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Prevalence of Themes Linked to Delayed Presentation of Breast Cancer in Africa: A Meta-Analysis of Patient-Reported Studies

Authors :
Olayide S. Agodirin
Isiaka Aremu
Ganiyu A. Rahman
Samuel A. Olatoke
Halimat J. Akande
Adetunji S. Oguntola
Olalekan Olasehinde
Sheriff Ojulari
Amarachukwu Etonyeaku
Julius Olaogun
Anya Romanoff
Source :
JCO Global Oncology, Vol , Iss 6, Pp 731-742 (2020)
Publication Year :
2020
Publisher :
American Society of Clinical Oncology, 2020.

Abstract

PURPOSE The prevalence of themes linked to delay in presentation of breast cancer (BC) and their underlying factors vary considerably throughout Africa. Regional differences and trends are largely unreported. The purpose of this research was to provide summary estimates of the prevalence and distribution of the themes and underlying factors linked to delay in the presentation of BC, regional variation, and trends in an effort to identify targets for intervention. DESIGN We screened articles found through PubMed/Medline, African Journal OnLine, Science Direct, Google/Google Scholar, and ResearchGate. We included patient-reported surveys on the reasons linked to delayed presentation under 6 previously identified themes: symptom misinterpretation, fear, preference for alternative care, social influence, hospital-related factors, and access factors. The meta-analytical procedure in MetaXL used the quality-effect model. RESULTS Twelve of the 236 identified articles were eligible for this review. The overall summary estimate of late presentation (> 90 days) was 54% (95% CI, 23 to 85) and was worst in the eastern and central regions. Symptom misinterpretation was the most common theme (50%; 95% CI, 21 to 56), followed by fear (17%; 95% CI, 3 to 27), hospital-related theme (11%; 95% CI, 1 to 21), preference for alternative care (10%; 95% CI, 0 to 21), social influence (7%; 95% CI, 0 to 14), and access-related theme (6%; 95% CI, 0 to 13). The most common factor underlying symptom misinterpretation was mischaracterizing the breast lesion as benign (60%; 95% CI, 4 to 100) which surpassed lack of awareness in the last decade. Misdiagnosis and failure to refer were the dominant hospital-related factors. CONCLUSION Modifiable factors such as mischaracterizing malignant masses as benign, fear, misdiagnosis, and failure to refer were the prevalent factors contributing to delays throughout Africa. These factors are promising targets for intervention.

Details

Language :
English
ISSN :
26878941
Volume :
6
Issue :
6
Database :
Directory of Open Access Journals
Journal :
JCO Global Oncology
Publication Type :
Academic Journal
Accession number :
edsdoj.842fee0c04bd43be9460401ae42e7252
Document Type :
article
Full Text :
https://doi.org/10.1200/JGO.19.00402