Late-Stage Diagnosis and Associated Factors Among Breast Cancer Patients in South and Southwest Ethiopia: A Multicenter Study |
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| Authors: | Aragaw Tesfaw Sefonias Getachew Adamu Addissie Ahmedin Jemal Andreas Wienke Lesley Taylor Eva Johanna Kantelhardt |
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| Affiliation: | 1. Department of Public Health, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia;2. Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia;3. Institute of Medical Epidemiology, Biometrics, and Informatics, Martin-Luther-University Halle-Wittenberg, Germany;4. Department of Gynaecology, Martin-Luther-University Halle-Wittenberg, Germany;5. American Cancer Society, Surveillance & Health Services Research, Atlanta, GA;6. City of Hope National Medical Center, Division of Breast Surgery, Department of Surgery, Duarte, Los Angeles County, CA;1. Department of Surgery, Mercy Breast Clinic, Coletta, Oklahoma City, OK;2. Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL;3. Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL;1. Allina Health System, Virginia Piper Cancer Institute, Minneapolis, MN;2. Hospital Pathology Associates, Allina Health Laboratories, Minneapolis, MN;3. Research Informatics, Allina Health System, Minneapolis, MN;1. Medical Imaging Research Center, Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran;2. Health Behavior Science Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;3. Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran;4. Sutter Imaging (SMG)-Sacramento, Department of Nuclear Medicine and Radiology (W.O.S), University of California Davis Medical Center, Sacramento, CA;5. Department of Radiology, University of California San Diego Health, La Jolla, CA;6. Breast Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;1. Department of Medicine, Medical College of Wisconsin, Milwaukee, WI;2. Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI;3. Department of Pharmacy, Froedtert & the Medical College of Wisconsin, Milwaukee, WI;4. Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI;1. Department of Radiology, Mayo Clinic, Phoenix, AZ;2. Department of Radiology, Mayo Clinic, Rochester, MN;1. University of Alabama School of Medicine, University of Alabama at Birmingham, Birmingham, AL;2. Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, AL;3. Division of Preventative Medicine, University of Alabama at Birmingham, Birmingham, AL;4. School of Nursing, University of Alabama at Birmingham, Birmingham, AL;5. School of Health Professions, University of Alabama at Birmingham, Birmingham, AL;6. Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA;7. Mitchell Cancer Institute, University of South Alabama, Mobile, AL |
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| Abstract: | BackgroundBreast cancer is a leading cause of cancer death in women in low- and middle-income countries, largely because of late-stage diagnosis. Yet studies are very limited in the Ethiopian context. Therefore, we determined the occurrence of late-stage disease and associated factors in selected public hospitals in south and southwest Ethiopia.Patients and MethodsA 5-year retrospective cross-sectional study was conducted on breast cancer patient medical records from January 2013 to December 2017 in 6 hospitals. Multivariable logistic regression was performed to identify factors associated with late-stage disease (stage III and IV). Adjusted odds ratios (AOR) with 95% confidence intervals were used. P < .05 was considered statistically significant.ResultsOverall, 426 breast cancer patients were identified, and 72.5% were diagnosed with late-stage disease. The mean ± standard deviation patient age was 42.8 ± 13.4 years. Factors associated with late diagnosis were patient delay in seeking care (AOR = 2.50; 95% confidence interval [CI], 1.51-4.16); health system delays (AOR = 1.62; 95% CI, 1.02-2.59); female sex (AOR = 3.46; 95% CI, 1.50-7.98); rural residence (AOR = 2.37; 95% CI, 1.45-3.86); chief complaint of breast lump (AOR = 3.01; 95% CI, 1.49-6.07); and history of comorbidities (AOR = 1.72; 95% CI, 1.02-2.91).ConclusionThe majority of patients were diagnosed with late-stage diagnosis of breast cancer. Patient delays in seeking care, health system delays, being female, rural residence, and patient comorbidities were associated factors. These findings provide evidence that efforts to increase public and health provider awareness to promote early breast cancer diagnosis, particularly in rural areas, are needed in south and southwest Ethiopia. |
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| Keywords: | Delay Ethiopia Health system Late-stage disease Rural |
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