Factors contributing to late presentation of breast cancer in Africa: a systematic literature review

Background: Over 50% of people diagnosed with breast cancer in most African countries present late and report to the hospital with advanced stage III and IV disease, a major reason for the poor survival rate. This study reviewed studies focusing on patient-related factors or reasons contributing to the late presentation or delayed diagnosis of breast cancer in Africa. Method: A rigorous literature search was conducted with search terms “Breast Neoplasms” AND “Late Presentation” OR “Delayed Diagnosis” AND “Africa” OR “the name of any of the African countries” within CINAHL, African Index Medicus, MEDLINE, Web of Science and PsycINFO electronic databases. Additional hand searching of reference lists of included articles was conducted. A thematic synthesis was conducted. Result: Of the eighty-two studies identified, nine were eligible and included in the review. Studies included were conducted in Egypt, Nigeria, Ghana, Kenya and Libya. The factors identified as contributing to late presentation of breast cancer among most African women were negative symptom interpretation, fear, belief in alternative medicine, social relations and networks, lack of trust and confidence in orthodox medicine, and access to healthcare. Conclusion: A complex matrix of factors were identified that contribute to the late presentation or delayed diagnosis of breast cancer among most African women. The orthodox medical system in most African countries is gradually losing their relationship and credibility because of false reassurance, frequent misdiagnosis and strike actions, which is leading to late presentation of breast cancer.