Late Presentation of Breast Cancer in Lower- and Middle-Income Countries

Clegg‐Lamptey, Joe‐Nat; Vanderpuye, Verna; Dedey, Florence

doi:10.1007/s12609-019-00312-8

Cited by 9 publications

(11 citation statements)

References 88 publications

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“…Malaysian women also tend to present late with breast cancer; more than half (52.2%) of the female population present with advanced-stage cancer (5,6). Delays between symptom onset and treatment lead to poorer BC survival (7,8). BC screening increases the chance that malignant tumours will be detected and treated earlier to improve survival.…”

Section: Introductionmentioning

confidence: 99%

Breast cancer and breast cancer screening use - beliefs and behaviours in a nationwide study in Malaysia

Tan

Jamil

Ismail

et al. 2023

Preprint

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Background Many upper-middle-income countries (UMICs), including Malaysia, continue to face low breast cancer (BC) screening rates and patients with delayed presentation of BC. This study investigated the role of beliefs about BC and use of screening (e.g. beliefs about whether or not screening reduced the possibility of dying from BC). Methods A nationwide cross-sectional study was conducted in which a total of 813 women (aged ≥ 40 years old) were randomly selected and surveyed using the validated Awareness and Beliefs about Cancer (ABC) measure. The association between BC screening use, sociodemographic characteristics, and negative beliefs about BC screening were analysed using stepwise Poisson regressions. Results Seven out of ten Malaysian women believed that BC screening was necessary only if and when they started experiencing cancer symptoms. Women > 50 years and from households with more than one car or motorcycle were 1.6 times more likely to attend a mammogram or a clinical breast examination (mammogram: PR = 1.60, 95% CI = 1.19–2.14, CBE: PR = 1.61, 95%CI 1.29–1.99). Approximately one quarter of women (23%) reported anticipated anxiety about attending BC screening to the extent that they would avoid undergoing the procedure. Women who held negative beliefs about BC screening were 37% less likely to attend a mammogram (PR = 0.63, 95% CI = 0.42–0.94) and 24% less likely to seek a CBE (PR = 0.75, 95% CI = 0.60–0.95). Conclusions There is a need for public health strategies designed to change beliefs about BC screening among Malaysian women as a way of increasing uptake and impacting on late presentation and advanced cancer. The results provide insights about targeting of public health strategies – women with BC screening uptake-inhibiting beliefs tend to be under 50 years, in the lower income group (that do not own a car or a motorcycle) and more likely to be ethnic Malay or Indian (compared to Chinese-Malay).

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Section: Introductionmentioning

confidence: 99%

Breast cancer and breast cancer screening use - beliefs and behaviours in a nationwide study in Malaysia

Tan

Jamil

Ismail

et al. 2023

Preprint

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“…Cancer incidence and mortality are predicted to increase to 30.2 million cases and 16.3 million deaths by 2040, respectively, because of aging populations and the adoption of unhealthy lifestyles [ 2 ]. Delay between symptom onset and treatment leads to poorer cancer survival [ 3 ]. Screening increases the chance of early detection and treatment and, ultimately, survival.…”

Section: Introductionmentioning

confidence: 99%

mHealth Interventions to Improve Cancer Screening and Early Detection: Scoping Review of Reviews

