Delay In Breast Cancer Diagnosis And Treatment In Africań A Review To Improve Design And Reporting Of Studies

Purpose
Delay in breast cancer diagnosis and treatment is a major problem in Africa, as it results in advanced stage and poor prognosis for patients. Several studies have measured time of delay in presentation, diagnosis and treatment and analyzed corntributing factors. This study reviewed the literature on delay in breast cancer in Africa to compare methods and to summarize findings.  
Methods
A systematic literature research was conducted in PubMed to identify studies analyzing time delay in presentation, diagnosis or treatment of female breast cancer patients in Africa. The Aarhus statement, a recent recommendation to promote greater precision and transparency in studies on early cancer-diagnosis, were used as a basis to evaluate methods. The Model of Pathway were used to compare time intervals and influencing factors.
Results
From 261 search results, 23 studies were included for final analysis. Methods of studies varied widely. 14 studies analyzed delay from symptom recognition until first medical consultation, 12 until diagnosis and 3 until treatment. The percentage of women delays less than 3 months were 11 to 69% until first consultation, 9 to 30% until diagnosis and 10-19% until treatment.
Conclusions
The analyzed literature showed a significant delay in presentation, diagnosis and treatment of breast cancer patients in Africa. However, the time of delay varied widely between studies and comparisons are difficult due to variations in methods and reporting of results. This study gives simple recommendations to improve on standardization of studies in future.
Funding source
The work leading to this study has been supported by a DAAD P.R.I.M.E. fellowship with funding from the German Federal Ministry of Education and Research and the People Programme (Marie Curie Actions) of the European Union’s Seventh Framework Programme (FP7/2007/2013) under REA grant agreement n° 605728.”