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Behrad MS, Rashed F, Zarabi A, Saidi S. Stage at Diagnosis and Patient Delay among Breast Cancer Women in Kabul, Afghanistan. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Breast cancer is the commonest cause of mortality among women. According to WHO in 2012, about 7400 women died because of cancers in Afghanistan.
Aim: To obtain information about clinical stages of breast cancer of women at the time of diagnosis in Kabul, Afghanistan.
Patient and Method: This was a cross-sectional study of 240 women diagnosed with breast cancer from March 2016 to March 2019. The diagnosis of breast cancer was made by the surgeon on the basis of physical examination and Biopsy/Pathological reports. Clinical staging of the tumor was recorded according to the tumor, nodal, and metastasis (TNM) classification. The gap between knowing the problem and consulting a physician (Patient delay) was categorized: less than 3 months, 3-6 months and more than 6 months.
Results:
The mean age of patients was 49.31 years (SD ± 11.80) ranging from 18 to 76 years. The Patient delay was more than 6 months (65%). Infiltrating ductal carcinoma was the commonest morphological type (76.7%). Breast cancer in left breast of patients was 52.1%. Stage II was higher in left and stage III in right breast. The majority of patients were in stage II & III at the time of diagnosis. All stages were frequent in fourth decades of age group. The association between the clinical stages of breast cancer at the time of diagnosis, the age and breast R/L involvement of the patients was significant (P<0.001). The association between clinical stage and marital status was not significant (P<0.953).
Conclusion:
Late referrals, diagnosis delay and advanced stages of breast cancer are still a serious problem in Afghanistan. Cancer in right breast should be given more attention because higher stages of the disease are expected. Awareness and social education is great need.
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Hutajulu SH, Prabandari YS, Bintoro BS, Wiranata JA, Widiastuti M, Suryani ND, Saptari RG, Taroeno-Hariadi KW, Kurnianda J, Purwanto I, Hardianti MS, Allsop MJ. Delays in the presentation and diagnosis of women with breast cancer in Yogyakarta, Indonesia: A retrospective observational study. PLoS One 2022; 17:e0262468. [PMID: 35025941 PMCID: PMC8757982 DOI: 10.1371/journal.pone.0262468] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 12/23/2021] [Indexed: 11/19/2022] Open
Abstract
Purpose
To investigate factors associated with delays in presentation and diagnosis of women with confirmed breast cancer (BC).
Methods
A cross-sectional study nested in an ongoing prospective cohort study of breast cancer patients at Dr Sardjito Hospital, Yogyakarta, Indonesia, was employed. Participants (n = 150) from the main study were recruited, with secondary information on demographic, clinical, and tumor variables collected from the study database. A questionnaire was used to gather data on other socioeconomic variables, herbal consumption, number of healthcare visits, knowledge-attitude-practice of BC, and open-ended questions relating to initial presentation. Presentation delay (time between initial symptom and first consultation) was defined as ≥3 months. Diagnosis delay was defined as ≥1 month between presentation and diagnosis confirmation. Impact on disease stage and determinants of both delays were examined. A Kruskal-Wallis test was used to assess the length and distribution of delays by disease stage. A multivariable logistic regression analysis was conducted to explore the association between delays, cancer stage and factors.
Results
Sixty-five (43.3%) patients had a ≥3-month presentation delay and 97 (64.7%) had a diagnosis confirmation by ≥1 month. Both presentation and diagnosis delays increased the risk of being diagnosed with cancer stage III-IV (odds ratio/OR 2.21, 95% CI 0.97–5.01, p = 0.059 and OR 3.03, 95% CI 1.28–7.19, p = 0.012). Visit to providers ≤3 times was significantly attributed to a reduced diagnosis delay (OR 0.15, 95% CI 0.06–0.37, p <0.001), while having a family history of cancer was significantly associated with increased diagnosis delay (OR 2.28, 95% CI 1.03–5.04, p = 0.042). The most frequent reasons for delaying presentation were lack of awareness of the cause of symptoms (41.5%), low perceived severity (27.7%) and fear of surgery intervention (26.2%).
