Reasons of Patient-Related Delay in Diagnosis of Breast Cancer Among Women from a Developing Country: A Multi-Centre Comparative Cross-Sectional Study

Abstract

Background and Objective: Breast cancer (BC) is the most commonly diagnosed cancer among women
globally, with developing countries like Pakistan facing significant challenges related to late diagnosis and
high mortality rates. A large proportion of Pakistani women present with late-stage BC due to a lack of
awareness, cultural barriers, and healthcare accessibility issues. This study aimed to identify patient-related
factors contributing to delays in BC diagnosis among women in Lahore, Pakistan.
Methods: A multi-centre comparative cross-sectional study was conducted at two hospitals in Lahore,
including public and private healthcare facilities. Atotal of 208 female BC patients were enrolled using nonprobability convenience sampling from June 2023 to December 2023. Data were collected through
structured interviews assessing socio-demographic factors, medical history, and healthcare-seeking
behaviors. Statistical analyses, including binary logistic regression, were performed to identify predictors of
delayed diagnosis, with a p-value of <0.05 considered statistically significant.
Results: The study found that 58.2% of participants experienced a delay in diagnosis of more than three
months. Significant predictors of delayed diagnosis included a preference for alternative therapies
(AOR=2.49, 95% CI: 1.17–5.29, p=0.018), fear of biopsy spreading cancer (AOR=5.99, 95% CI:
2.70–13.32, p<0.001), and social stigma associated with cancer (AOR=3.67, 95% CI: 1.58–8.48, p=0.002).
Additionally, lack of awareness regarding breast self-examinations and screening programs was prevalent
among delayed cases.
Conclusion: Patient-related factors such as fear, misconceptions, and cultural stigma play a significant role
in delayed BC diagnosis in Pakistan. Targeted public health interventions, awareness campaigns, and
culturally sensitive educational programs are critical to promoting early detection and improving BC
outcomes in developing countries.