Assessment of patient delay among women presenting with breast cancer at Mulago Hospital: Magnitude and factors.

Abstract

Background: In Uganda, the majority of patients with breast cancer present with advanced disease which is majorly attributed to late presentation and this is associated with low survival rates. The aim of this study was to determine the magnitude of patient delay and the factors that influence delay in seeking health care in female breast cancer patients at Mulago hospital. Methods: the study was cross-sectional. 162 female patients with histologically confirmed breast cancer above the age of 18 years were interviewed between January and April 2014. Data entry and analysis were done. Association between independent and dependent variables was determined using logistic regression. Odds ratios at 95% confidence interval were computed. A p value of less than 0.05 was considered statistically significant. Results: the mean patient delay in months was 22.6(SD=26.4), median delay was 13 months and range was 1-127 months.139(89%) patients delayed by more than 3 months after noticing symptoms. We found that; patients with no social support from spouses and family were more likely to delay(OR=7.1, 95% CI=2.4-21.5, P=0.001), those who perceived the symptoms as very serious were less likely to delay(OR=0.2, 95% CI=0.1-0.6, P=0.007). There was significant association between delayed presentation and advanced stage at presentation.(P=0.006). Conclusion: the results showed that 89% of women with breast cancer delayed by more than 3 months to first medical consultation after noticing symptoms of breast cancer and this has significant effect on their disease prognosis. Patients who had no social support from their spouses and close family members were more likely to delay.