ArticlePloS one2018
Barriers to early presentation of breast cancer among women in Soweto, South Africa.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 6 of them syntheses that pooled it.
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Who cites it
51 citing papers in PubMed, 6 syntheses or guidelines pooled it, 100 citations in OpenAlex.
- Where do delays occur? A systematic review of the barriers to early breast cancer diagnosis across South Africa's health system.BMJ open · 2026Pooled it
- Delays in seeking, reaching and access to quality cancer care in sub-Saharan Africa: a systematic review.BMJ open · 2023Pooled it
- The Impact of Breast Awareness on the Early Detection of Breast Cancer in Young Women: A Systematic Review.Breast care (Basel, Switzerland) · 2023Pooled it
- Health system factors that influence diagnostic and treatment intervals in women with breast cancer in sub-Saharan Africa: a systematic review.BMC public health · 2021Pooled it
- Determinants of Delayed Presentation and Advanced-Stage Diagnosis of Breast Cancer in Africa: A Systematic Review and Meta-Analysis.Asian Pacific journal of cancer prevention : APJCP · 2021Pooled it
- Prevalence of Themes Linked to Delayed Presentation of Breast Cancer in Africa: A Meta-Analysis of Patient-Reported Studies.JCO global oncology · 2020Pooled it
- Bridging gaps in community cancer care: exploring Traditional Health Practitioners' perceptions of common adult cancer and their role in raising community awareness and early detection in Soweto, South Africa.Global health action · 2026Article
- Impact of and recovery after Covid-19 on breast cancer diagnosis and care in Johannesburg, South Africa.BMC cancer · 2026Article
- Article
- Disparities in disease presentation and survival after pathological fracture surgery at a middle- and a high-income centre.BMC surgery · 2026Article
- CK8/18 and Claudin Profile of Female Breast Cancers from Botswana.Breast cancer : basic and clinical research · 2026Article
- Care-seeking among hepatocellular carcinoma patients in Uganda: health system navigation and its impact on diagnosis and survival in a prospective case-cohort study.BMJ public health · 2026Article
- Overall survival, poverty differentials, and mediating pathways among women with breast cancer: South African Breast Cancer and HIV Outcomes cohort.The oncologist · 2025Article
- Understanding delays in breast cancer diagnosis in Africa: Key insights and contributing factors.International journal of cancer · 2025Article
- Breast Cancer Screening Using Clinical Breast Examination: A Cost-Effectiveness Analysis for South Africa.Value in health regional issues · 2025Article
- Time to pathologic diagnosis of suspicious breast lesions: An institution-based study in five Ethiopian hospitals.International journal of cancer · 2025Article
- Predictors of advanced-stage presentation among patients with a diagnosis of breast and cervical cancer in Ethiopia.The oncologist · 2025Article
- Clinicopathological and molecular subtypes of breast cancer in the Eastern Cape, South Africa: A two-year retrospective study.PloS one · 2025Article
- Determinants of delayed specialist presentation in head and neck cancer to Tygerberg Hospital, Western Cape.Journal of the colleges of medicine of South Africa · 2025Article
- Comparison of Ante-Mortem Clinical Diagnosis and Final Autopsy Diagnosis: Experience from a Single Academic Centre in Pretoria, South Africa.Diseases (Basel, Switzerland) · 2024Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 3 countries.
Funding
Abstract
purposeReported breast cancer incidence is rising in South Africa, where some women are diagnosed late and have poor outcomes. We studied patient and provider factors associated with clinical stage at diagnosis among women diagnosed at the Chris Hani Baragwanath Academic Hospital in Soweto, Johannesburg in 2015-2016.
methodsFrom face-to-face interviewer-administered questionnaires we compared self-reported socioeconomics, demographics, comorbidities, risk factors, personal and health system barriers, and from patient clinical records, clinical staging, receptor subtype, and tumor grade among 499 consecutive women newly diagnosed with advanced stage (III/IV) breast cancer versus those diagnosed early (stage 0/I/II). Logistic regression models were used to identify factors associated with advanced stage at diagnosis.
resultsAmong the women, 243 (49%) were diagnosed at early and 256 (51%) at advanced stages. In the multiple logistic regression adjusted model, completion of high school or beyond (odds ratio (OR) 0.59, and greater breast cancer knowledge and awareness (OR 0.86) were associated with lower stage of breast cancer at presentation. Advanced stage was associated with Luminal B (OR 2.25) and triple-negative subtypes (OR 3.17) compared to luminal A, with delays >3 months from first breast symptoms to accessing the health system (OR 2.79) and with having more than 1 visit within the referral health system (OR 3.19) for 2 visits; OR 2.73 for ≥3 visits).
conclusionsLimited patient education, breast cancer knowledge and awareness, and health system inefficiencies were associated with advanced stage at diagnosis. Sustained community and healthcare worker education may down-stage disease and improve cancer outcomes.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.