Delayed breast cancer presentation, diagnosis, and treatment in Kenya

Purpose In this mixed-methods study, we evaluated the factors that contribute to delayed breast cancer (BC) diagnosis and treatment at a Kenyan hospital. Methods Individuals with a diagnosis of BC, either as a referral or index patient, were recruited to participate in this study through convenience...

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Bibliographic Details
Published in:Breast cancer research and treatment 2023-12, Vol.202 (3), p.515-527
Main Authors: Daniel, Ojuka, Ashrafi, Adiba, Muthoni, Musibi Alice, Njoki, Njiraini, Eric, Hungu, Marilynn, Omondi, Faith, Aseta Bonareri, Beth, Wambui Githambo, Nyakio, Mburu, Odero-Marah, Valerie, Ragin, Camille, Llanos, Adana A. M.
Format: Article
Language:English
Subjects:
Breast cancer
Breast Neoplasms - diagnosis
Breast Neoplasms - epidemiology
Breast Neoplasms - therapy
Cancer research
Cancer therapies
Child
Contraception
Delivery of Health Care
Diagnosis
Epidemiology
Female
Females
Health care
Hospitals
Humans
Kenya - epidemiology
Medical diagnosis
Medicine
Medicine & Public Health
Middle Aged
Oncology
Patients
Referral and Consultation
Sociodemographics
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Summary:Purpose In this mixed-methods study, we evaluated the factors that contribute to delayed breast cancer (BC) diagnosis and treatment at a Kenyan hospital. Methods Individuals with a diagnosis of BC, either as a referral or index patient, were recruited to participate in this study through convenience sampling. Data were collected on sociodemographics, health history, and cancer history, diagnosis, and treatment of patients at Kenyatta National Hospital (KNH). For the quantitative analyses, the relationship between sociodemographic and health history factors with stage at diagnosis, number of visits before diagnosis, time to diagnosis, and time to initial intervention, stratified by time to onset of symptoms, were examined using regression analyses. For the qualitative analysis, in-depth interviews of every fifth patient were completed to assess reasons for delayed diagnosis and treatment. Results The final analytic sample comprised of 378 female BC patients with an average age of 50. These females were generally of lower SES: 49.2% attained no or only primary-level education, 57.4% were unemployed, and the majority (74.6%) had a monthly household income of 
ISSN:0167-6806
1573-7217
DOI:10.1007/s10549-023-07067-y