RT Journal Article
T1 Duration of the patient interval in breast cancer and factors associated with longer delays in low-and middle-income countries: A systematic review with meta-analysis.
A1 Petrova, Dafina
A1 Garrido, Dunia
A1 Špacírova, Zuzana
A1 Fernandez-Martinez, Nicolas Francisco
A1 Ivanova, Ganka
A1 Rodriguez-Barranco, Miguel
A1 Pollan, Marina
A1 Barrios-Rodriguez, Rocio
A1 Sanchez-Perez, Maria-Jose
K1 cancer
K1 early diagnosis
K1 help-seeking
K1 low- and middle-income countries
K1 oncology
K1 patient interval
K1 psycho-oncology
K1 psychosocial determinants
AB Breast cancer survival is lower in low- and middle-income countries (LMICs) partially due to many women being diagnosed with late-stage disease. The patient interval refers to the time elapsed between the detection of symptoms and the first consultation with a healthcare provider and is considered one of the core indicators for early diagnosis and treatment. The goal of the current research was to conduct a meta-analysis of the duration of the patient interval in LMICs and investigate the socio-demographic and socio-cultural factors related to longer delays in presentation. We conducted a systematic review with meta-analysis (pre-registered protocol CRD42020200752). We searched seven information sources (2009-2022) and included 50 articles reporting the duration of patient intervals for 18,014 breast cancer patients residing in LMICs. The longest patient intervals were reported in studies from the Middle East (3-4 months), followed by South-East Asia (2 months), Africa (1-2 months), Latin America (1 month), and Eastern Europe (1 month). Older age, not being married, lower socio-economic status, illiteracy, low knowledge about cancer, disregarding symptoms or not attributing them to cancer, fear, negative beliefs about cancer, and low social support were related to longer delays across most regions. Longer delays were also related to use of alternative medicine in the Middle East, South-East Asia, and Africa and distrust in the healthcare system in Eastern Europe. There is large variation in the duration of patient intervals across LMICs in different geographical regions. Patient intervals should be reduced and, for this purpose, it is important to explore their determinants taking into account the social, cultural, and economic context.
PB John Wiley & Sons Ltd.
SN 1057-9249
YR 2022
FD 2022-10-31
LK http://hdl.handle.net/10668/22483
UL http://hdl.handle.net/10668/22483
LA en
NO Petrova D, Garrido D, Špacírová Z, Fernández-Martínez NF, Ivanova G, Rodríguez-Barranco M, et al. Duration of the patient interval in breast cancer and factors associated with longer delays in low-and middle-income countries: A systematic review with meta-analysis. Psychooncology. 2023 Jan;32(1):13-24.
NO We thank Dr. Yasmina Okan for her participation in the formulation of the review protocol and the shortened form of the Aarhus checklist. We thank Camila Higueras-Callejon for her help with the literature search and Dr. Elena Salamanca-Fernández and Dr. Ana Ching-Lopez for their contribution to abstract screening and data extraction. This work was supported by the Spanish Association Against Cancer (Asociación Española Contra el Cáncer, PROYEC20023SANC “High resolution study of social inequalities in cancer (HiReSIC)” to Maria José Sánchez), the Cancer Epidemiological Surveillance Subprogram of the CIBER of Epidemiology and Public Health and the Health Institute Carlos III (VICA to Maria José Sánchez), and the Health Institute Carlos III (PI18/01593 to Dafina Petrova). Dafina Petrova is supported by a Juan de la Cierva Fellowship from the Ministry of Science and the National Research Agency of Spain (MCIN/AEI, JC2019-039691-I, http://doi.org/10.13039/501100011033, Accessed 4 October 2021). The funding agencies had no role in the design, reporting, or publication of the research. Funding for open access charge: Universidad de Granada/CBUA.
DS RISalud
RD Apr 5, 2025