare dilemma, is also affected in this scenario. Our aim was to find out the impact of COVID-19 on presentation of breast cancer stage and its effects on overall onco-surgical management. Methods This cohort single-centered retrospective review was carried out at our hospital, over a period of 18 months. Females with known breast cancer were included in the study. Data was collected on performas by a single researcher. Effect of COVID pandemic on presentation stage and its impact on overall management was studied. SPSS 23.0 used for data analysis. A 95% CI was used. Descriptive statistics were presented as range/means. Categorical data was analyzed by Fisher exact test, t-test was applied to numerical data, p value ≤ 0.05 was considered significant. Results Out of 87 patients presenting with suspicious lump, 69 who had malignancy on histo-pathology were included in study. Twelve out of 69 were COVID positive. Sixty patients presented with advanced stage (≥stage 2b) out of which 21 underwent upstaging of disease due to delay in presentation/management. We found that 9 out of 12 (majority) Covid positive patients had disease upstaging. Overall main reason for delay in presentation was found to be unawareness of disease. Conclusion We concluded that COVID-19 pandemic had no impact on presentation delay, breast cancer management/treatment and disease upstaging as compared to figures available for our population before the pandemic. However, our study showed significant correlation between disease upstaging and COVID status. This led us to reconsider our preformed protocols for COVID positive breast cancer patients. Our results can be used by future researchers to investigate if COVID itself can contributes in patho-physiology of upstaging in breast cancer or not.
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16
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Saeed S, Asim M, Sohail MM. Fears and barriers: problems in breast cancer diagnosis and treatment in Pakistan. BMC WOMENS HEALTH 2021; 21:151. [PMID: 33853583 PMCID: PMC8045297 DOI: 10.1186/s12905-021-01293-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 04/07/2021] [Indexed: 11/28/2022]
Abstract
Background Women in Pakistan lack appropriate awareness about diagnosis and treatment for breast cancer due to a range of multifaceted barriers. There is a dearth of literature examining the socio-cultural factors that inhibit women from breast cancer screening, diagnosis and treatment in Punjab, Pakistan. Addressing this gap, this qualitative study sought to identify and explore the barriers that hinder women from seeking timely screening and treatment. Methods In this process 45 women (age = 18–50 years) with breast cancer were purposively sampled and interviewed from the Punjab Institute of Nuclear Medicine (PINUM) hospital, Faisalabad, Pakistan. Results An inductive approach was used to analyze the data which resulted in the emergence of eight subthemes under the umbrella of three major themes that delineate individual, socio-cultural and structural barriers to seek screening and treatment of breast cancer in Punjab. Individual barriers included lack of awareness, hesitance in accepting social support, and spiritual healing. The identified socio-cultural factors included feminine sensitivity, stigmatization, and aversion to male doctors. Lack of financial resources and apathetic medical services were structural barriers that hinder screening and treatment. Conclusions These barriers can be addressed through raising awareness and community mobilization about breast-self exam and treatment. The healthcare system should also pay attention to socio-psychological and cultural factors impeding women's access to available health facilities. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01293-6.
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Affiliation(s)
- Sidra Saeed
- Department of Sociology and Social Research, University of Trento, Trento, Italy
| | - Muhammad Asim
- Department of Community Health Sciences, Aga Khan University, Stadium Road, PO Box 3500, Karachi, 74800, Pakistan.
