title: Factors Delaying Presentation of Sudanese Breast Cancer Patients: an Analysis Using Andersen's Model.
abstract: OBJECTIVE
  A multicenter, observational, cross-sectional study was conducted to assess factors delaying presentation of breast cancer cases.
  
  
  METHODS
  Data were collected from a pair of highly specialized referral centers, both located in the center of the Sudanese capital, Khartoum. For a total of 153 eligible respondents, durations of delay, clinicodemographic factors and reasons of referral were collected from our respondents through self-administered questionnaires. Logistic regression analysis and ANOVA were used to test the relation between periods of delay and different factors. Odd ratios (OR's) and their correspondent Confidence intervals (95% CI's). Delay periods were studied with Andersen's model.
  
  
  RESULTS
  The average duration of delay in our study was 11.9 (±11.2) months. Only a quarter of our patients presented early within the first 3 months after onset of their symptoms. About 47.7% arrived later during the course of the first year, while it took beyond that for the last 27% to come. A prior diagnosis of BC was the only predictor of early presentation (for 3-12 months OR=9.6 (<0.00), 95% CI 9.55-9.75; for >12 months OR=9.3 (<0.00), 95% CI 9.33-9.33). Out of the 12 different reasons for delay given by our respondents, none showed a significant difference between patients presenting early or late. Financial incapacity (17.5%), ignorance about BC (14.3), and misinterpreting symptoms (12.7%) were the top three whys of delay.
  
  
  CONCLUSIONS
  Our findings support existence of a non-uniform pattern of delay among Sudanese BC patients. Changing currently adopted awareness elevating strategies into much more inclusive approaches is strongly recommended.
authors.affiliation: Faculty of Medicine, International University of Africa, Sudan, E-mail : alaaddinsalih@yahoo.com.
authors.forename: Alaaddin M
authors.initials: AM
authors.lastname: Salih
authors.forename: Musab M
authors.initials: MM
authors.lastname: Alfaki
authors.forename: Dafallah M
authors.initials: DM
authors.lastname: Alam-Elhuda
authors.forename: Momin M
authors.initials: MM
authors.lastname: Nouradyem
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009367:Neoplasm Staging; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D011379:Prognosis; D011787:Quality of Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D013397:Sudan / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult