Factors affecting delay in the presentation of breast cancer symptoms among women in Gaza, occupied Palestinian territory: A cross-sectional survey

<p>Objective: To identify factors related to women's delay in presenting with breast cancer symptoms to improve earlier diagnosis in the occupied Palestinian territory (oPt).</p> <p>Design: Cross-sectional</p> <p>Setting: Two government cancer hospitals.</p> <p>Participants: A consecutive sample of 130 Palestinian women living in Gaza with newly diagnosed breast cancer were approached in the waiting rooms of cancer hospitals in Gaza between 1 January and 31 December 2017. 120 women took part and returned the completed questionnaire.</p> <p>Primary and secondary outcome measures: Clinical information about breast cancer were collected from hospital cancer records. An interval of three months or more between women's self-discovery of symptoms and their first presentation to a medical provider was considered as a delay.</p> <p>Results: 94% (122/130) of women attending cancer hospitals in Gaza agreed to take part in the study. Their mean age was 51 years (range: 23-72), 33.6% (31/122) had a family history of breast cancer, and 74.5% (41/55) of those whose cancer stage was known had been diagnosed at stage III or IV. Around one half (62/122) said they had not recognised the seriousness of their breast changes but only 20% (24/122) of women delayed seeking healthcare by three months and more. Considering that the symptom was not serious (X2= 13.94, p&gt; 0.05), and lack of pain (X2= 6.63, p&gt; 0.05) were the only two factors statistically associated with later presentation. Lower socio-economic status, older age, lower education, and negative family history of breast cancer were not statistically associated with women's delay.</p> <p>Conclusions: Women's awareness about the seriousness of breast changes and the critical importance of seeking prompt diagnosis needs to be improved using context-relevant and evidence-based awareness campaigns. This should be accompanied with training of female nurses on promoting early detection and improvement in diagnostic facilities to ensure timely diagnosis of cancer in the oPt.</p>