Timeliness of diagnosis of breast and cervical cancers and associated factors in low-income and middle-income countries: a scoping review

Chukwudi A. Nnaji, Elochukwu F. Ezenwankwo, Paul Kuodi, Fiona M. Walter, Jennifer Moodley

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations

Abstract

ObjectivesAddressing the barriers to early breast and cervical cancer diagnosis in low and middle-income countries (LMICs) requires a sound understanding and accurate assessment of diagnostic timeliness. This review aimed to map the current evidence on the time to breast and cervical cancer diagnosis and associated factors in LMICs.DesignScoping review.SourcesMEDLINE (via PubMed), Cochrane Library, Scopus and CINAHL.Eligibility criteriaStudies describing the time to diagnosis and associated factors in the context of breast and cervical cancer in LMICs published from 1 January 2010 to 20 May 2021.Study selection and data synthesisTwo reviewers independently screened all abstracts and full texts using predefined inclusion criteria. The review was reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Evidence was narratively synthesised using predefined themes.ResultsTwenty-six studies conducted across 24 LMICs were included in the review, most (24/26) of which focused on breast cancer. Studies varied considerably in their conceptualisation and assessment of diagnostic time, events, intervals and delays, with a minority of the studies reporting the use of validated methods and tools. Patient-related intervals and delays were more frequently evaluated and reported than provider-related and health system-related intervals and delays. Across studies, there were variations in the estimated lengths of the appraisal, help-seeking, patient and diagnostic intervals for both cancers and the factors associated with them.ConclusionsDespite the significant burden of breast and cervical cancer in LMICs, there is limited information on the timeliness of diagnosis of these cancers. Major limitations included variations in conceptualisation and assessment of diagnostic events and intervals. These underscore the need for the use of validated and standardised tools, to improve accuracy and translation of findings to better inform interventions for addressing diagnostic delays in LMICs.

Original languageEnglish
Article numbere057685
JournalBMJ Open
Volume12
Issue number2
DOIs
StatePublished - 4 Feb 2022
Externally publishedYes

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords

  • breast tumours
  • diagnostic radiology
  • public health
  • quality in health care

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