Prevalence and Factors Associated With Delay in Presentation of Breast Cancer Patients in Ethiopia: A Cross-Sectional Institution-Based Study

Abstract

Background: In developing countries, the high mortality of breast cancer (BC) patients is strongly related to delayed presentation and subsequent advanced stage diagnosis, pointing to the need for improved detection programs. This study aims to assess the prevalence and factors associated with delayed presentation of BC patients at Hawassa University Oncology Center (HUOC), Hawassa, Ethiopia. Methods: A cross-sectional institution-based survey was conducted among BC patients between May 1st and August 30th, 2021. BC patients attending HUOC were included by consecutive sampling. Data was collected using an interviewer-administered questionnaire and medical record data extraction. A multivariable binary logistic regression model was carried out to identify associations between delayed presentation and potential risk factors. Results: A total of 150 BC patients participated in the study giving a response rate of 100%. Of these, 86 (57.3%) women presented with a long delay of ≥ 3 months. The median time to visit a health care provider after recognition of the first symptoms was 5.5 months. Urban residence (adjusted odds ratio (AOR) = 0.42; 95 %-CI=0.18-0.97) and not visiting of traditional healer (AOR=0.15, 95 %-CI=0.07-0.34) was associated with shorter delay time. No breast pain symptoms (AOR=8.57; 95 %-CI=3.47-21.15), no family history of BC (AOR=5.12; 95 %-CI=1.36-19.33), and travel distance ≥ 5 km (AOR=3.00, 95 %-CI=1.25-7.21) were associated with longer delay in presentation. Conclusion: A substantial proportion of patients with BC in southern Ethiopia have delays in seeking medical care. Interventional programs like public BC awareness campaigns are strongly needed to reduce delayed presentation and to increase early detection of cancer cases.