Conclusions
Almost half of BC patients in our setting had a delay in presentation and 64.7% experienced a delay in diagnosis. These delays increased the likelihood of presentation with a more advanced stage of disease. Future research is required in Indonesia to explore the feasibility of evidence-based approaches to reducing delays at both levels, including educational interventions to increase awareness of BC symptoms and reducing existing complex and convoluted referral pathways for patients suspected of having cancer.
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Affiliation(s)
- Susanna Hilda Hutajulu
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia
- * E-mail:
| | - Yayi Suryo Prabandari
- Department of Health Behaviour, Environment, and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Center of Health Behaviour and Promotion, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Bagas Suryo Bintoro
- Department of Health Behaviour, Environment, and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Center of Health Behaviour and Promotion, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Juan Adrian Wiranata
- Medical Internship Program, Academic Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Mentari Widiastuti
- Center of Health Behaviour and Promotion, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Norma Dewi Suryani
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Dr Sardjito Hospital, Yogyakarta, Indonesia
| | - Rorenz Geraldi Saptari
- Medicine Study Program, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Kartika Widayati Taroeno-Hariadi
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Johan Kurnianda
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ibnu Purwanto
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Mardiah Suci Hardianti
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Matthew John Allsop
- Leeds Institute of Health Sciences, School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
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Baig M, Sohail I, Altaf HN, Altaf OS. Factors influencing delayed presentation of breast cancer at a tertiary care hospital in Pakistan. Cancer Rep (Hoboken) 2019; 2:e1141. [PMID: 32721102 DOI: 10.1002/cnr2.1141] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 09/09/2018] [Accepted: 09/11/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Breast cancer is the leading cause of death despite the continuous development of newer and more effective modalities of treatment for breast cancer. In Asia, Pakistan has the highest rate of breast cancer. Breast cancer treatment shows better prognosis when it is diagnosed at an early stage, but mortality increases significantly with delayed diagnosis and advanced stage of disease. Delay in diagnosis and nonavailability of treatment are the major factors responsible for advanced stage and low survival. AIMS The objective of our study was to identify the factors responsible for delayed presentation of patients with breast carcinoma. METHODS AND RESULTS A cross-sectional study using a questionnaire method was conducted at the Foundation University Medical College from January 2015 to December 2016. A total of 89 patients gave consent and were interviewed using a prestructured questionnaire during the study. Age ranged from 25 to 64 years. Majority of patients were in stage T3N1M0 (31.5%). Second most common stage was T4N0M0 (14.6%). Thirteen patients (12.4%) were in stage T3N0M0, and 10 patients (11.2%) were in T3N2M0. Delay ranged from 3 months to more than 1 year; 43.8% presented with delay of 3 to 6 months. The reasons for delay were lack of knowledge about breast cancer (41%), lack of availability of health care services (32.6%), purdah and religious reasons (6.7%), and fear of being diagnosed with cancer (10.1%). CONCLUSION The main reasons for delay identified in our study were lack of knowledge and availability of appropriate health care facilities. In order to improve outcome of breast cancer, more focus is needed on spreading awareness and improving health care services in rural areas.
