title: Non-practice of breast self examination and marital status are associated with delayed presentation with breast cancer.
abstract: Delay in seeking treatment for breast cancer is a barrier to the early diagnosis and management of the disease, resulting in a poorer prognosis. We here estimated the prevalence of delayed presentation for breast cancer and identified possible influential sociodemographic factors in a cross-sectional study of 250 patients diagnosed with primary breast cancer at the Radiotherapy and Oncology Clinic in Kuala Lumpur Hospital. Data were collected by face-to-face interview using a structured questionnaire and from medical records. We examined associations between delayed presentation (presenting to a physician more than 3 months after self-discovery of a symptom) and sociodemographic characteristics, practice of breast self examination (BSE), history of benign breast disease, family history of breast cancer and type of symptom, symptom disclosure and advice from others to seek treatment using multiple logistic regression. Time from self-discovery of symptom to presentation ranged from tghe same day to 5 years. Prevalence of delayed presentation was 33.1% (95%CI: 27.4, 39.3). A significantly higher proportion of delayers presented with late stages (stage III/IV) (58.3% vs. 26.9%, p<0.001). Divorced or widowed women (OR: 2.23, 95% CI: 1.11, 4.47) had a higher risk of delayed presentation than married women and women who never performed breast self examination were more likely to delay presentation compared to those who regularly performed BSE (OR: 2.74, 95% CI: 1.33, 5.64). Our findings indicate that delayed presentation for breast cancer symptoms among Malaysian women is high and that marital status and breast self examination play major roles in treatment-seeking for breast cancer symptoms.
authors.affiliation: Epidemiology and Biostatistics Unit, Institute for Medical Research, Kuala Lumpur, Malaysia. sumarni@imr.gov.my
authors.forename: Sumarni Mohd
authors.initials: SM
authors.lastname: Ghazali
authors.forename: Zabedah
authors.initials: Z
authors.lastname: Othman
authors.forename: Kee Chee
authors.initials: KC
authors.lastname: Cheong
authors.forename: Lim Kuang
authors.initials: LK
authors.lastname: Hock
authors.forename: Wan Rozita
authors.initials: WR
authors.lastname: Wan Mahiyuddin
authors.forename: Muhammad Amir
authors.initials: MA
authors.lastname: Kamaluddin
authors.forename: Ahmad Faudzi
authors.initials: AF
authors.lastname: Yusoff
authors.forename: Amal Nasir
authors.initials: AN
authors.lastname: Mustafa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D016504:Breast Self-Examination / Q000379:methods*; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D008296:Malaysia; D017533:Marital Status; D008875:Middle Aged; D010349:Patient Compliance; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires