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Factors Related to Delayed Diagnosis and Treatment of Breast Cancer Among Moroccan Women in Casablanca

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Indian Journal of Gynecologic Oncology Aims and scope Submit manuscript

Abstract

Purpose

Breast cancer is the first most common type of cancer among women worldwide. Delay in diagnosis and treatment may lead to late-stage and poor prognosis. Measuring waiting times is a good indicator of the quality and performance of cancer care. This study aims at investigating the factors associated with delayed diagnosis and treatment of breast cancer in Casablanca.

Methods

This is a cross-sectional study with consecutive recruitment from January to June 2018 of patients with breast cancer in the University hospital center Ibn Rochd of Casablanca and the private center Ryad of Casablanca. The target population consisted of women newly diagnosed with breast cancer. Women who had secondary breast cancer or refused to answer the questionnaire were excluded. The information was collected by trained Ph.D. student via a structured questionnaire based on the patients’ medical records. Ordinal logistic regressions, stratified on medical care type (public and private), were used to identify factors associated with a longer delay: Patient Delay (PD), Diagnosis Delay (DD), and Health System Delay (HSD). The p-values < 0.05 were considered statistically significant. Statistical analyses were performed using R statistical analysis software version 4.0.5. We used quartiles to define long delays. A longer PD was defined as a delay ≥ 35 days, a longer DD as a delay ≥ 16 days and a longer HSD as a delay ≥ 48 days.

Results

The total study population included 300 women with an average age of 52 ± 11 years. Fifty-one percent (51.7%) are diagnosed at a late stage. For women who received public care, the factors associated with diagnostic delay were marriage (aOR = 1.66 [0.92–3.01]) and consulting once or twice before diagnosis (aOR = 2.86 [1.31–6.24]). For women who received private care, delay in treatment was higher for women who were housewives (aOR = 3.94 [1.05–14.75]).

Conclusion

Our study showed that factors associated with diagnosis delay were marriage and consulting once or twice before diagnosis in public care, and with treatment delay was higher for women who were housewives in private care which leads us to conclude that population-wide awareness and education programs are needed

to improve the recognition of symptoms and promote prompt healthcare seeking to improve early diagnosis and survival. The ideas highlighted in this study can be used to provide recommendations for areas of improved cancer education as well as potential prevention and screening programs. Additional studies are needed to determine if similar differential delays exist in other regions of Morocco.

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Data Availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to acknowledge all patients who participated in this study. The authors would like to thank the staff of the university hospital center IBN ROCHD and the private center of oncology RYAD.

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Laboratory of Cellular and Molecular Pathology/ Research team: Epidemiology and histology of chronic and cancerous diseases, University of Hassan II Faculty of medicine and pharmacy, Casablanca, Morocco

    Houda Zahfir, Sofia Zoukal, Samira Hassoune & Samira Nani

Authors
  1. Houda Zahfir
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  2. Sofia Zoukal
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  3. Samira Hassoune
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  4. Samira Nani
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Contributions

HZ, SN were responsible for study conception, design. SN and SZ for supervision. HZ collected the data, and HZ and SZ extracted and analyzed the data. HZ wrote the manuscript. All authors reviewed the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Houda Zahfir.

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Conflict of interest

The authors have no relevant financial or non-financial interest to disclose.

Ethical Approval

The study was approved by the Medical Ethics Committee in the Faculty of medicine and pharmacy in Casablanca with the number order N° 11/17.

Consent to participate

Written informed consent was obtained from all individual participants included in the study and was approved by the ethics committee.

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Zahfir, H., Zoukal, S., Hassoune, S. et al. Factors Related to Delayed Diagnosis and Treatment of Breast Cancer Among Moroccan Women in Casablanca. Indian J Gynecol Oncolog 20, 68 (2022). https://doi.org/10.1007/s40944-022-00668-3

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  • DOI: https://doi.org/10.1007/s40944-022-00668-3

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