Barriers to Early Presentation and Diagnosis of Breast Cancer Among African Women Living in Sub-Saharan Africa

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2017 Feb 14

PMID 28192444

Citations 92

Authors

Cynthia Pomaa Akuoko

Ernestina Armah

Theresa Sarpong

Dan Yedu Quansah

Isaac Amankwaa

Daniel Boateng

Affiliations

Soon will be listed here.

Abstract

Background: Breast cancer (BC) has been described as the leading cause of cancer deaths among women especially in the developing world including sub Saharan Africa (SSA). Delayed presentation and late diagnosis at health facilities are parts of the contributing factors of high BC mortality in Africa. This review aimed to appraise the contributing factors to delayed breast cancer presentation and diagnosis among SSA women.

Methods: Five databases encompassing medical and social sciences were systematically searched using predefined search terms linked with breast cancer presentation and diagnosis and sub Saharan Africa. Reference lists of relevant papers were also hand searched. Quality of quantitative and qualitative articles were assessed using the National Institute of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and the Critical Appraisal Skills Programme (CASP) quality appraisal checklist. Thematic analysis was used to synthesize the qualitative studies to integrate findings.

Results: Fourteen (14) quantitative studies, two (2) qualitative studies and one (1) mixed method study merited inclusion for analysis. This review identified low knowledge of breast cancer among SSA women. This review also found lack of awareness of early detection treatment, poor perception of BC, socio-cultural factors such as belief, traditions and fear as factors impacting African women's health seeking behavior in relation to breast cancer.

Conclusion: Improving African women's knowledge and understanding will improve behaviors related to breast cancer and facilitate early presentation and detection and enhance proper management and treatment of breast cancer.

Citing Articles

A qualitative study on the psycho-oncological experiences of women navigating breast cancer diagnosis, treatment, and survivorship in Ethiopia.

Deressa B, Pierz A, Jyung H, Rosario B, Andoh-B-Baidoo N, Tibebu B J Cancer Surviv. 2025; .

PMID: 39921697 DOI: 10.1007/s11764-024-01742-9.

Multifaceted barriers associated with clinical breast examination in sub-Saharan Africa: A multilevel analytical approach.

Ayebeng C, Okyere J, Okantey C, Addo I PLoS One. 2025; 20(1):e0316800.

PMID: 39804868 PMC: 11730425. DOI: 10.1371/journal.pone.0316800.

Barriers to Radiotherapy Access in Sub-Saharan Africa for Patients with Cancer: A Systematic Review.

Ramashia P, Nkosi P, Mbonane T Int J Environ Res Public Health. 2025; 21(12.

PMID: 39767437 PMC: 11675486. DOI: 10.3390/ijerph21121597.

Screening of Breast among Women: A Cross-Sectional Study in Nepal.

Shah S, Dahal K, Pangeni P, Niroula S, Paudel K, Subedi P Breast J. 2025; 2024:9969169.

PMID: 39742371 PMC: 11129906. DOI: 10.1155/2024/9969169.

Awareness and its determinant factors towards breast examination to detect breast cancer among reproductive age women in Kenya: Multi level analysis of the recent demographic and health survey data.

Wassie M, Zegeye A, Aemro A, Terefe B, Zeleke G, Workneh B PLoS One. 2024; 19(12):e0314700.

PMID: 39637069 PMC: 11620592. DOI: 10.1371/journal.pone.0314700.

References

Cutler D, Lleras-Muney A . Understanding differences in health behaviors by education. J Health Econ. 2009; 29(1):1-28. PMC: 2824018. DOI: 10.1016/j.jhealeco.2009.10.003. View

Morse E, Maegga B, Joseph G, Miesfeldt S . Breast Cancer Knowledge, Beliefs, and Screening Practices among Women Seeking Care at District Hospitals in Dar es Salaam, Tanzania. Breast Cancer (Auckl). 2014; 8:73-9. PMC: 4022700. DOI: 10.4137/BCBCR.S13745. View

GATES M, Lackey N, Brown G . Caring demands and delay in seeking care in African American women newly diagnosed with breast cancer: an ethnographic, photographic study. Oncol Nurs Forum. 2001; 28(3):529-37. View

