SynthesisBMJ global health2021
Psychosocial influences on help-seeking behaviour for cancer in low-income and lower middle-income countries: a mixed-methods systematic review.
Synthesis in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 8 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
40 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- A mixed methods systematic review of cancer treatment decision-making in vulnerable populations.Patient education and counseling · 2026Pooled it
- Pooled it
- Implementation of mHealth to support cancer diagnosis in Sub-Saharan Africa: A systematic review.African journal of primary health care & family medicine · 2025Pooled it
- Alarming findings of psycho-socio-spiritual interventions on physical, mental, and social health for children with cancer and their families in low- and middle-income countries: a meta-analysis.Frontiers in psychiatry · 2025Pooled it
- Barriers to Radiotherapy Access in Sub-Saharan Africa for Patients with Cancer: A Systematic Review.International journal of environmental research and public health · 2024Pooled it
- A Systematic Review of Patient Education Strategies for Oncology Patients in Low- and Middle-Income Countries.The oncologist · 2023Pooled it
- Duration of the patient interval in breast cancer and factors associated with longer delays in low-and middle-income countries: A systematic review with meta-analysis.Psycho-oncology · 2023Pooled it
- The patient, diagnostic, and treatment intervals in adult patients with cancer from high- and lower-income countries: A systematic review and meta-analysis.PLoS medicine · 2022Pooled it
- Shared decision-making experiences regarding urinary diversion among Chinese patients with muscle-invasive bladder cancer: A qualitative study.Asia-Pacific journal of oncology nursing · 2026Article
- Factors associated with help-seeking for urinary symptoms among Chinese patients with bladder cancer: A qualitative study.Asia-Pacific journal of oncology nursing · 2026Article
- Factors, including patient education, that impact cancer treatment adherence in low- and middle-income African countries: a scoping review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Application of the Three Delays Framework to Assess Barriers to Surgical Care in an East African Refugee Camp: A Cross-sectional Survey Among 1,135 Adults.The Journal of surgical research · 2026Article
- Factors Associated With Delay in Seeking Medical Care Among Breast Cancer Patients in Bangladesh.Cureus · 2026Article
- Challenges and strategies for delivering effective breast cancer care in conflict zones.Communications medicine · 2026Review
- Article
- Worldwide barriers of optimal surgical care provision in advanced ovarian cancer.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Review
- Barriers in an East African refugee camp: applying the three delays framework to pediatric surgical care.Pediatric surgery international · 2025Article
- Exploring the impact of breast cancer support groups on survivorship and treatment decision-making in eastern Ethiopia: a qualitative study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Radical cystectomy for bladder cancer in Sub-Saharan Africa: techniques, challenges, and survival outcomes: a comprehensive review.BMC surgery · 2025Review
- Digital technology as a tool to provide social support to individuals with cancer in low- and middle-income countries: A scoping review.PLOS digital health · 2025Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
introductionStarting cancer treatment early can improve outcomes. Psychosocial factors influencing patients' medical help-seeking decisions may be particularly important in low and lower middle-income countries (LMIC) where cancer outcomes are poor. Comprehensive review evidence is needed to understand the psychosocial influences on medical help-seeking for cancer symptoms, attendance for diagnosis and starting cancer treatment.
methodsMixed-methods systematic review registered on PROSPERO (CRD42018099057). Peer-reviewed databases were searched until April 2020 for studies assessing patient-related barriers and facilitators to medical help-seeking for cancer symptoms, diagnosis and treatment in adults (18+ years) living in LMICs. Quality of included studies was assessed using the Critical Appraisal Skills Programme tool. Data were synthesised using meta-analytic techniques, meta-ethnography or narrative synthesis as appropriate.
resultsOf 3963 studies identified, 64 were included. In quantitative studies, use of traditional, complementary and alternative medicine (TCAM) was associated with 3.60 higher odds of prolonged medical help-seeking (95% CI 2.06 to 5.14). Qualitative studies suggested that use of TCAM was a key barrier to medical help-seeking in LMICs, and was influenced by causal beliefs, cultural norms and a preference to avoid biomedical treatment. Women face particular barriers, such as needing family permission for help-seeking, and higher stigma for cancer treatment. Additional psychosocial barriers included: shame and stigma associated with cancer such as fear of social rejection (eg, divorce/disownment); limited knowledge of cancer and associated symptoms; and financial and access barriers associated with travel and appointments.
conclusionDue to variable quality of studies, future evaluations would benefit from using validated measures and robust study designs. The use of TCAM and gender influences appear to be important barriers to help-seeking in LMIC. Cancer awareness campaigns developed with LMIC communities need to address cultural influences on medical help-seeking behaviour.
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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.