Most breast cancer symptoms are discovered by women themselves, and at least one third of these women will be aware of their symptoms for 3 months or more before seeking an initial provider evaluation. The authors identify personal, social, and environmental influences on women's intention to seek an immediate provider evaluation (helpseek) versus to delay evaluation of a breast symptom that worried them.
Black women (N = 352) from the San Francisco Bay are women's organizations, community settings, and churches formed this convenience sample. Participants ranged across age, income, and educational levels. The survey contained 10 scales that measured health behavior variables, including new and existing scales augmented by items derived from prior interview and focus group investigations.
Women of younger age and lower income were significantly less likely to intend to seek an evaluation for self-discovered breast symptoms. Single and partnered women were less likely to seek a provider evaluation than married or widowed women. Perceiving negative consequences of delaying, having previous habits of healthcare utilization, perceiving access to services, and feeling fearful were positively related to the intention to seek evaluation of breast symptoms. Holding fatalistic beliefs about getting breast cancer or dying and perceiving constraints to seeing a provider negatively influenced helpseeking intention. Racism in the healthcare delivery system was perceived, but was not a significant influence on helpseeking intention. A multiple linear regression model containing these variables explained 46% of the variance in helpseeking intention.
This study shows that the intent to helpseek is not merely a matter of education and economics, but is dependent on a complex picture of personal, social, and economic factors. Gynecologic and primary care providers should consider this and the potential influences on helpseeking in the women for whom they provide cancer screening and early detection services. History taking should be expanded to assess women's ideas about the consequences of delaying evaluation of self-discovered breast symptoms, their sense of vulnerability to breast cancer, the constraints on cancer early detection they may be feeling related to role obligations, their economic or strategic limitations to accessing services, the pressures they may feel to hide a breast cancer symptom, or their own tendency to interpret the breast symptom as not threatening. Healthcare providers should not assume that helpseeking for breast symptoms is an automatic behavior for all women. Rather, providers should assess whether a women is the one in three who will delay the evaluation of a breast cancer symptom she discovers herself for months or years.
"Results of study indicate that the ratio of women who apply for the early cervical cancer detection is low. It was emphasized in these studies that financial problems and lack of health insurance for access to transportation and service were placed near the top among the impeding factors (Facione et al., 1997; Remennick, 2006). Moreover, fear of cancer, negligence, shyness, lack of knowledge as regards to cancer and early detection, health perception of the individual, negative experiences with the health personnel, sex of the health personnel, transportation difficulties of the healthcare organisation, complaints about getting an appointment and waiting in the queue, cultural and traditional practices are also counted among barriers (Juon et al., 2003; Van Til et al., 2003; Fang et al., 2007; Wong et al., 2009). "
[Show abstract][Hide abstract] ABSTRACT: Background:
The aim of the present study was to investigate perceived inhibiting and facilitating factors concerning cervical cancer early diagnosis behavior in Turkish women over the age of 40.
Materials and methods:
The study was carried out by qualitative focus group interview with 35 participating women, in the period between April-June 2010. A semi-structured interview questionnaire based on the Health Belief Model and the Health Promotion Model was used. Content analysis was applied to the study data.
Barriers such as lack of knowledge of women as regards to the cervical cancer and early detection, lack of sensitivity- negligence, forgetting, fear, inadequacy of health insurance and transportation, financial problems, inability to get an appointment, lack of female doctors, embarrassment, fatalist approach were frequently addressed. As for facilitating factors, these included provision of information, health professionals showing interest and tolerance, free services, provision of transportation means and reminding telephone calls.
Focus group interviews were found to be effective in determining inhibiting and facilitating factors concerning cervical cancer early diagnosis behavior. In line with the results of the study, preparation of structured national and regional education programs and their addition to curriculum programs may be effective in realizing and maintaining positive early detection behavior.
Asian Pacific journal of cancer prevention: APJCP 09/2013; 14(9):4977-82. DOI:10.7314/APJCP.2013.14.9.4977 · 2.51 Impact Factor
"One explanation for such a difference might relate to the patients' health related behaviors and the social context they live in. It is argued that an intention to seek evaluation of breast symptoms is not merely a matter of education and economics but it is dependent on a complex picture of personal and social factors on the perceived amount of negative consequences of delaying diagnosis and on previous habit of health care utilization [5,14]. "
[Show abstract][Hide abstract] ABSTRACT: Background
A cross sectional study was conducted in Tehran Iran to examine the extent of patient delay and associated factors in the presentation of breast cancer.
A group of newly diagnosed breast cancer patients were interviewed and were asked about the period from first onset of symptoms to first medical consultation to indicate patient delay. This was studied in relation to patients' age, educational level, marital status, family history of breast cancer, history of benign breast disease, number of children and the nature of the first symptom seen.
In all, 190 breast cancer patients were interviewed. Of these, 75% presented to physician within 3 months. Forty-two patients (25%) delayed more than 3 months. In multivariate regression analysis it was found that there was a risk for longer delay in widowed or divorced women (OR 3.7, 95% CI 1.5–9.7), women with a positive family history of breast cancer (OR 2.8, 95% CI 1.1–7.7), and less educated patients (illiterate: OR 5.2, 95% CI 1.5–17.7; primary schooling: OR 4.6, 95% CI 1.4–14.7). Significant associations also were found between delay presentation and the late stage disease (P = 0.01) and bigger tumor size (P = 0.004).
The findings suggest that one in four women with breast cancer present late and this has significant effect on their disease prognosis. To reduce patient delay health education programs regarding breast cancer should be implemented and target women who are at higher risk of delay.
BMC Women's Health 08/2003; 3(1):4. DOI:10.1186/1472-6874-3-4 · 1.50 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Despite the increased availability of breast screening services, the majority of breast cancer symptoms are self-discovered. Further, estimates suggest more than a third of women who self-discover breast changes delay seeking a medical evaluation for at least three months, and delays such as these have been associated with reduced chances of long-term survival. This paper presents the results of individual in-depth interviews with women who had sought a medical evaluation for self-discovered breast changes. Results suggested that women follow a staged process that moves from symptom appraisal and attribution, to the consideration of possible consequences of seeking an evaluation, to the decision about whether or not to seek a medical evaluation. Suggestions are made regarding how the study's findings might be used by practitioners seeking to reduce delays in seeking evaluations, and for future research.
Roberta Castagno, Debora Canuti, Marco Petrella, Lauro Bucchi, Chiara Fedato, Francesca Garena, Livia Giordano
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