Determinants of System and Patient Delays in Breast Cancer Diagnosis and Treatment: A Multi-Level Observational Analysis in a Tertiary Care Setting.

BACKGROUND

Delays in breast cancer diagnosis and treatment significantly impact patient outcomes. Understanding the determinants of system-related and patient-related delays is crucial for improving cancer care pathways.

OBJECTIVES

To identify and analyse the sociodemographic, clinical, psychological, and awareness factors associated with system and patient delays in breast cancer diagnosis and treatment in a tertiary care setting.

METHODS

A cross-sectional observational study was conducted at a tertiary care hospital involving 95 breast cancer patients. Participants were interviewed using a comprehensive questionnaire assessing sociodemographic factors, barriers and facilitators to care, clinical characteristics, and psychological factors. Bivariate and multivariate logistic regression analyses were performed to identify significant associations.

RESULTS

Illiteracy (OR = 5.20, p = 0.007) and housewife status (p = 0.036) were significant predictors of patient delay. Major barriers included financial constraints (67.4%), fear of excessive treatment (40%), discomfort with male doctors (67.4%), and transportation challenges (66.3%). Healthcare provider recommendations (58.9%), female doctors (61.1%), and spousal support (62.1%) were key facilitators. Multivariate analysis revealed that the first point of care (p = 0.009), emotional distress (p = 0.041), and personal shyness (p = 0.007) significantly influenced delays. Homeopathy use was associated with delay (p = 0.010), while early breast self-examination practice was protective (p = 0.000).

CONCLUSIONS

Delays in breast cancer care are multifactorial, stemming from sociodemographic disparities, cultural beliefs, psychological factors, and system-level challenges. Interventions addressing health literacy, gender-sensitive care, financial assistance, and family/workplace support are essential for reducing delays and improving treatment outcomes.