Modifiable Factors Associated With Delayed Diagnosis of Breast Cancer in Pakistan: An Epidemiological Study

Abstract

Introduction: Breast cancer (BC) is a leading cause of death and has become an emerging issue for global public health. We aimed to explore and identify the modifiable factors associated with delayed diagnosis among patients with BC in Pakistan. Methods: An epidemiological analytical cross-sectional study was conducted on patients with BC undergoing chemotherapy at a specialized cancer hospital in Punjab, Pakistan. Data on demographic characteristics and factors associated with delayed diagnosis were collected directly from patients using a self-structured questionnaire. Simultaneously, tumor-related information was obtained from their medical records. Chi-square test and forward stepwise binary logistic regression were applied to find out association and statistical significance. Results: Of the 490 BC patients analyzed, 68.6% experienced diagnostic delays. Multivariable logistic regression identified several significant predictors of delay: high diagnostic costs (AOR = 0.627; 95% CI: 0.403-0.976; P = 0.039), consultation with traditional healers (AOR = 0.317; 95% CI: 0.196-0.512; P < 0.001), and negligence toward the disease (AOR = 2.35; 95% CI: 1.30-4.28; P = 0.005). Financial problems showed a borderline association (AOR = 0.634; 95% CI: 0.398-1.009; P = 0.055). Conclusion: Delayed BC diagnosis was significantly associated with high diagnostic costs, consultation with traditional healers before diagnosis, and patient negligence.