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Factors Delaying Presentation of Sudanese Breast Cancer Patients: an Analysis Using Andersen's Model

  • Salih, Alaaddin M (Faculty of Medicine, International University of Africa) ;
  • Alfaki, Musab M (National Academy of Health Sciences) ;
  • Alam-Elhuda, Dafallah M (Department of Community Medicine, Faculty of Medicine, University of Khartoum) ;
  • Nouradyem, Momin M (National Ribat University and Central Police Hospitals, National Ribat University)
  • Published : 2016.06.01

Abstract

Purpose: A multicenter, observational, cross-sectional study was conducted to assess factors delaying presentation of breast cancer cases. Materials and Methods: Data were collected from a pair of highly specialized referral centers, both located in the center of the Sudanese capital, Khartoum. For a total of 153 eligible respondents, durations of delay, clinicodemographic factors and reasons of referral were collected from our respondents through self-administered questionnaires. Logistic regression analysis and ANOVA were used to test the relation between periods of delay and different factors. Odd ratios (OR's) and their correspondent Confidence intervals (95% CI's). Delay periods were studied with Andersen's model. Results: The average duration of delay in our study was 11.9 (${\pm}11.2$) months. Only a quarter of our patients presented early within the first 3 months after onset of their symptoms. About 47.7% arrived later during the course of the first year, while it took beyond that for the last 27% to come. A prior diagnosis of BC was the only predictor of early presentation (for 3-12 months OR=9.6 (p<0.00), 95% CI 9.55-9.75; for >12 months OR=9.3 (p<0.00), 95% CI 9.33-9.33). Out of the 12 different reasons for delay given by our respondents, none showed a significant difference between patients presenting early or late. Financial incapacity (17.5%), ignorance about BC (14.3), and misinterpreting symptoms (12.7%) were the top three whys of delay. Conclusions: Our findings support existence of a non-uniform pattern of delay among Sudanese BC patients. Changing currently adopted awareness elevating strategies into much more inclusive approaches is strongly recommended.

Keywords

Breast cancer;delayed presentation;late;advanced stage;Sudanese women

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