A new article, by researchers from the International Agency for Research on Cancer (IARC) and partner institutions collaborating on the African Breast Cancer–Disparities in Outcomes (ABC-DO) cohort study, provides evidence that long delays of up to 12 months and more to breast cancer diagnosis, which are the main driver of advanced stage at diagnosis in sub-Saharan Africa, were due largely to prolonged intervals between a patient’s first visit to a health-care provider and the final diagnosis, whereas delays between self-recognition of a symptom and the patient’s first visit to a health-care provider were present but were shorter. Long journey times to cancer diagnosis are a major driver of low survival in patients with cancer types that have potentially favourable prognoses if they are diagnosed and treated early.
Most breast cancer patients in sub-Saharan Africa are diagnosed at advanced stages after prolonged symptomatic periods. The researchers investigated the journey of women with symptomatic breast cancer in sub-Saharan Africa. They found that the journeys of less-educated women were on average 3.6 months longer than those of more-educated women, and that women who attributed their initial symptoms to cancer had a shorter journey to diagnosis than those who did not.
The researchers highlight that the long time to diagnosis represents an interval that can be shortened through supportive systems to ensure that women visit a health-care provider early and are referred to a specialized centre in a timely fashion. They recommend that the promotion of breast cancer awareness and the implementation of accelerated supported referral pathways for women with suspicious symptoms are vital to shift the stage distribution of breast cancers diagnosed in the region towards a lower stage.
The ABC-DO cohort study is generously supported by Susan G. Komen, with additional funds provided by IARC.
Foerster M, McKenzie F, Zietsman A, Galukande M, Anele A, Adisa C, et al.
Dissecting the journey to breast cancer diagnosis in sub-Saharan Africa: findings from the multi-country ABC-DO cohort study
Int J Cancer, Published online 14 July 2020;