SynthesisBMC public health2021
Health system factors that influence diagnostic and treatment intervals in women with breast cancer in sub-Saharan Africa: a systematic review.
Synthesis in BMC public 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.
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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, 57 citations in OpenAlex.
- 5-year survival rate and determinants of decreased survival among patients with breast cancer in Africa: a systematic review and meta-analysis.BMJ global health · 2026Pooled it
- 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
- Factors Influencing Patient and System Delays in Women with Breast Cancer in Morocco: A Systematic Review.Asian Pacific journal of cancer prevention : APJCP · 2025Pooled it
- Dietary factors associated with breast cancer among women in Ethiopia: a systematic review and meta-analysis of case-control studies.Frontiers in nutrition · 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
- Delayed presentation of breast cancer patients and contributing factors in East Africa: Systematic review and meta-analysis.PloS one · 2024Pooled it
- Predictors of survival among breast cancer patients in Ethiopia: a systematic review and meta-analysis.Frontiers in oncology · 2024Pooled it
- Health system barriers influencing timely breast cancer diagnosis and treatment among women in low and middle-income Asian countries: evidence from a mixed-methods systematic review.BMC health services research · 2022Pooled it
- Impact of and recovery after Covid-19 on breast cancer diagnosis and care in Johannesburg, South Africa.BMC cancer · 2026Article
- Review
- Access and time to chemotherapy among Ethiopian cancer patients: a population-based registry study.The oncologist · 2026Article
- Women's preferences and concerns on HPV screening sampling methods for cervical cancer in Ibadan, Nigeria: a cross-sectional study.BMJ open · 2026Article
- Factors Associated with Delays in Breast Cancer Diagnosis in Low- and Middle-income Countries: A Scoping Review.International journal of community based nursing and midwifery · 2026Review
- Factors Contributing to Late Breast Cancer Diagnosis: A Qualitative Study on the Patient's Perspective in Tanzania.BMC women's health · 2025Article
- Cost-effectiveness protocol for treating adult HIV-infected patients with Kaposi sarcoma in resource-limited settings: a phase III, randomized, open-label, non-inferiority study of paclitaxel and pegylated liposomal doxorubicin.Cost effectiveness and resource allocation : C/E · 2025Article
- Article
- Article
- Perceived barriers to timely diagnosis among Iranian women diagnosed with advanced breast cancer: a qualitative study.BMJ open · 2025Article
- Applying a Novel Measure of Community-Level Healthcare Access to Assess Breast Cancer Care Timeliness.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Article
- Understanding the role of the husband in supporting early detection, diagnosis, and treatment for breast cancer patients in Northern Tanzania: a qualitative study.BMC public health · 2025Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundBreast cancer patients in sub-Saharan Africa experience long time intervals between their first presentation to a health care facility and the start of cancer treatment. The role of the health system in the increasing treatment time intervals has not been widely investigated. This review aimed to identify existing information on health system factors that influence diagnostic and treatment intervals in women with breast cancer in sub-Saharan Africa to contribute to the reorientation of health policies in the region.
methodsPubMed, ScienceDirect, African Journals Online, Mendeley, ResearchGate and Google Scholar were searched to identify relevant studies published between 2010 and July 2020. We performed a qualitative synthesis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Related health system factors were extracted and classified according to the World Health Organization's six health system building blocks. The quality of qualitative and quantitative studies was assessed by using the Critical Appraisal Skills Program Quality-Assessment Tool and the National Institute of Health Quality Assessment Tool, respectively. In addition, we used the Confidence in the Evidence from Reviews of Qualitative Research tool to assess the evidence for each qualitative finding.
resultsFrom 14,184 identified studies, this systematic review included 28 articles. We identified a total of 36 barriers and 8 facilitators that may influence diagnostic and treatment intervals in women with breast cancer. The principal health system factors identified were mainly related to human resources and service delivery, particularly difficulty accessing health care, diagnostic errors, poor management, and treatment cost.
conclusionThe present review shows that diagnostic and treatment intervals among women with breast cancer in sub-Saharan Africa are influenced by many related health system factors. Policy makers in sub-Saharan Africa need to tackle the financial accessibility to breast cancer treatment by adequate universal health coverage policies and reinforce the clinical competencies for health workers to ensure timely diagnosis and appropriate care for women with breast cancer in this region.
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Registered trials
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.