Determinants of Delayed Breast Cancer Diagnosis: A Sample From the Mohammed VI Center for Cancer Treatment, Morocco

A delayed diagnosis of breast cancer (BC) is linked to more advanced stages of the disease and lower survival rates. This study aims to explore the association between personal factors, family and community interactions, awareness of BC and breast self-examination (BSE), and delays in BC diagnosis among patients at the Mohammed VI Oncology Center, Casablanca, Morocco.

We conducted a cross-sectional study at the Mohammed IV Oncology Center from January 2023 to July 2024. A questionnaire was administered to collect data on sociodemographic and clinical characteristics of participants, personal factors, and community and family interactions, as well as their knowledge about BC and BSE practices. BC stages I and IIa were categorized as "early diagnosis," while stages IIb, IIIa, IIIb, and IV were classified as "delayed diagnosis." A time interval of more than three months was considered delayed. The chi-square test or Fisher's exact test was employed to assess the association between independent variables and outcomes. To examine the impact of the included factors on the interval of time (<3 months or >3 months), binary logistic regression analyses were conducted. Variables achieving statistical significance (p < 0.05) were subsequently included in the final multiple logistic regression models for each outcome.

A total of 436 patients were interviewed, with a majority (65.1%) diagnosed at an advanced stage. The main factors impacting diagnosis interval included the individual's residency in rural or semi-urban areas (OR: 2.01, 95% CI: 1.01-4.00), fear of death (OR: 0.97, 95% CI: 0.95-0.99), fear of total mastectomy (OR: 5.44, 95% CI: 1.39-21.32), distrust in the expertise of institutions (OR: 9.07, 95% CI: 1.52-53.88), and having never heard of BC (OR: 4.79, 95% CI: 1.49-15.41). Conversely, performing BSE (OR: 0.35, 95% CI: 0.12-1.01) was identified as a significant protective factor against delayed diagnosis.

It is crucial to focus on enhancing access to affordable, high-quality healthcare and to promote health literacy related to BC among the general public.