ArticleAsian Pacific journal of cancer prevention : APJCP2023
Factors Associated with Diagnostic Delays among Tunisian Breast Cancer Patients.
Article in Asian Pacific journal of cancer prevention : APJCP, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 5 citations in OpenAlex.
- Factors associated with breast self-examination and mammography screening among women attending primary healthcare centers in central Tunisia.BMC women's health · 2026Article
- Improving Breast Cancer Outcomes Through Quality Care: Call to Action for the Implementation of the Breast Cancer Care Quality Index (BCCQI).International journal of environmental research and public health · 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
- Understanding delays in breast cancer diagnosis in Africa: Key insights and contributing factors.International journal of cancer · 2025Article
- Patient journey and timeliness of care for patients with breast cancer in Africa: a scoping review.BMJ open · 2025Article
- Diagnostic delay among symptomatic breast cancer patients: a study in Sudanese women.Journal of preventive medicine and hygiene · 2024Article
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3 authors at 2 institutions in 1 country.
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Abstract
backgroundBreast cancer (BC) remains one of the most common and deadliest cancer among women worldwide and in Tunisia. The lethality of BC is particularly high in developing countries, such as Tunisia, due to late diagnosis in the majority of cases. The objective of this study was to analyze factors associated with delayed presentation among women followed at the Salah Azaiez institute of Tunis during the year 2021.
methodsIt was a retrospective cohort study, including patients with primary BC, consulting at the Salah Azaeiz institute of Tunis over a period of six months, from january 1st to june, 30th, 2021. The total diagnostic interval (DI) was divided into patient interval (PI) and healthcare system interval (HSI). Diagnosis delay due to patient (PD) was defined as a delay more than three months between the discovery of symptoms and the first medical consultation. Data were collected using a valid questionnaire "the breast cancer questionnaire delay" and from patients' medical records. The calculation of crude and adjusted Odds Ratios using a stepwise descending binary logistic regression model was performed to measure the association of the studied factors with the delayed presentation.
resultsA total, 146 patients were included. The mean age of the patients was 50.1 ± 10.9 years. More than a half of patients had a primary education (56.8%). Majority of patients were married (86.3%) and unemployed (90.4%). The median of patient interval (PI) and HSI were 31 days [IQR: 12.5-151.5] and 53 days [IQR: 33.0-88.7] respectively. About three quarter of patients (76.4%) presented a healthcare system delay (HSD). After univariate analysis, factors significantly associated with PD were the low level of education (illiterate/primary) (RR: 2.7; 95% CI [1.1-6.4]; p=0.02) and the lack of knowledge about BC symptoms by patients (RR: 15.0; 95% CI [6.0-37.4]; p<10-3). The only variable that remained associated with PD, after multivariate analysis, was lack of initial knowledge of symptoms (OR: 15.0; 95% CI [6.0-37.4]; p<10-3).
conclusionLack of knowledge of symptoms was the main factor associated with delayed presentation among BC women.This study shows the need to inform women about performing breast self-examination as well as clinical signs of BC.
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