Factors influencing diagnosis delay of advanced breast cancer in Moroccan womenReport as inadecuate




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BMC Cancer

, 16:356

Epidemiology, prevention and public health

Abstract

BackgroundDelay in the diagnosis of breast cancer in symptomatic women of 3 months or more is associated with advanced stage and low survival. We conducted this study to learn more about the extent and reasons behind diagnosis delay of advanced breast cancer in Moroccan women.

MethodsA group of patients with advanced breast cancer were interviewed at the National Institute of Oncology in Rabat during the period from February to December 2014. Diagnosis delay was devised into patient delay and system delay. Patient delay was defined as time from first symptoms until first medical consultation. System delay was defined as time from first presentation to a health care provider until definite diagnosis or treatment. Prospective information and clinical data were collected on a form during an interview with each patient and from medical records.

ResultsIn all, 137 patients were interviewed. The mean age of women was 48.3 ± 10.4 years. The median of consultation time was 64,12 months and the median of diagnosis time was 11,3 months. Diagnosis delay was associated to a personal reason in 96 70.1 % patients and to a medical reason in 19 13.9 % patients. A number of factors predicted diagnosis delay: symptoms were not considered serious in 66 55.9 % patients; traditional therapy was applied in 15 12.7 % patients and fear of cancer diagnosis and-or treatment in 14 11.9 % patients. A use of traditional methods was significantly associated with rural residence and far away from basic health center p = 0.000. Paradoxically, a family history of breast cancer was significantly higher in who report a fear of cancer diagnosis and-or treatment to diagnosis delay p < 0.001. Also, a significantly higher risk of more than 6 months delay was found among rural women P = 0.035 and women who live far away from specialized care center P = 0.001.

ConclusionsDiagnosis delay is very serious problem in Morocco. Diagnosis delay was associated with complex interactions between several factors and with advanced stages. There is a need for improving breast cancer information in our populations and training of general practitioners to reduce advanced breast cancer by promoting early detection.

KeywordsBreast cancer Diagnosis delay Patient delay System delay Electronic supplementary materialThe online version of this article doi:10.1186-s12885-016-2394-y contains supplementary material, which is available to authorized users.

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Author: A. Maghous - F. Rais - S. Ahid - N. Benhmidou - K. Bellahamou - H. Loughlimi - E. Marnouche - S. Elmajjaoui - H. Elkacemi

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