Evidence map›Paper›PMID 40562561›Full record

ArticleBMJ open2025

Challenges and facilitators in pathways to cancer diagnosis in Southern Africa: a qualitative study.

Sarah Day, Kirsten Deanne Arendse, Suzanne E Scott, Melinda Moyo, Sunga Mzeche, Bothwell Takaingofa Guzha, Natalie Tegama, Valerie Anne Sills, Tasleem Ras, Fiona M Walter and 1 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
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  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Sarah DayCancer Research Initiative, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South Africa sarah.day@uct.ac.za.ORCID http://orcid.org/0000-0003-2165-3580
Kirsten Deanne ArendseWolfson Institute of Population Health, Queen Mary University of London, London, UK.
Suzanne E ScottWolfson Institute of Population Health, Queen Mary University of London, London, UK.
Melinda MoyoDepartment of Obstetrics and Gynaecology, Faculty of Medicine & Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Sunga MzecheDepartment of Obstetrics and Gynaecology, Faculty of Medicine & Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Bothwell Takaingofa GuzhaDepartment of Obstetrics and Gynaecology, Faculty of Medicine & Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Natalie TegamaOxford Population Health, University of Oxford, Oxford, UK.
Valerie Anne SillsWolfson Institute of Population Health, Queen Mary University of London, London, UK.
Tasleem RasDepartment of Family, Community and Emergency Care, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South Africa.
Fiona M WalterWolfson Institute of Population Health, Queen Mary University of London, London, UK.
Jennifer MoodleyCancer Research Initiative, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South Africa.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo explore healthcare workers' (HCWs) experiences, barriers and facilitators in managing patients with symptoms of possible breast, cervical or colorectal cancer.

designA qualitative in-depth interview study with HCWs managing patients with breast, cervical and colorectal cancer symptoms. We also conducted workshops with a group of HCWs to check the credibility of the interview findings.

settingThe study was conducted with staff working in primary, secondary and tertiary public health facilities in the Eastern and Western Cape in South Africa (SA), and Harare and Bulawayo and their referral provinces in Zimbabwe.

participantsHCWs with experience in managing patients with symptoms of possible breast, cervical or colorectal cancer were recruited for the study. Participants were purposively sampled based on region, healthcare level and job role. A total of 56 participants (26 in SA and 30 in Zimbabwe) participated in the in-depth interviews. 26 (12 in SA and 14 in Zimbabwe) participated in four clinical advisory group workshops across both countries.

resultsDrawing on the Model of Pathways to Treatment, HCWs' perceptions of patient-level factors influencing the diagnostic interval included financial limitations, patients' absence and delays in attendance. Healthcare provider and system factors included: challenges with referral and feedback systems; training needs; low awareness of protocols and guidelines; inappropriate and suboptimal clinical assessments; and broader socioeconomic factors and resource limitations.

conclusionImproving the timely diagnosis of breast, cervical and colorectal cancer in Southern Africa necessitates targeted strategies that address both patient-related, provider and health-system delays.

Indexed as

Attitude of Health PersonnelBreast NeoplasmsColorectal NeoplasmsHealth PersonnelUterine Cervical NeoplasmsAdultEarly Detection of CancerFemaleHumansInterviews as TopicMaleMiddle AgedQualitative ResearchSouth AfricaZimbabweONCOLOGYPrimary Health CarePUBLIC HEALTH

Identifiers

PMID40562561
PMCPMC12198797

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.