Factors Affecting Delayed Presentation and Diagnosis of Breast Cancer in Asian Developing Countries Women: A Systematic Review

Document Type : Systematic Review and Meta-analysis


1 Faculty of Public Health, Universitas Indonesia, Depok, Indonesia.

2 Department of Health Policy and Administration, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia.

3 Department of Surgery, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.

4 Pondok Indah Hospital, Jakarta, Indonesia.

5 Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.

6 Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.


Background: Advance in screening strategies and management had steadily decreased the mortality rates of breast cancer. In developing countries, conducting screening and early diagnosis of breast cancers may face several problems. This systematic review aims to determine factors affecting the delayed diagnosis of breast cancer in developing countries in Asia. Methods: Literature research was conducted through Pubmed, ScienceDirect, Scopus, EbscoHost, Cochrane Library, and Google Scholar. The main keywords were “breast cancer”, “delayed diagnosis” and “developing countries”. Both quantitative and qualitative studies were included. Results: A total of 26 studies were included. The definition of delayed presentation or diagnosis varied from 1 month to 6 months. Among all the factors from patients and providers, breast symptoms and examinations consistently showed a significant contribution in reducing delayed diagnosis. Strengthened by qualitative studies, patients’ knowledge and perception also had a major role in delayed diagnosis. Conclusion: Among Asian developing countries, breast symptoms and examination, as well as individual knowledge and perception, are the main factors related to delayed diagnosis of breast cancer. 


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