Factors associated with late stage diagnosis of breast cancer patients seen at the Kenyatta National Hospital

Abstract

OBJECTIVE: To determine the factors associated with late stage diagnosis of breast cancer patients seen at the Kenyatta National Hospital. DESIGN: Descriptive cross sectional study. SETTING: Kenyatta National Hospital within various clinics and wards. SUBJECTS: One hundred and forty seven breast cancer patients attending various clinics and wards at the Kenyatta National Hospital. MAIN OUTCOME MEASURES: Stage of breast cancer at presentation, duration to initial medical consultation and reasons for late stage presentation. RESULTS: One hundred and forty seven patients were recruited, 144 (98%) were female, the median age was 44 years. One hundred and twenty eight patients (87%) had had formal education but to varying levels. Majority of patients [119 (81 %)] presented with late stage disease. Factors found to be significantly associated with late stage breast cancer at diagnosis included long symptom duration prior to initial health consultation [OR 2.758 (1.090-6.976) p=0.02B], lack of practice of breast self exam[OR 3.478 (1.014-11.92) p=0.04], low level of education [OR 3.155 (1.248-7.98) p =0.01], rural residence [OR 2.953 (1.253-6.96) p=0.01], and factors associated with low socioeconomic factors such as unemployment [OR 5.045 (1.984-12.829) p<0.001] and living in semi-permanent housing [OR 2.660 (1.149-6.15) p=0.02]. The majority of study participants (70%) had a general lack of knowledge on risk factors for breast cancer. CONCLUSIONS: Majority of breast cancer patients present with late stage disease at diagnosis. This is related to low level of education, low socioeconomic status and lack of practice of breast self exam. There exists, in our population, a knowledge gap on breast cancer. Breast cancer awareness needs to be increased. Further, improvement in the socioeconomic status and education of the population will have a positive impact on presentation of patients earlier before advanced stages of breast cancer manifest.