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

PLoS One. 2021 Nov 3;16(11):e0256847. doi: 10.1371/journal.pone.0256847. eCollection 2021.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / pathology
  • Breast Self-Examination
  • Delayed Diagnosis
  • Disease Progression
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Middle Aged
  • Nigeria
  • Surveys and Questionnaires
  • Young Adult

Grants and funding

The African Research Group for Oncology (ARGO) sponsored the data-generating primary research with a pilot grant award to AO. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.