Determinants of late detection and advanced-stage diagnosis of breast cancer in Nigeria

Abstract

Late detection of Breast cancer(BC) and progressing with advanced-stage diagnosis after early detection contribute differently to the challenges of managing BC in Africa. Understanding the difference may improve cancer education programs and their effectiveness. Objective To describe the risk factors for late detection and advanced-stage diagnosis among patients who detected their BC early. Method Using secondary data, we analyzed the impact of socio-demographic factors, premorbid experience, BC knowledge, and health-seeking pattern on the risk of late detection and advanced-stage diagnosis after early BC detection. Test of statistical significance in SPSS and EasyR was set at 5% using Sign-test, chi-square tests (of independence and goodness of fit), odds ratio, or risk ratio as appropriate. Result Most socio-demographic factors did not affect detection size or risk of disease progression in the 405 records analyzed. High BC knowledge, p-value = 0.001, and practicing breast self-examination (BSE) increased early detection, p-value = 0.04, with a higher probability (OR 1.6 (95% CI 1.1–2.5) of detecting <2cm lesions. Visiting alternative care (RR 1.5(95% CI 1.2–1.9), low BC knowledge (RR 1.3(95% CI 1.1–1.9), and registering concerns for hospital care increased the risk of advanced-stage diagnosis after early detection (64% (95% CI 55–72)). Adhering to the monthly BSE schedule reduced the risk of advanced-stage diagnosis by -25% (95% CI -49, -1.1) in the presence of socioeconomic barriers. Conclusion Strategies to increase BC knowledge and BSE may help BC downstaging, especially among women with common barriers to early diagnosis.

Knowledge regarding breast cancer among Congolese women in Kinshasa, Democratic Republic of the Congo

“…20 Increased knowledge of risk factors, symptoms/signs, and screening methods of BC will lead to early BC diagnosis and management and a high survival rate. 21 The present study showed poor BC knowledge among respondents in general. The results of the survey showed that there is a small proportion of respondents (22.09%) with good knowledge on the set of items evaluated, including knowledge of signs/symptoms, risk factors, and screening methods of BC.…”

“… 20 Increased knowledge of risk factors, symptoms/signs, and screening methods of BC will lead to early BC diagnosis and management and a high survival rate. 21 …”

“…The breast cancer awareness is vital in disease diagnosis and prevention, and primary healthcare clinics are the health system's first point of contact with women and families 20 . Increased knowledge of risk factors, symptoms/signs, and screening methods of BC will lead to early BC diagnosis and management and a high survival rate 21 …”

The social determinants associated with decreased rate of breast cancer screening, delayed presentation, and advanced stage diagnosis of breast cancer: A systematic review

“…Education inequalities were significantly associated with rate of BCS performance, diagnostic journey, and stage of BC diagnosis. Several studies claimed that highly educated individuals were more likely to practice BCS, have shorter delay, and were less likely to present at advanced stages compared to those with low educational level (5,8,14,15,17–20,22,28,29,31–33,36,40,44,49,51). This could be explained by the fact that individuals with low educational level are less likely to be offered good paying jobs; subsequently, they cannot afford access to healthcare.…”

“…In contrast, other three studies with much less sample sizes (one in Thailand, one in Colombia and one in Korea) concluded that older patients had higher odds of getting diagnosed at late stages compared to younger patients (36–38). Moreover, four other studies that have been conducted in three African countries (two in Nigeria, one in South Africa, and one in Ethiopia) concluded that age was not significantly associated with advanced stage diagnosis of BC (4,5,39,40).…”