Document Type : Research Articles
Authors
1
Laboratory of Cellular and Molecular Inflammatory, Degenerative, and Oncologic Pathophysiology Faculty of Medicine and Pharmacy, Casablanca Hassan II University, Morocco.
2
Department of Epidemiology and Public Health, Ibn Rochd Hospital, Casablanca Cancer Registry, Casablanca, Morocco.
3
Desbrest Institute of Epidemiology and Public Health, INSERM, University of Montpelier, Montpellier, France.
4
Laboratory of Engineering and Applied Technologies, Faculty of Science and Technology, Sultan Moulay Slimane University, Beni Mellal, Morocco.
Abstract
Background: Breast cancer (BC) is the most common type of cancer in women; a delayed diagnosis of BC is associated with advanced stages at diagnosis and reduced survival rates. This study aims to identify the barriers and factors contributing to delayed BC diagnosis among Moroccan women admitted to the Mohammed VI Oncology Center in Casablanca. Methods: We conducted a cross-sectional study from January 2023 to July 2024 at the Mohammed VI Oncology Center in Casablanca. A questionnaire was administered to collect sociodemographic, clinical, behavioral, and healthcare system data. Stages I and IIa were classified as “early diagnosis,” while stages IIb and above were classified as “delayed diagnosis.” We used the Chi-square test to examine the association between independent variables and outcomes. All variables were included in a multiple logistic regression model using the stepwise backward method, and those with a p < 0.05 were retained in the final model. Result: A total of 436 patients were interviewed, and the majority had been diagnosed at a late stage (65.1%). The main factors and barriers included individuals residing in rural or semi-urban areas (OR=2.24, 95% CI [1.22-4.11]), opting for traditional treatments (OR=3.41, 95% CI [1.44-8.04]); individuals expressed a willingness to consult a doctor but faced barriers such as lack of time, financial constraints, or fear (OR=2.23, 95% CI [0.98-5.07]), and poor communication quality among administrative staff (OR = 7.48, 95% CI [1.06-52.68]). Conversely, having a family history of BC (OR=0.52, 95% CI [0.28-0.97]), knowledge about free-of-charge diagnostic services (OR=0.53, 95% CI [0.29-0.97]), and a positive behavior of the practitioner during the initial consultation (OR = 0.21, 95% CI [0.05-0.9]) emerged as protective factors against delayed presentation and diagnosis. Conclusion: Efforts should concentrate on improving access to affordable, high-quality healthcare and increasing cancer awareness among the population and health professionals.
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