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Affiliation(s)
- Mehreen Baig
- MRCS General Surgery, Department of surgery, Surgical Unit I, Foundation University Medical College, Rawalpindi, Pakistan
| | - Iram Sohail
- FRCS Histopathology, Department of Pathology, Foundation University Medical College, Rawalpindi, Pakistan
| | - Humera Naz Altaf
- FCPS General Surgery, Department of Surgery, Shifa College of Medicine, Shifa Tameer e' Millat University, Islamabad, Pakistan
| | - Omar Shahzad Altaf
- Tehsil Head Quarter Hospital Hazro Khebar Pakhtoonkhawa, Hazro, Pakistan
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Gulzar F, Akhtar MS, Sadiq R, Bashir S, Jamil S, Baig SM. Identifying the reasons for delayed presentation of Pakistani breast cancer patients at a tertiary care hospital. Cancer Manag Res 2019; 11:1087-1096. [PMID: 30774437 PMCID: PMC6357878 DOI: 10.2147/cmar.s180388] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Background Delay in seeking health care by breast cancer patients is associated with advanced stage of disease at presentation and poor survival rates. This study aimed to identify the reasons for delayed presentation and their association with various sociodemographic variables. Methods A total of 200 female patients with abnormal clinical findings, ie, lump or palpable mass, were consecutively invited for this study. Diagnostic delay was defined as a consultation with a health care provider more than 3 months from the appearance of the first symptoms. Sociodemographic variables, presenting symptoms, knowledge about diseases and its symptoms, time between seeking medical attention after appearance of symptoms and causes of delayed presentation were investigated. Chi-squared and logistic regression tests for significance and associations were used. Results Among 125 women with breast cancer fulfilling the inclusion criteria, aged 24–75 years, 88.8% (n=111) presented late (≥3 months) and 59% presented with advanced stage of disease (stage III/IV). The majority (65.6%) were older than 40 years of age, 99.2% were married, 60.8% had <8 years of education, 67.2% had poor social status, and 64.8% had a negative family history of any cancer type. Almost all patients (96%) complained about the presence of a painless lump in their breast. Ignorance of disease or the presence of painless lumps in the breast and low financial resources for therapy (81.1%) were the main variables associated with delayed presentation. Educational factors (P<0.001, OR 4.682) and social status (P<0.001, OR 1.8) were also associated with delayed presentation. Conclusion Our study highlighted the variables associated with delayed presentation in Pakistani breast cancer patients. A significant number of patients presented late owing to misconceptions and poor knowledge about the disease and its symptoms, while illiteracy and poor social status were the major contributing factors for delayed presentation, resulting in an advanced presentation of disease and ultimately a decreased survival rate.
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Affiliation(s)
- Faisal Gulzar
- Department of Pharmacology, College of Pharmacy, University of Sargodha, Sargodha, Punjab, Pakistan, .,Department of Pharmacology, Faculty of Pharmacy, The University of Lahore, Lahore, Punjab, Pakistan,
| | - Muhammad Shoaib Akhtar
- Department of Pharmacology, College of Pharmacy, University of Sargodha, Sargodha, Punjab, Pakistan,
| | - Rafshan Sadiq
- Punjab Institute for Nuclear Medicines (PINUM) Cancer Hospital, Faisalabad, Punjab, Pakistan
| | - Sajid Bashir
- Department of Pharmacology, College of Pharmacy, University of Sargodha, Sargodha, Punjab, Pakistan,
| | - Sajida Jamil
- Department of Pharmacology, Faculty of Pharmacy, The University of Lahore, Lahore, Punjab, Pakistan,
| | - Shahid Mahmood Baig
- Human Molecular Genetics Laboratory, Health Biotechnology Division, National Institute for Biotechnology and Genetic Engineering (NIBGE), Faisalabad, Punjab, Pakistan, .,Pakistan Institute of Engineering and Applied Sciences (PIEAS), Islamabad, Punjab, Pakistan,
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Analysis of Health Behaviors and Personal Values of Childless Women, Pregnant Women and Women Who Recently Delivered. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15030411. [PMID: 29495488 PMCID: PMC5876956 DOI: 10.3390/ijerph15030411] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 02/08/2018] [Accepted: 02/25/2018] [Indexed: 11/25/2022]
Abstract
Preconception lifestyle modifications and reduction of several known risk factors may have an influence on future pregnancy outcomes. The aim of the study was to analyze health behaviors and personal values as well as to assess the relationship between these factors in women without children, in pregnant women and in women who had already delivered babies. The questionnaire survey included the Health Behavior Inventory (HBI), the Personal Value List (PVL) and sociodemographic data and was conducted in 538 women. These women were divided into three groups: women who had recently delivered (n = 235), pregnant women (n = 121) and childless women (n = 182). Pregnant women demonstrated a significantly higher level of declared health behaviors, and also, they rated higher on the subscales values “positive mental attitude” and “health practices”, in comparison to women who had recently delivered and to childless women. In all tested groups, the highest rated personal value was “a successful family life”, while the most appreciated symbol of happiness was “love and friendship”. Our results suggest that the system of values and the perception of happiness symbols may influence women’s health behaviors. Positioning “health” in the hierarchy of personal values as the most important one may facilitate the introduction of healthy behaviors. This, in turn, could reduce several adverse pregnancy outcomes that are potentially modifiable with changing preconception health attitudes. Our results also identify several unanswered questions and highlight areas where new research is needed.
