DELAY AND CONTRIBUTING FACTORS IN PATIENTS WITH BREAST CANCER AT HIWOT FANA COMPREHENSIVE SPECIALIZED HOSPITAL, HARAR, EASTERN ETHIOPIA

Abstract

Background: Breast cancer is a growing health challenge in developing countries with high mortality and morbidity associated with prolonged patient delays and advanced-stage presentations. However, evidence-based information about contributing factors and delays in the presentation of patients with breast cancer in Eastern Ethiopia is scarce. Objective: To assess delay in presentation and contributing factors in patients with breast cancer at Hiwot-Fana Comprehensive Specialized Hospital, Harar, Eastern Ethiopia from January 1, 2022, to June 30, 2023. Methods: An institution-based cross-sectional study was conducted at the Oncology units of Hiwot-Fana Comprehensive Specialized Hospital in newly diagnosed breast cancer patients from January 2022 to June 2023. Data was collected from July 5 to October 30, 2023, using a structured questionnaire and checklist to capture primary and secondary information. Collected data was entered into SPSS version 26 for cleaning and analysis. Descriptive statistics is used to summarize the socio-demographic and clinical characteristics of the patients. Logistic regression was carried out to examine factors associated with patient delay in presentation. AOR at a 95% confidence interval and P-value<0.05 was used to declare a significant association. Results: A total of 206 (203 female and 3 males), median age of 43 years, patients were studied. A significant number of 158 (76.7%) patients had long patient delay of ≥90 days (3 months) with a median (IQR) time of 6(3-15) months, and advanced-stage diagnosis was found in 173 (84%) participants. Rural residence (AOR=7.63; 95% CI=1.97-29.44), being illiterate (AOR=5.23; 95% CI=1.05-26.18), having a painless lump (AOR=6.83; 95% CI=1.85-25.14), travel distance ≥5 km (AOR=4.08; 95% CI=1.06-15.78), have ever been heard of breast cancer before (AOR=0.13; 95% CI=0.04-0.44), and history of traditional treatment (AOR=4.53; 95% CI=1.02-20.22) were predictors for long patient delay. Conclusion: Delayed presentation with advanced breast cancer disease was found to be common in Eastern Ethiopia. rural residence, illiteracy, having a painless lump, travel distance ≥5km to the health facility, not having heard of breast cancer, and visiting a traditional healer were the factors associated with delays in presentation to a health facility after recognition of the first symptom. Therefore, concerned stakeholders should strengthen awareness creation and address other associated factors to minimize the dalliance of the patients in seeking health care.