Factors contributing to delays in diagnosis of breast cancers in Ghana, West Africa

Louise Brinton, Jonine Figueroa, Ernest Adjei, Daniel Ansong, Richard Biritwum, Lawrence Edusei, Kofi M. Nyarko, Seth Wiafe, Joel Yarney, Beatrice Wiafe Addai, Baffour Awuah, Joe Nat Clegg-Lamptey, behalf of the Ghana Breast Health Study team On behalf of the Ghana Breast Health Study team, Anthony Adjei, Florence Dedey, Verna Vanderpuye, Victoria Okyne, Naomi Ohene Oti, Evelyn Tay, Adu-AryeeAngela Kenu, Obed Ekpedzor, Francis Aitpillah, Joseph Oppong, Ernest Osei-Bonsu, Nicholas Titiloye, Isaac Boakye, Bernard Arhin, Emmanuel Assimah, Samuel Ka-chungu, Margaret Frempong, Emma Brew Abaidoo, Bridget Nortey Mensah, Samuel Amanama, Prince Agyuapong, Debora Boateng-Ansong, Thomas Agyei, Richard Opoku, Kofi Owusu Gyimah, Stephen Hewitt, Maya Palakal, Jake Thistle, Lisa Newman, Michelle Brotzman, Shelley Niwa, Usha Singh

Research output: Contribution to journalArticlepeer-review

46 Citations (Scopus)

Abstract

Background: Late diagnoses and poor prognoses of breast cancer are common throughout Africa. Methods: To identify responsible factors, we utilized data from a population-based case–control study involving 1184 women with breast malignancies conducted in three hospitals in Accra and Kumasi, Ghana. Interviews focused on potential breast cancer risk factors as well as factors that might contribute to presentation delays. We calculated odds ratios (OR) and 95% confidence intervals (CI) comparing malignances with biopsy masses larger than 5 cm. (62.4% of the 1027 cases with measurable lesions) to smaller lesions. Results: In multivariate analyses, strong predictors of larger masses were limited education (OR 1.96, 95% CI 1.32–2.90 <primary vs. ≥senior secondary school), being separated/divorced or widowed (1.75, 1.18–2.60 and 2.25, 1.43–3.55, respectively, vs. currently married), delay in care seeking after onset of symptoms (2.64, 1.77–3.95 for ≥12 vs. ≤2 months), care having initially been sought from someone other than a doctor/nurse (1.86, 0.85–4.09), and frequent use of herbal medications/treatment (1.51, 0.95–2.43 for ≥3x/day usage vs. none). Particularly high risks associated with these factors were found among less educated women; for example, women with less than junior secondary schooling who delayed seeking care for breast symptoms for 6 months or longer were at nearly 4-times the risk of more educated women who promptly sought assistance. Conclusions: Our findings suggest that additional communication, particularly among less educated women, could promote earlier breast cancer diagnoses. Involvement of individuals other than medical practitioners, including traditional healers, may be helpful in this process.

Original languageEnglish
Pages (from-to)105-114
Number of pages10
JournalBreast Cancer Research and Treatment
Volume162
Issue number1
DOIs
Publication statusPublished - 1 Feb 2017

Keywords

  • Africa
  • Breast cancer
  • Diagnosis delays
  • Epidemiology

Fingerprint

Dive into the research topics of 'Factors contributing to delays in diagnosis of breast cancers in Ghana, West Africa'. Together they form a unique fingerprint.

Cite this