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Awofeso O, Roberts AA, Salako O, Balogun L, Okediji P. Prevalence and Pattern of Late-Stage Presentation in Women with Breast and Cervical Cancers in Lagos University Teaching Hospital, Nigeria. Niger Med J 2018; 59:74-79. [PMID: 31423046 PMCID: PMC6668301 DOI: 10.4103/nmj.nmj_112_17] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Cervical and breast cancers are the most common cancers among women in developing countries contributing to high morbidity and mortality. Even though both these cancers have a better prognosis if caught early; however, studies conducted in Nigeria still show a large incidence of late tumor stage presentation. Objectives: This study aimed at identifying the patient and disease characteristics of women with breast and cervical cancers presenting at a tertiary medical facility in Nigeria, with emphasis on the prevalence of late-stage presentation and reasons for late-stage presentation. Patients and Methods: This cross-sectional study recruited women at Lagos University Teaching Hospital (LUTH) with breast and cervical cancers from April to June 2016; an interviewer-based questionnaire was administered to 105 patients who seen to elicit information needed to achieve the set objectives. Results: The mean age of patients was 51.09 (±11.70) years; majority had no known family history and no health insurance. Most cervical cancer patients were unaware of their human papillomavirus status. About 72.81% of all patients presented late, surprisingly 87.6% of patients presented in an appropriate health-care facility as place of the first contact, but still presented in LUTH at late stages of their disease mostly due to misdiagnosis. Reasons for late presentation included fear, misconceptions, misdiagnosis, ignorance, and prolonged investigation time. Conclusion: As late-stage presentation was associated with both poor health-seeking behavior and health system delays; interventions should not only include increased awareness for the early detection and diagnosis but also measures to ensure improvements in health service delivery to ensure timely diagnosis and the management of breast and cervical cancers.
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Affiliation(s)
- Opeyemi Awofeso
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos State, Nigeria
| | - Alero Ann Roberts
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos State, Nigeria
| | - Omolola Salako
- Department of Radiotherapy and Oncology, Lagos University Teaching Hospital, Lagos State, Nigeria
| | - Lanre Balogun
- General Surgery Unit, Department of Surgery, Lagos University Teaching Hospital, Lagos State, Nigeria
| | - Paul Okediji
- Sebeccly Cancer Care, Yaba, Lagos State, Nigeria
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Mirfarhadi N, Ghanbari A, Khalili M, Rahimi A. Predictive Factors for Diagnosis and Treatment Delay in Iranian Women with Breast Cancer. Nurs Midwifery Stud 2017. [DOI: 10.17795/nmsjournal27452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Mei H, Turale S. Coping experience of health concerns and physical disability for older Chinese people: A qualitative, descriptive study. Nurs Health Sci 2017; 19:444-451. [PMID: 28752946 DOI: 10.1111/nhs.12363] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 03/31/2017] [Accepted: 04/17/2017] [Indexed: 11/27/2022]
Abstract
In this qualitative, descriptive study, we explored the perspectives of older, community-dwelling Chinese people regarding their experiences of coping with a physical disability and their health concerns. Twenty participants were interviewed in-depth, and data were analyzed using content analysis. Five themes with 13 subthemes emerged that described older people's experiences of coping with health concerns and disability: (i) ignoring health concerns; (ii) managing self; (iii) seeking medical help; (iv) living with physical disability; and (v) relying on limited resources. Most participants did not have sufficient access to health services due to physical disability and financial deficits, so they tended to ignore their health conditions or tackle them independently before seeking medical help. At the same time, they were impacted on by social and cultural factors. Policies are required that offer more resources to community-dwelling people with disabilities in China.
