DELAY IN MEDICAL CONSULTATION AMONG WOMEN WITH BREAST CANCER IN WESTERN INDONESIA: A CROSS-SECTIONAL STUDY
DOI:
https://doi.org/10.37268/mjphm/vol.23/no.2/art.1813Abstract
Studies on the role of social context in understanding why breast cancer patients are diagnosed at an advanced stage in developing countries are scarce. This study described delays in medical consultation among women with breast cancer in West Sumatera Province and its related factors. A hospital-based, cross-sectional design was conducted involving 218 respondents. Multiple logistic regression analysis was performed to determine the association between early treatment practices and respondent characteristics, breast cancer knowledge, symptoms, health service utilization, and social capital. The study found that 69.7% of respondents sought health services within three months after the first signs notification. Most of those who postponed medical consultation thought their symptoms did not indicate an illness and were not harmful (48.5%). Delay in medical consultation was related to low education level (OR=4.8, 95% CI: 1.37-16.62) and lower knowledge of breast cancer (OR=2.3, 95% CI: 1.18-4.39) This study found that an increase of one unit in the social capital score resulted in an 11% (0.11) decrease in the odds of delaying medical consultation for breast cancer (95% CI: 0.19-0.02). One-third of breast cancer patients were found to have delayed medical consultation, related to lower education level, inadequate knowledge of breast cancer, and lack of social capital. Therefore, education on the importance of prompt medical consultation should reach all community members. Social capital building is needed to introduce the message of early detection and early treatment of breast cancer for community members to share.
References
Stewart B, Wild CP. World Cancer Report 2014. Lyon: International Agency for Research on Cancer; 2014. 2015.
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer Journal for Clinicians. 2018;68(6):394-424.
World Health Organization. Breast Cancer. 2021; https://www.who.int/news-room/fact-sheets/detail/breast-cancer.
Brinton LA, Figueroa JD, Awuah B, et al. Breast cancer in Sub-Saharan Africa: opportunities for prevention. Journal Breast cancer research treatment. 2014;144(3):467-478.
Kantelhardt EJ, Frie KG. How advanced is breast cancer in Africa? The Lancet Global Health. 2016;4(12):e875-e876.
Cancer IAfRo, Organization WH. Breast Cancer Estimated Incidence, Mortality and Prevalence Worldwide. Globocan 2012. World Health Organization. 2012.
Francies FZ, Hull R, Khanyile R, Dlamini Z. Breast cancer in low-middle income countries: abnormality in splicing and lack of targeted treatment options. American journal of cancer research. 2020;10(5):1568.
Youlden DR, Cramb SM, Yip CH, Baade PD. Incidence and mortality of female breast cancer in the Asia-Pacific region. Cancer Biol Med. 2014;11(2):101-115.
Poum A, Promthet S, Duffy SW, Parkin DM. Factors associated with delayed diagnosis of breast cancer in northeast Thailand. Journal of epidemiology. 2014;24(2):102-108.
Sankaranarayanan R, Ramadas K, Qiao YL. Managing the changing burden of cancer in Asia. BMC Med. 2014;12:3.
Caplan LS, May DS, Richardson LC. Time to diagnosis and treatment of breast cancer: results from the National Breast and Cervical Cancer Early Detection Program, 1991-1995. Am J Public Health. 2000;90(1):130-134.
Caplan L. Delay in breast cancer: implications for stage at diagnosis and survival. Front Public Health. 2014;2:87.
Richards M, Westcombe A, Love S, Littlejohns P, Ramirez A. Influence of delay on survival in patients with breast cancer: a systematic review. The Lancet. 1999;353(9159):1119-1126.
Rivera-Franco MM, Leon-Rodriguez E. Delays in breast cancer detection and treatment in developing countries. Journal of Breast cancer: basic clinical research. 2018;12:1178223417752677.
Abdulrahman GO, Jr., Rahman GA. Epidemiology of breast cancer in Europe and Africa. J Cancer Epidemiol. 2012;2012:915610.
Pace LE, Mpunga T, Hategekimana V, et al. Delays in breast cancer presentation and diagnosis at two rural cancer referral centers in Rwanda. The oncologist. 2015;20(7):780-788.
Unger-Saldana K. Challenges to the early diagnosis and treatment of breast cancer in developing countries. World J Clin Oncol. 2014;5(3):465-477.
Ramirez A, Westcombe A, Burgess C, Sutton S, Littlejohns P, Richards M. Factors predicting delayed presentation of symptomatic breast cancer: a systematic review. The Lancet. 1999;353(9159):1127-1131.
Derose KP, Varda DM. Social capital and health care access: a systematic review. Med Care Res Rev. 2009;66(3):272-306.
Kawachi I, Berkman L. Social cohesion, social capital, and health. Social epidemiology. 2000;174(7).
Forbes LJ, Warburton F, Richards MA, Ramirez AJ. Risk factors for delay in symptomatic presentation: a survey of cancer patients. Br J Cancer. 2014;111(3):581-588.
Gueye M, Gueye S, Diallo M, et al. Sociodemographic Factors Associated with Delays in Breast Cancer. Open Journal of Obstetrics and Gynecology. 2017;7(4):455-463.
Grootaert CNDJVNWM. Measuring Social Capital. The World Bank; 2004.
Unger-Saldaña K. Challenges to the early diagnosis and treatment of breast cancer in developing countries. World journal of clinical oncology. 2014;5(3):465.
Norsa'adah B, Rampal KG, Rahmah MA, Naing NN, Biswal BM. Diagnosis delay of breast cancer and its associated factors in Malaysian women. BMC cancer. 2011;11(1):141.
Gangane N, Anshu, Manvatkar S, Ng N, Hurtig AK, San Sebastian M. Prevalence and Risk Factors for Patient Delay Among Women With Breast Cancer in Rural India. Asia Pac J Public Health. 2016;28(1):72-82.
Ramirez A, Westcombe A, Burgess C, Sutton S, Littlejohns P, Richards M. Factors predicting delayed presentation of symptomatic breast cancer: a systematic review. Journal The Lancet. 1999;353(9159):1127-1131.
Bish A, Ramirez A, Burgess C, Hunter M. Understanding why women delay seeking help for breast cancer symptoms. Journal of psychosomatic research. 2005;58(4):321-326.
Ruddy KJ, Gelber S, Tamimi RM, et al. Breast cancer presentation and diagnostic delays in young women. Cancer. 2014;120(1):20-25.
Angus J, Miller KL, Pulfer T, McKeever P. Studying delays in breast cancer diagnosis and treatment: critical realism as a new foundation for inquiry. Oncol Nurs Forum. 2006;33(4):E62-70.
Dyanti GAR, Suariyani NLP. Faktor-faktor keterlambatan penderita kanker payudara dalam melakukan pemeriksaan awal ke pelayanan kesehatan. Jurnal Kesehatan Masyarakat. 2016;11(2):276-284.
Montazeri A, Ebrahimi M, Mehrdad N, Ansari M, Sajadian A. Delayed presentation in breast cancer: a study in Iranian women. Journal BMC women's health. 2003;3(1):1-6.
Rocco L, Suhrcke M. Is Social Capital Good for Health?: A European Perspective. WHO Regional Office for Europe Copenhagen; 2012.
