Socio-cultural and Economic Determinants of Delayed Reporting of Breast Cancer Among Ghanaian Women: A Qualitative Study
Abstract
Delayed reporting of breast cancer continues to increase in African countries, including Ghana, which is attributable to socio-cultural and economic factors. However, there is a paucity of data on socio-cultural and economic determinants of delayed reporting of breast cancer in Ghana. This study aimed to explore the socio‐cultural and economic determinants of delayed reporting of breast cancer among Ghanaian women. The study adopted an exploratory descriptive qualitative design with purposive sampling to recruit 17 women with breast cancer from the Tamale Teaching Hospital, Ghana. Data were collected through in-depth interviews. Analysis: Data analysis was done using the thematic analysis approach. Delayed reporting was due to inaccurate information, the influence of social networks, cultural misconceptions, belief in alternative treatment, high cost of treatment, and extreme poverty. A combination of socio‐cultural and economic factors influences the delay in reporting breast cancer in Ghana. Culturally appropriate and adequate health information and education, integration of alternative treatment into the formal healthcare system in Ghana, and financial support from the government are needed to promote early reporting for treatment.
References
Agodirin, S. O., Aremu, I., Rahman, A. G., Olatoke, A. S., Akande, J. H., & al., O. e. (2020). Prevalence of Themes Linked to Delayed Presentation of Breast Cancer in Africa: A Meta-Analysis of Patient-Reported Studies. Journal of Global Oncology, 6(6), 731‒742. DOI: https://doi.org/10.1200/JGO.19.00402
Akweongo, P., Aikins, M., Wyss, K., Salari, P., & Tediosi, F. (2021). Insured clients' out-of-pocket payments for health care under the national health insurance scheme in Ghana. BMC Health Serv Res, 21(1), 440-451. DOI: 10.1186/s12913-021-06401-8
Asobayire, A., & Barley, R. (2015). Women's cultural perceptions and attitudes towards breast cancer: Northern Ghana. Health Promotion International, 30(3), 647‒657. DOI: 10.1093/heapro/dat087
Asoogo, C., & Duma, S. E. (2015). Factors contributing to late breast cancer presentation for health care amongst women in Kumasi, Ghana. Curationis, 38(1), 1‒7. DOI: 10.4102/curation is.v38i1.1287
Aziato, L., & Clegg-Lamptey, J. N. (2015). Breast cancer diagnosis and factors influencing treatment decisions in Ghana. Health Care for Women International, 36(5), 543‒557. DOI: 10.1080/07399332.2014.911299
Bonsu, A. B., & Ncama, B. P. (2019). Recognizing and appraising symptoms of breast cancer as a reason for delayed presentation in Ghanaian women: A qualitative study. PLoS One, 14(1), e0208773–21. DOI: 10.1371/journal.pone.0208773
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77‒101. DOI: 10.1191/1478088706qp063oa
Brinton, L., Figueroa, J., Adjei, E., Ansong, D., Biritwum, R., Edusei, L., . . . Clegg-Lamptey, J. N. (2017). Factors contributing to delays in diagnosis of breast cancers in Ghana, West Africa. Breast Cancer Research and Treatment, 162(1), 105‒114. DOI: 10.1007/s10549-016-4088-1
Chotipanich, A., Sooksrisawat, C., & Jittiworapan, B. (2019). Association between complementary and alternative medicine use and prolonged time to conventional treatment among Thai cancer patients in a tertiary-care hospital. Peer Journal, 7, e7159-11. DOI: 10.7717/peerj.7159
Ferlay, J., Ervik, m., Colombet, M., Mery, L., & Pineros, M. (2020). The Global Cancer Observatory: Cancer Today. Cancer Today. Lyon: International Agency for Research on Cancer. https://gco.fr/today
Dumrongpanapakorn, P., & Liamputtong, P. (2017). Social support and coping means: the lived experiences of Northeastern Thai women with breast cancer. Health Promotion International, 32(5), 768‒777. DOI: 10.1093/heapro/dav023
Freitas, A. G., & Weller, M. (2015). Patient delays and system delays in breast cancer treatment in developed and developing countries. Cien Saude Colet, 20(10), 3177‒3189. DOI: 10.1590/1413-812320152010.19692014
