title: Patient delay factors in women presenting with breast cancer in a low income country.
abstract: BACKGROUND
  In low income countries, many patients with breast cancer present with advanced disease which is majorly attributed to late presentation and this is associated with poor survival rates. The aim of this study was to determine the magnitude of patient delay and the factors that influence, delay in seeking health care in female breast cancer patients.
  
  
  METHODS
  A cross-sectional study was done between January and April 2014 at a tertiary breast unit. Female patients with breast cancer above the age of 18 years were interviewed. Ethical approval was obtained.
  
  
  RESULTS
  In total 162 patients were recruited, the mean patient delay in months was 22.6 (SD = 26.4), median delay was 13 months and range was 1-127 months. 139 (89 %) patients delayed by more than 3 months after noticing symptoms of breast anomaly. Patients with no social support from spouses and family were more likely to delay (OR = 7.1, 95 % CI 2.4-21.5, p = 0.001), those who perceived the symptoms as very serious were less likely to delay (OR = 0.2, 95 % CI 0.1-0.6, p = 0.007). There was a significant association between delayed presentation and advanced stage at presentation (p = 0.006).
  
  
  CONCLUSIONS
  Most women (89 %) with breast cancer delayed by more than 3 months to seek the first medical consultation after noticing symptoms. Patients who had no social support from their families were more likely to delay.
authors.affiliation: Department of Surgery, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda. jamesodongo57@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Odongo
authors.affiliation: Department of Surgery, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda. tmakumbi@gmail.com.
authors.forename: T
authors.initials: T
authors.lastname: Makumbi
authors.affiliation: Department of Pathology, Mulago National Referral Hospital, Kampala, Uganda. skalungi@yahoo.com.
authors.forename: S
authors.initials: S
authors.lastname: Kalungi
authors.affiliation: Department of Surgery, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda. mosesg@img.co.ug.
authors.forename: M
authors.initials: M
authors.lastname: Galukande
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income / Q000145:classification / Q000706:statistics & numerical data*; D016015:Logistic Models; D008875:Middle Aged; D011203:Poverty / Q000145:classification / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D063128:Tertiary Health Care; D013997:Time Factors; D014454:Uganda