Factors Contributing to Late-Stage Breast Cancer Presentation in sub-Saharan Africa

• DOI: 10.1007/s12609-018-0278-7
• Publication Date: 2018-07-03T01:28:06Z
• Authors: John R. Scheel; Sarah Anderson; Milena Foerster; Moses Galukande; Valerie McCormack
• Keywords: Surgical oncology; Breast cancer awareness; Presentation (obstetrics); Stigma

Late stage at breast cancer diagnosis is a major contributor to poor survival from breast cancer in many sub-Saharan African countries. Using Ugandan as an example, we discuss barriers along the journey to diagnosis and highlight areas where improvements are needed. In Uganda, the majority of breast cancer patients noticed symptoms of their cancer for at least 9 months prior to diagnosis, which is typical of many African countries. For most women, the health provider delay is extensive, owing to barriers related to cost, transport, stigma, provider knowledge, and difficult-to-navigate referral systems. Downstaging efforts should focus on reducing health system delay and target low community awareness. Implementation research to strengthen women’s breast cancer knowledge, access to breast health services, and referral pathways provide clear opportunities for downstaging.