Determinants of late detection and advanced-stage diagnosis of breast cancer in Nigeria

Abstract

Late detection of Breast cancer(BC) and progressing with advanced-stage diagnosis after early detection contribute differently to the challenges of managing BC in Africa. Understanding the difference may improve cancer education programs and their effectiveness. Objective To describe the risk factors for late detection and advanced-stage diagnosis among patients who detected their BC early. Method Using secondary data, we analyzed the impact of socio-demographic factors, premorbid experience, BC knowledge, and health-seeking pattern on the risk of late detection and advanced-stage diagnosis after early BC detection. Test of statistical significance in SPSS and EasyR was set at 5% using Sign-test, chi-square tests (of independence and goodness of fit), odds ratio, or risk ratio as appropriate. Result Most socio-demographic factors did not affect detection size or risk of disease progression in the 405 records analyzed. High BC knowledge, p-value = 0.001, and practicing breast self-examination (BSE) increased early detection, p-value = 0.04, with a higher probability (OR 1.6 (95% CI 1.1–2.5) of detecting <2cm lesions. Visiting alternative care (RR 1.5(95% CI 1.2–1.9), low BC knowledge (RR 1.3(95% CI 1.1–1.9), and registering concerns for hospital care increased the risk of advanced-stage diagnosis after early detection (64% (95% CI 55–72)). Adhering to the monthly BSE schedule reduced the risk of advanced-stage diagnosis by -25% (95% CI -49, -1.1) in the presence of socioeconomic barriers. Conclusion Strategies to increase BC knowledge and BSE may help BC downstaging, especially among women with common barriers to early diagnosis.