Nuamah G, Agyei-Baffour P, Akohene K, Boateng D, Dobin D, Addai-Donkor K . Incentives to yield to Obstetric Referrals in deprived areas of Amansie West district in the Ashanti Region, Ghana. Int J Equity Health. 2016; 15(1):117. PMC: 4957873. DOI: 10.1186/s12939-016-0408-7. View

Lannin D, Mathews H, Mitchell J, Swanson M . Impacting cultural attitudes in African-American women to decrease breast cancer mortality. Am J Surg. 2002; 184(5):418-23. DOI: 10.1016/s0002-9610(02)01009-7. View

Coates R, Bransfield D, Wesley M, Hankey B, Eley J, Greenberg R . Differences between black and white women with breast cancer in time from symptom recognition to medical consultation. Black/White Cancer Survival Study Group. J Natl Cancer Inst. 1992; 84(12):938-50. DOI: 10.1093/jnci/84.12.938. View

Ibrahim N, Oludara M . Socio-demographic factors and reasons associated with delay in breast cancer presentation: a study in Nigerian women. Breast. 2012; 21(3):416-8. DOI: 10.1016/j.breast.2012.02.006. View

Gullatte M, Brawley O, Kinney A, Powe B, Mooney K . Religiosity, spirituality, and cancer fatalism beliefs on delay in breast cancer diagnosis in African American women. J Relig Health. 2009; 49(1):62-72. DOI: 10.1007/s10943-008-9232-8. View

Kazaura M, Kombe D, Yuma S, Mtiro H, Mlawa G . Health seeking behavior among cancer patients attending Ocean Road Cancer Institute, Tanzania. East Afr J Public Health. 2007; 4(1):19-22. View

10.

Suh M, Atashili J, Fuh E, Eta V . Breast self-examination and breast cancer awareness in women in developing countries: a survey of women in Buea, Cameroon. BMC Res Notes. 2012; 5:627. PMC: 3522012. DOI: 10.1186/1756-0500-5-627. View

11.

Witter S, Osiga G . Health service quality and users' perceptions in West Nile, Uganda. Int J Health Plann Manage. 2004; 19(2):195-207. DOI: 10.1002/hpm.753. View

12.

Long E . Breast cancer in African-American women. Review of the literature. Cancer Nurs. 1993; 16(1):1-24. View

13.

Pace L, Dusengimana J, Hategekimana V, Habineza H, Bigirimana J, Tapela N . Benign and Malignant Breast Disease at Rwanda's First Public Cancer Referral Center. Oncologist. 2016; 21(5):571-5. PMC: 4861361. DOI: 10.1634/theoncologist.2015-0388. View

14.

Facione N . Delay versus help seeking for breast cancer symptoms: a critical review of the literature on patient and provider delay. Soc Sci Med. 1993; 36(12):1521-34. DOI: 10.1016/0277-9536(93)90340-a. View

15.

Bish A, Ramirez A, Burgess C, Hunter M . Understanding why women delay in seeking help for breast cancer symptoms. J Psychosom Res. 2005; 58(4):321-6. DOI: 10.1016/j.jpsychores.2004.10.007. View

16.

Bairati I, Jobin E, Fillion L, Larochelle M, Vincent L . Determinants of delay for breast cancer diagnosis. Cancer Detect Prev. 2007; 31(4):323-31. DOI: 10.1016/j.cdp.2007.08.001. View

17.

Maree J, Wright S, Lu X . Breast cancer risks and screening practices among women living in a resource poor community in Tshwane, South Africa. Breast J. 2013; 19(4):453-4. DOI: 10.1111/tbj.12143. View

18.

Pillay A . Rural and urban South African women's awareness of cancers of the breast and cervix. Ethn Health. 2003; 7(2):103-14. DOI: 10.1080/1355785022000038588. View

19.

Guyatt G, Sackett D, Cook D . Users' guides to the medical literature. II. How to use an article about therapy or prevention. A. Are the results of the study valid? Evidence-Based Medicine Working Group. JAMA. 1993; 270(21):2598-601. DOI: 10.1001/jama.270.21.2598. View

20.

Ramirez A, Westcombe A, Burgess C, Sutton S, Littlejohns P, Richards M . Factors predicting delayed presentation of symptomatic breast cancer: a systematic review. Lancet. 1999; 353(9159):1127-31. DOI: 10.1016/s0140-6736(99)02142-x. View