Factors associated with late diagnosis of breast cancer among women in Botswana

Abstract

Background: Breast cancer is a public health issue in Botswana. Associations of patient-level factors with late breast cancer diagnosis are not well understood. This may explain why there are many cases of late diagnosis.
Aim: We assessed patient-level factors associated with late breast cancer diagnosis among women in Botswana.
Setting: The study was conducted at four designated cancer public health facilities in Botswana.
Methods: A cross-sectional hospital-based survey questionnaire was administered to 211 adult women (15 September 2023 – 15 December 2023). Descriptive statistics, Chi-square/Fisher’s exact test and logistic regression were performed using StataNow 18 SE to analyse the association of patient factors with late diagnosis for breast cancer.
Results: Forty-six per cent (n = 90) of women studied presented with advanced cancer at the first stage of diagnosis. Occupation (χ² = 9.0342; p = 0.029) and age at first full-term pregnancy (χ² = 6.3287; p = 0.042) were associated with late diagnosis at bivariate analysis. With univariate analysis, being single (odds ratio [OR]: 0.184, 95% confidence interval [CI]: 0.036–0.932) and formally employed (OR 3.395, 95% CI: 1.467–7.860) were associated with late diagnosis. Multivariate analysis identified second-degree family history as a major predictor of late cancer diagnosis among women (adjusted odds ratio [AOR]: 0.340, 95% CI: 0.129–0.893).
Conclusion: Almost half (45.91%, n = 90) of the study participants presented with advanced stages of breast cancer at the time of initial diagnosis. While we did not study all women in Botswana, the geographical spread of our sample reflects a countrywide problem. We recommend scaling-up cancer awareness campaigns for improved benefits of early breast cancer screening and diagnosis.
Contribution: We identified patient level factors associated with late breast cancer diagnosis among women studied in Botswana. Thus, our study informs an awareness campaign for reducing cases of breast cancer late diagnosis.