Exploring causes of delays in help-seeking behaviours among symptomatic Omani women diagnosed with late-stage breast cancer - A qualitative study

Abstract

Purpose: Breast cancer (BC) is the most commonly diagnosed cancer in Oman; however, the majority of women are diagnosed at a relatively young age and late stage. Delays in BC diagnosis may be attributable to patient-related barriers to medical help-seeking, such as embarrassment arising from breast examinations or negative perceptions of cancer or a cancer diagnosis. Identifying and addressing patients-related barriers to medical help-seeking may help early BC detection, increase the survival rate, and improve prognosis. This study aimed to explore causes of delays in medical help-seeking behaviours among symptomatic Omani women diagnosed with late-stage BC. Methods: Purposeful sampling was used to identify Omani women diagnosed with late-stage BC (i.e., stages III or IV) at the two main referral oncology centres in Oman. Semi-structured individual interviews were utilised to collect data regarding the participants’ reasons for delaying seeking medical help. The qualitative framework analysis approach was used for data analysis. Results: A total of 17 women participated in the study. The mean age was 41.94 ± 7.87 years (range: 27–56 years). Six reasons for delays in seeking medical help were identified, including: (1) Being in denial of BC symptoms; (2) normalisation of BC symptoms attributed to hormonal changes, dietary changes, or work-induced stress; (3) misinterpretation of BC symptoms attributed to other diseases or expectation of more alarming/obvious BC symptoms; (4) pursuit of alternative medicine remedies; (5) false reassurance or incorrect advice from family members or friends; and (6) practical barriers, such as childcare responsibilities and lack of access to transport. Conclusion: Several reasons were identified for delays in seeking medical help for BC symptoms, including cultural and emotional factors and a lack of knowledge of BC symptoms. Increased awareness of BC symptoms and a better understanding of Omani women's beliefs, cultures, and behaviours may help to reduce delays in BC presentation and diagnosis.