| | - Malik Muhammad Sohail
- Department of Sociology, Institute of Arts and Sciences, Government College University Faisalabad, Chiniot Campus, Chiniot, Pakistan
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17
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Khan NH, Duan SF, Wu DD, Ji XY. Better Reporting and Awareness Campaigns Needed for Breast Cancer in Pakistani Women. Cancer Manag Res 2021; 13:2125-2129. [PMID: 33688255 PMCID: PMC7936924 DOI: 10.2147/cmar.s270671] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 11/12/2020] [Indexed: 01/04/2023] Open
Abstract
Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer deaths in women globally. In 2018, 2.1 million new cases were reported, with 627,000 deaths. Pakistan has the highest incidence rate of breast cancer among Asian countries: one in every nine women has a lifetime risk of being diagnosed with breast cancer. By reason of many misconceptions about the etiology of the disease and socioeconomic factors, Pakistani women have very low rates of early detection and diagnose breast cancer at advance stages with fewer chances of survival. The key to cure the breast cancer is early diagnosis. The aim of current review is to highlight the factors leading to the delays in early presentation of breast cancer in Pakistani women and to summarize possible recommendations for educating women about early diagnosis along with palliative care facilities for patients suffering from breast cancer. Furthermore, this study appeals to both the general public and government in the belief that better reporting and awareness campaigns may bring more women to clinics for early diagnosis.
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Affiliation(s)
- Nazeer Hussain Khan
- Henan International Joint Laboratory for Nuclear Protein Regulation, Henan University, Kaifeng, Henan, 475004, People's Republic of China.,School of Life Sciences, Henan University, Kaifeng, Henan, 475004, People's Republic of China
| | - Shao-Feng Duan
- Institute for Innovative Drug Design and Evaluation, School of Pharmacy, Henan University, Kaifeng, Henan, 475004, People's Republic of China
| | - Dong-Dong Wu
- Henan International Joint Laboratory for Nuclear Protein Regulation, Henan University, Kaifeng, Henan, 475004, People's Republic of China.,School of Basic Medical Sciences, Henan University College of Medicine, Kaifeng, Henan, 475004, People's Republic of China
| | - Xin-Ying Ji
- Henan International Joint Laboratory for Nuclear Protein Regulation, Henan University, Kaifeng, Henan, 475004, People's Republic of China.,School of Basic Medical Sciences, Henan University College of Medicine, Kaifeng, Henan, 475004, People's Republic of China.,Kaifeng Key Laboratory of Infection and Biological Safety, Henan University College of Medicine, Kaifeng, Henan, 475004, People's Republic of China
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18
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Rahool R, Haider G, Hayat M, Shaikh MR, Memon P, Pawan B, Abbas K. Factors Associated With Treatment Delay in Breast Cancer: A Prospective Study. Cureus 2021; 13:e13242. [PMID: 33728191 PMCID: PMC7948313 DOI: 10.7759/cureus.13242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2021] [Indexed: 02/07/2023] Open
Abstract
Introduction The frequency of breast cancer (BC) is increasing among Pakistani females. It has been estimated that one out every nine women is predicted to develop BC, which is the highest disease occurring rate in the Asian population. The study aimed to evaluate the factors responsible for delay in diagnosis of BC in Sindh, Pakistan. Methodology This study was conducted at the Medical Oncology Department of Jinnah Postgraduate Medical Center Karachi from December 2018 to June 2019. All women between 17 and 80 years diagnosed with BC who had treatment delay of more than six months were included in the study using a non-probability consecutive sampling technique. The face-to-face interviews were conducted by the researcher himself and all the data regarding demographics and factors related to treatment delay of BC was noted in a structured questionnaire. Data were analyzed using SPSS version 23 (IBM Corp., Armonk, NY). Results Appointment delay was significantly associated with a treatment-seeking delay in patients (p=0.03). Lack of awareness was another significant factor associated with treatment delay in BC patients. About 50 (70.4%) women who reported a lack of awareness sought treatment after 10 months of their first onset of symptoms (p=0.001). Cultural beliefs were a significant cause of treatment delay of 10-12 months in 71.8% of patients (p=0.021). Financial constraints significantly correlated with treatment delay (p=0.015). Conclusion The cultural beliefs, poor financial status, and lack of awareness are the significant factors for the treatment delay in BC patients. Promoting female health awareness can tackle many of these issues.
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Affiliation(s)
- Raja Rahool
- Oncology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Ghulam Haider
- Oncology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Muhammad Hayat
- Oncology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | | | - Paras Memon
- Oncology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Bhunisha Pawan
- Oncology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Kiran Abbas
- Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK
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