Schliemann¹,

Tan²,

Hoe³

et al. 2022

J Med Internet Res

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Background Cancer screening provision in resource-constrained settings tends to be opportunistic, and uptake tends to be low, leading to delayed presentation and treatment and poor survival. Objective The aim of this study was to identify, review, map, and summarize findings from different types of literature reviews on the use of mobile health (mHealth) technologies to improve the uptake of cancer screening. Methods The review methodology was guided by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Ovid MEDLINE, PyscINFO, and Embase were searched from inception to May 2021. The eligible criteria included reviews that focused on studies of interventions that used mobile phone devices to promote and deliver cancer screening and described the effectiveness or implementation of mHealth intervention outcomes. Key data fields such as study aims, types of cancer, mHealth formats, and outcomes were extracted, and the data were analyzed to address the objective of the review. Results Our initial search identified 1981 titles, of which 12 (0.61%) reviews met the inclusion criteria (systematic reviews: n=6, 50%; scoping reviews: n=4, 33%; rapid reviews: n=1, 8%; narrative reviews: n=1, 8%). Most (57/67, 85%) of the interventions targeted breast and cervical cancer awareness and screening uptake. The most commonly used mHealth technologies for increasing cancer screening uptake were SMS text messages and telephone calls. Overall, mHealth interventions increased knowledge about screening and had high acceptance among participants. The likelihood of achieving improved uptake-related outcomes increased when interventions used >1 mode of communication (telephone reminders, physical invitation letters, and educational pamphlets) together with mHealth. Conclusions mHealth interventions increase cancer screening uptake, although multiple modes used in combination seem to be more effective.

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“… 3 4 Consequently, most people living in LMICs are not diagnosed until their cancer is on advanced stage. 5 Individuals with treatable cancer must receive treatment at dedicated comprehensive cancer centres, which are scarce and may be costly and far from their home. 6 Further, cancer management requires long-term treatment and adherence to follow-up care visits, but loss to follow-up remains a major issue in LMICs.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…However, the capacity to diagnose cancer is scarce in LMICs given that many hospitals and health clinics are not equipped with the adequate medical equipment or laboratories to diagnose cancer 3 4. Consequently, most people living in LMICs are not diagnosed until their cancer is on advanced stage 5. Individuals with treatable cancer must receive treatment at dedicated comprehensive cancer centres, which are scarce and may be costly and far from their home 6.…”

Section: Introductionmentioning

confidence: 99%

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Impact of COVID-19 on access to cancer care in Rwanda: a retrospective time-series study using electronic medical records data

Habinshuti¹,

Nshimyiryo²,

Fejfar

et al. 2022

BMJ Open

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IntroductionThe COVID-19 pandemic has caused disruptions in access to routine healthcare services worldwide, with a particularly high impact on chronic care patients and low and middle-income countries. In this study, we used routinely collected electronic medical records data to assess the impact of the COVID-19 pandemic on access to cancer care at the Butaro Cancer Center of Excellence (BCCOE) in rural Rwanda.MethodsWe conducted a retrospective time-series study among all Rwandan patients who received cancer care at the BCCOE between 1 January 2016 and 31 July 2021. The primary outcomes of interest included a comparison of the number of patients who were predicted based on time-series models of pre-COVID-19 trends versus the actual number of patients who presented during the COVID-19 period (between March 2020 and July 2021) across four key indicators: the number of new patients, number of scheduled appointments, number of clinical visits attended and the proportion of scheduled appointments completed on time.ResultsIn total, 8970 patients (7140 patients enrolled before COVID-19 and 1830 patients enrolled during COVID-19) were included in this study. During the COVID-19 period, enrolment of new patients dropped by 21.7% (95% prediction interval (PI): −31.3%, −11.7%) compared with the pre-COVID-19 period. Similarly, the number of clinical visits was 25.0% (95% PI: −31.1%, −19.1%) lower than expected and the proportion of scheduled visits completed on time was 27.9% (95% PI: −39.8%, −14.1%) lower than expected. However, the number of scheduled visits did not deviate significantly from expected.ConclusionAlthough scheduling procedures for visits continued as expected, our findings reveal that the COVID-19 pandemic interrupted patients’ ability to access cancer care and attend scheduled appointments at the BCCOE. This interruption in care suggests delayed diagnosis and loss to follow-up, potentially resulting in a higher rate of negative health outcomes among cancer patients in Rwanda.

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Late Presentation of Breast Cancer in Lower- and Middle-Income Countries

Cited by 9 publications

References 88 publications

Breast cancer and breast cancer screening use - beliefs and behaviours in a nationwide study in Malaysia

Breast cancer and breast cancer screening use - beliefs and behaviours in a nationwide study in Malaysia

mHealth Interventions to Improve Cancer Screening and Early Detection: Scoping Review of Reviews

Impact of COVID-19 on access to cancer care in Rwanda: a retrospective time-series study using electronic medical records data

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