Breast Cancer Incidence and Factors Affecting Delayed Presentation in a Rural Fiji Population: A Qualitative Study.

Area of Science:

• Oncology
• Public Health
• Global Health Disparities

Background:

• Breast cancer mortality is higher in low- and middle-income countries.
• Fiji faces a high breast cancer mortality rate, with delayed presentation as a suspected major factor.
• The reasons behind delayed presentation in Fiji remain poorly understood.

Purpose of the Study:

• To investigate the incidence and mortality rates of breast cancer in Fiji.
• To identify and understand the factors contributing to delayed hospital presentation for breast cancer patients in Fiji.

Main Methods:

• A retrospective mixed-method study was conducted at Labasa Hospital, Fiji (2018-2022).
• Incidence and mortality data were extracted from hospital records.
• Qualitative patient interviews were conducted to explore reasons for delayed presentation, adhering to SRQR guidelines.

Main Results:

• 112 breast cancer cases were confirmed, with incidence rising from 13 to 24.3/100,000 (p < 0.05).
• Median delay from symptom onset to presentation was 86.9 weeks.
• Six key themes for delay emerged: lack of knowledge, fear, healthcare system issues, alternative treatments, financial/transportation barriers, and lack of family support.

Conclusions:

• Breast cancer incidence is increasing in Fiji.
• Substantial delays in presentation persist, significantly impacting patient outcomes.
• Addressing identified barriers is essential for improving breast cancer care in Fiji.