Frie, G. K., Samoura, H., Diop, S., Kamate, B., Traore, C. B., & Malle et al. (2018). Why Do Women with Breast Cancer Get Diagnosed and Treated Late in Sub-Saharan Africa? Perspectives from Women and Patients in Bamako, Mali. Breast Care, 13(1), 39‒43. DOI: 10.1159/000481087
Ghafouri, R., & Ofoghi, S. (2016). Trustworthy and Rigor in Qualitative Research. International Journal of Advanced Biotechnology and Research, 7(4), 1914-1922. DOI: http://www.bipublication.com
Hu, K., Ding, P., Wu, Y., Tian, W., Pan, T., & Zhang, S. (2019). Global patterns and trends in the breast cancer incidence and mortality according to socio-demographic indices: an observational study based on the global burden of diseases. British Medical Journal Open, 9(10), e028461-8. DOI: 10.1136/bmjopen-2018-028461
Ibrahim, N. A., & Oludara, M. A. (2012). Socio-demographic factors and reasons associated with delay in breast cancer presentation: a study in Nigerian women. The Breast, 21(3), 416‒418. DOI: 10.1016/j.breast.2012.02.006
Iddrisu, M., Aziato, L., & Dedey, F. (2019). A qualitative study on coping strategies of young women living with breast cancer in Ghana. International Journal of Africa Nursing Sciences, 11, 100173. DOI: 10.1016/j.ijans.2019.100173
Jemebere, W. (2019). Barriers Associated with Presentation Delay among Breast Cancer Patients at Hawassa University Comprehensive and Specialized Hospital, Southern Ethiopia. International Journal of Caring Sciences, 12(3), 1356‒1363. Retrieved from: www.internationaljournalofcaringsciences.org
Kusi, A., Hansen, K. S., Asante, F. A., & Enemark, U. (2015). Does the National Health Insurance Scheme provide financial protection to households in Ghana? BMC Health Serv Res, 15, 331–342. DOI: 10.1186/s12913-015-0996-8
Lim, J. N., Potrata, B., Simonella, L., Ng, C. W., Aw, T. C., Dahlui, M., & Taib, N. A. (2015). Barriers to early presentation of self-discovered breast cancer in Singapore and Malaysia: a qualitative multicentre study. British Medical Journal Open, 5(12), e009863-9. DOI: 10.1136/bmjopen-2015-009863
Loh, J. (2013). Inquiry into Issues of Trustworthiness and Quality in Narrative Studies: A Perspective. The Qualitative Report, 18(65), 1-15. DOI: http://www.nova.edu/ssss/QR/QR18/loh65.pdf
Mbuka-Ongona, D., & Tumbo, J. M. (2013). Knowledge about breast cancer and reasons for late presentation by cancer patients seen at Princess Marina Hospital, Gaborone, Botswana. African Journal of Primary Health Care & Family Medicine, 5(1), 465‒476. DOI: 10.4102/phcfm.v5i1.465
McCutchan, G., Wood, F., Smits, S., Edwards, A., & Brain, K. (2016). Barriers to cancer symptom presentation among people from low socioeconomic groups: a qualitative study. BioMed Central Public Health, 16(1), 1052‒1061. DOI: 10.1186/s12889-016-3733-2
Merriam, S., & Muhamad, M. (2013). Roles traditional healers play in cancer treatment in Malaysia: implications for health promotion and education. Asian Pacific Journal of Cancer Prevention, 14(6), 359‒361. DOI: 10.7314/apjcp.2013.14.6.3593
Odongo, J., Makumbi, T., Kalungi, S., & Galukande, M. (2015). Patient delay factors in women presenting with breast cancer in a low-income country. BioMedical Central Research Notes, 8, 467‒472. DOI: 10.1186/s13104-015-1438-8
Ogunkorode, A., Holtslander, L., Ferguson, L., Maree, J. E., Anonson, J., & Ramsden, V. R. (2021). Factors influencing the health-seeking behaviours of women with advanced stages of breast cancer in Southwestern Nigeria: An interpretive description study. International Journal of Africa Nursing Sciences, 14(2012), 100273-9. DOI: 10.1016/j.ijans.2020.100273
Opoku, Y. S., Benwell, M., & Yarney, J. (2012). Knowledge, attitudes, beliefs, behaviour, and breast cancer screening practices in Ghana, West Africa. Pan African Medical Journal, 11(28), 548‒557. DOI: 10.11604/pamj.2012.11.28.548
Polit, D., & Beck, C. (2014). Essentials of nursing research (Vol. 8). Wolters Kluwer.
Sung, H., Ferlay, J., Siegel, L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. Cancer Journal for Clinicians, 2021(71), 209-249. DOI: 10.3322/caac.21660.
World Medical Association. (2013). World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. JAMA, 310(20), 2191-2194. DOI: 10.1001/Jama.
