Personal delays contributing to advanced-stage breast cancer diagnosis in Soweto

Research in Soweto, South Africa, explored connections between personal and health system factors and women accessing the health system in the early clinical stage of breast cancer (0/I/II) compared to the advanced stage (III/IV). 499 women were evaluated at the Chris Hani Baragwanath Academic Hospital (CHBAH), a tertiary referral facility.

The findings revealed that greater breast cancer awareness and knowledge, completion of at least secondary school education, and treatment for hypertension were factors found to be protective against advanced-stage presentation of the disease. Time from initial breast symptoms to first presentation to the health system was associated with higher likelihood of advanced-stage diagnosis, with delays exceeding 3 months having close to 3 times higher odds of advanced disease. About twice the number of women in late-stage (34%) compared to early-stage (17%) took over 3 months to connect to a facility.  Additional factors linked to higher risk of advanced-stage diagnosis included: more than one visit prior to CHBAH, luminal B and triple-negative breast cancer subtypes, and being 40 years old or younger. For detailed information about this research, click here.