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Affiliation(s)
- He Mei
- HOPE School of Nursing, Wuhan University, Wuhan, China
| | - Sue Turale
- HOPE School of Nursing, Wuhan University, Wuhan, China
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Predictive Factors for Diagnosis and Treatment Delay in Iranian Women with Breast Cancer. Nurs Midwifery Stud 2016. [DOI: 10.5812/nmsjournal.27452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Khan MA, Hanif S, Iqbal S, Shahzad MF, Shafique S, Khan MT. Presentation delay in breast cancer patients and its association with sociodemographic factors in North Pakistan. Chin J Cancer Res 2015; 27:288-93. [PMID: 26157325 DOI: 10.3978/j.issn.1000-9604.2015.04.11] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Accepted: 03/02/2015] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND There is strong evidence that delayed diagnosis of breast cancer is associated with poor survival. The objectives were to determine the frequency of breast cancer patients with delayed presentation, the reasons of delay and its association with different socio-demographic variables in our settings. METHODS We interviewed 315 histologically confirmed breast cancer patients. Delay was defined as more than 3 months from appearance of symptoms to the consultation from doctor. Questions were asked from each patient which could reflect their understanding about the disease and which could be the likely reasons for their delayed presentation. RESULTS A total of 39.01% (n=123) of patients presented late and out of those, 40.7% wasted time using alternative medicines; 25.2% were not having enough resources; 17.1% presented late due to painless lump; 10.6% felt shyness and 6.5% presented late due to other reasons. Higher age, negative family history, <8 school years of education and low to middle socio-economic status were significantly associated with delayed presentation (P<0.05). Education and socioeconomic status were two independent variables related to the delayed presentation after adjustment for others [odds ratios (OR) of 2.26, 2.29 and 95% confidence intervals (CI) was 1.25-4.10, 1.06-4.94 respectively]. CONCLUSIONS Significant percentage of women with breast cancer in North Pakistan is experiencing presentation delay due to their misconceptions about the disease. Coordinated efforts with public health department are needed to educate the focused groups and mitigating the barriers identified in the study. Long term impact will be reduced overall burden of the disease in the region.
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Affiliation(s)
- Muhammad Aleem Khan
- 1 Department of Nuclear Medicine, Nuclear Medicine, Oncology and Radiotherapy Institute, Islamabad, Pakistan ; 2 Department of Medicine, Ziauddin Medical University, Kemari Campus, Karachi, Pakistan ; 3 Armed Forces Institute of Cardiology, Rawalpindi, Pakistan ; 4 Department of Physiology, Rawal Institute of Health Sciences, Islamabad, Pakistan ; 5 Nuffield Brentwood Hospital, Brentwood, Essex, UK
| | - Sheharyar Hanif
- 1 Department of Nuclear Medicine, Nuclear Medicine, Oncology and Radiotherapy Institute, Islamabad, Pakistan ; 2 Department of Medicine, Ziauddin Medical University, Kemari Campus, Karachi, Pakistan ; 3 Armed Forces Institute of Cardiology, Rawalpindi, Pakistan ; 4 Department of Physiology, Rawal Institute of Health Sciences, Islamabad, Pakistan ; 5 Nuffield Brentwood Hospital, Brentwood, Essex, UK
| | - Sundas Iqbal
- 1 Department of Nuclear Medicine, Nuclear Medicine, Oncology and Radiotherapy Institute, Islamabad, Pakistan ; 2 Department of Medicine, Ziauddin Medical University, Kemari Campus, Karachi, Pakistan ; 3 Armed Forces Institute of Cardiology, Rawalpindi, Pakistan ; 4 Department of Physiology, Rawal Institute of Health Sciences, Islamabad, Pakistan ; 5 Nuffield Brentwood Hospital, Brentwood, Essex, UK
| | - Muhammad Faheem Shahzad
