Patient Delay in Breast Cancer Diagnosis in Two Hospitals in Karachi, Pakistan: Preventive and Life-Saving Measures Needed
PURPOSE Patients with breast cancer in Pakistan commonly present with advanced disease. The objectives of this study were to evaluate the frequency and length of delays in seeking medical consultation and to assess the factors associated with them. METHODS Four hundred ninety-nine patients with newl...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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American Society of Clinical Oncology
2020-11-01
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| Series: | JCO Global Oncology |
| Online Access: | https://ascopubs.org/doi/10.1200/GO.20.00034 |
| _version_ | 1830230490472251392 |
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| author | Uzma Shamsi Shaista Khan Iqbal Azam Shaheryar Usman Amir Maqbool Tiffany Gill Romaina Iqbal David Callen |
| author_facet | Uzma Shamsi Shaista Khan Iqbal Azam Shaheryar Usman Amir Maqbool Tiffany Gill Romaina Iqbal David Callen |
| author_sort | Uzma Shamsi |
| collection | DOAJ |
| description | PURPOSE Patients with breast cancer in Pakistan commonly present with advanced disease. The objectives of this study were to evaluate the frequency and length of delays in seeking medical consultation and to assess the factors associated with them. METHODS Four hundred ninety-nine patients with newly diagnosed breast cancer were enrolled and interviewed over the period from February 2015 to August 2017. Information on sociodemographic factors, delay to medical consultation, stage of breast cancer at presentation, and tumor characteristics of the breast cancer were collected through face-to-face interviews and medical file review. RESULTS The mean (standard deviation) age of patients with breast cancer was 48.0 (12.3) years. The mean (standard deviation) patient delay was 15.7 (25.9) months, with 55.2% of women detecting a breast lump but not seeking a medical consultation because of a lack of awareness about the significance of the lump. A total of 9.4% of the women decided to seek treatment initially using complementary and alternative medicine and traditional treatment; 9.4% of the women presented to a health care provider with a breast lump but no action was taken, and they were wrongly reassured about the lump without mammography or biopsy. For 26% of the women, the delay in presentation was caused by anxiety, fears and misconceptions regarding diagnosis and treatment, and other social factors including possible adverse effects on their relationship with their husband. Multivariable analysis showed a strong association of lower socioeconomic status (odds ratio [OR], 8.11 [95% CI, 2.46 to 26.69]) and late stage of breast cancer (OR, 4.83 [95% CI, 1.74 to 13.39]) with a patient delay of ≥ 3 months. CONCLUSION Patient delay is a serious problem in Pakistan. There is an urgent need for intensive and comprehensive breast cancer education that addresses the myths and misconceptions related to breast cancer. |
| first_indexed | 2024-12-18T10:55:29Z |
| format | Article |
| id | doaj.art-2ee5edde76264eeda4386110af478d0b |
| institution | Directory Open Access Journal |
| issn | 2687-8941 |
| language | English |
| last_indexed | 2024-12-18T10:55:29Z |
| publishDate | 2020-11-01 |
| publisher | American Society of Clinical Oncology |
| record_format | Article |
| series | JCO Global Oncology |
| spelling | doaj.art-2ee5edde76264eeda4386110af478d0b2022-12-21T21:10:21ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412020-11-01687388310.1200/GO.20.00034Patient Delay in Breast Cancer Diagnosis in Two Hospitals in Karachi, Pakistan: Preventive and Life-Saving Measures NeededUzma Shamsi0Shaista Khan1Iqbal Azam2Shaheryar Usman3Amir Maqbool4Tiffany Gill5Romaina Iqbal6David Callen7Adelaide Medical School, University of Adelaide, Adelaide, AustraliaDepartment of Surgery, Aga Khan University, Karachi, PakistanDepartment of Community Health Sciences, Aga Khan University, Karachi, PakistanDepartment of Community Health Sciences, Aga Khan University, Karachi, PakistanDepartment of Oncology, Karachi Institute of Radiation and Nuclear Medicine Hospital, Karachi, PakistanAdelaide Medical School, University of Adelaide, Adelaide, AustraliaDepartment of Community Health Sciences, Aga Khan University, Karachi, PakistanAdelaide Medical School, University of Adelaide, Adelaide, AustraliaPURPOSE Patients with breast cancer in Pakistan commonly present with advanced disease. The objectives of this study were to evaluate the frequency and length of delays in seeking medical consultation and to assess the factors associated with them. METHODS Four hundred ninety-nine patients with newly diagnosed breast cancer were enrolled and interviewed over the period from February 2015 to August 2017. Information on sociodemographic factors, delay to medical consultation, stage of breast cancer at presentation, and tumor characteristics of the breast cancer were collected through face-to-face interviews and medical file review. RESULTS The mean (standard deviation) age of patients with breast cancer was 48.0 (12.3) years. The mean (standard deviation) patient delay was 15.7 (25.9) months, with 55.2% of women detecting a breast lump but not seeking a medical consultation because of a lack of awareness about the significance of the lump. A total of 9.4% of the women decided to seek treatment initially using complementary and alternative medicine and traditional treatment; 9.4% of the women presented to a health care provider with a breast lump but no action was taken, and they were wrongly reassured about the lump without mammography or biopsy. For 26% of the women, the delay in presentation was caused by anxiety, fears and misconceptions regarding diagnosis and treatment, and other social factors including possible adverse effects on their relationship with their husband. Multivariable analysis showed a strong association of lower socioeconomic status (odds ratio [OR], 8.11 [95% CI, 2.46 to 26.69]) and late stage of breast cancer (OR, 4.83 [95% CI, 1.74 to 13.39]) with a patient delay of ≥ 3 months. CONCLUSION Patient delay is a serious problem in Pakistan. There is an urgent need for intensive and comprehensive breast cancer education that addresses the myths and misconceptions related to breast cancer.https://ascopubs.org/doi/10.1200/GO.20.00034 |
| spellingShingle | Uzma Shamsi Shaista Khan Iqbal Azam Shaheryar Usman Amir Maqbool Tiffany Gill Romaina Iqbal David Callen Patient Delay in Breast Cancer Diagnosis in Two Hospitals in Karachi, Pakistan: Preventive and Life-Saving Measures Needed JCO Global Oncology |
| title | Patient Delay in Breast Cancer Diagnosis in Two Hospitals in Karachi, Pakistan: Preventive and Life-Saving Measures Needed |
| title_full | Patient Delay in Breast Cancer Diagnosis in Two Hospitals in Karachi, Pakistan: Preventive and Life-Saving Measures Needed |
| title_fullStr | Patient Delay in Breast Cancer Diagnosis in Two Hospitals in Karachi, Pakistan: Preventive and Life-Saving Measures Needed |
| title_full_unstemmed | Patient Delay in Breast Cancer Diagnosis in Two Hospitals in Karachi, Pakistan: Preventive and Life-Saving Measures Needed |
| title_short | Patient Delay in Breast Cancer Diagnosis in Two Hospitals in Karachi, Pakistan: Preventive and Life-Saving Measures Needed |
| title_sort | patient delay in breast cancer diagnosis in two hospitals in karachi pakistan preventive and life saving measures needed |
| url | https://ascopubs.org/doi/10.1200/GO.20.00034 |
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