title: Factors influencing late presentation for breast cancer in the middle East: a systematic review.
abstract: BACKGROUND
  Breast cancer is the most common female type of cancer in the Middle East. A review of the evidence about the reasons people did not seek medical care has not been conducted for this region.
  
  
  METHODS
  A systematic review was undertaken to identify the explanatory factors and assess the strength of the evidence leading to late or delayed presentation for breast cancer in the Middle East.
  
  
  RESULTS
  Electronic databases and websites were searched from 1970 to March 2011 and yielded approximately 1801 studies and of which, only 10 were relevant. Of these, 6 studies met the inclusion criteria and they were either Egyptian or Iranian. All studies employed quantitative methods to investigate late and delayed presentation for breast cancer, and most defined the term delay in number of weeks or months. Older age and lower educational level were found to have strong effects in explaining late presentation. Having no family history of breast cancer was found to have moderately effect on breast cancer late presentation.
  
  
  CONCLUSIONS
  Our review revealed the need to conduct research in the Middle East and our findings indicated the importance of considering older age, low educational level and a family history of cancer when planning and developing health strategies to reduce the burden of late presentation.
authors: Leeds Institute of Health Sciences, School of Medicine, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, United Kingdom.
authors: Sultana
authors: S
authors: Alhurishi
authors: Jennifer N W
authors: JN
authors: Lim
authors: Barbara
authors: B
authors: Potrata
authors: Robert
authors: R
authors: West
mesh_terms: D000367:Age Factors; D001943:Breast Neoplasms / Q000175:diagnosis*; D057210:Delayed Diagnosis; D004522:Educational Status; D005260:Female; D006801:Humans; D008877:Middle East