- 1 Department of Nuclear Medicine, Nuclear Medicine, Oncology and Radiotherapy Institute, Islamabad, Pakistan ; 2 Department of Medicine, Ziauddin Medical University, Kemari Campus, Karachi, Pakistan ; 3 Armed Forces Institute of Cardiology, Rawalpindi, Pakistan ; 4 Department of Physiology, Rawal Institute of Health Sciences, Islamabad, Pakistan ; 5 Nuffield Brentwood Hospital, Brentwood, Essex, UK
| | - Sehrish Shafique
- 1 Department of Nuclear Medicine, Nuclear Medicine, Oncology and Radiotherapy Institute, Islamabad, Pakistan ; 2 Department of Medicine, Ziauddin Medical University, Kemari Campus, Karachi, Pakistan ; 3 Armed Forces Institute of Cardiology, Rawalpindi, Pakistan ; 4 Department of Physiology, Rawal Institute of Health Sciences, Islamabad, Pakistan ; 5 Nuffield Brentwood Hospital, Brentwood, Essex, UK
| | - Muhammad Taha Khan
- 1 Department of Nuclear Medicine, Nuclear Medicine, Oncology and Radiotherapy Institute, Islamabad, Pakistan ; 2 Department of Medicine, Ziauddin Medical University, Kemari Campus, Karachi, Pakistan ; 3 Armed Forces Institute of Cardiology, Rawalpindi, Pakistan ; 4 Department of Physiology, Rawal Institute of Health Sciences, Islamabad, Pakistan ; 5 Nuffield Brentwood Hospital, Brentwood, Essex, UK
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Pakseresht S, Ingle GK, Garg S, Sarafraz N. Stage at diagnosis and delay in seeking medical care among women with breast cancer, delhi, India. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e14490. [PMID: 25763229 PMCID: PMC4341328 DOI: 10.5812/ircmj.14490] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 09/06/2014] [Accepted: 10/18/2014] [Indexed: 11/30/2022]
Abstract
Background: Patients with cancer often delay seeking medical advice in developing countries. It can adversely influence the outcome of disease. Objectives: The present study was performed to determine the stage at diagnosis and delay in seeking medical care among women with breast cancer in Delhi, India. Patients and Methods: This was a cross-sectional study based on a census (case series) approach to reach all women (172) diagnosed with primary breast cancer “detected in surgery Out Patient Department (OPD) from January 2007 to December 2009” at Lok Nayak Hospital, Delhi, India. Patients were interviewed using a self-structure questionnaire. Seeking behavior variables were awareness of problem, first consultation, followed physician's advice, detection of problem, system of medicine and gap between knowing the problem and consultation (patient delay). Statistical Analysis was performed using the Microsoft SPSS-pc version 14.0 statistical program. The analytic methods were used (mean, standard deviation, X2, Fisher's Exact Test, K-S, Kruskal-Wallis) for variables. All statistical tests were performed at a significance level of 5% (P < 0.05). Results: the mean age of women was 46.99 years. 38.4% of women were ≤ 40 years. 61% of women were in stage IV of cancer at the time of diagnosis. The mean duration of gap between knowing the problem and consulting a physician (patients delay) was 10.90 months. There was no significant association between stage of cancer and consultation gap. A significant association was found between the stage of breast cancer and income; women with lower income had a higher stage of breast cancer (P < 005). Conclusions: A significant association was found between ages of women with their delays in consultation. Delay is still prevalent amongst women with breast cancer. It seems necessary to design educating programs for women in both clinical and community settings, about breast cancer and early detection practices.
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Affiliation(s)
- Sedigheh Pakseresht
- Reproductive Health Research Center, Department of Obstetrics, Guilan University of Medical Sciences, Rasht, IR Iran
| | - Gopal Krishna Ingle
- Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
| | - Suneela Garg
- Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
| | - Nahid Sarafraz
- Department of Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran
- Corresponding Author: Nahid Sarafraz, Department of Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-9132614866, Fax: +98-3615556633, E-mail:
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