Health system factors that influence diagnostic and treatment intervals in women with breast cancer in sub-Saharan Africa: a systematic review.
Breast cancer
Diagnostic interval
Health system
Sub-Saharan Africa
Treatment interval
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
06 07 2021
06 07 2021
Historique:
received:
08
01
2021
accepted:
15
06
2021
entrez:
7
7
2021
pubmed:
8
7
2021
medline:
6
8
2021
Statut:
epublish
Résumé
Breast cancer patients in sub-Saharan Africa experience long time intervals between their first presentation to a health care facility and the start of cancer treatment. The role of the health system in the increasing treatment time intervals has not been widely investigated. This review aimed to identify existing information on health system factors that influence diagnostic and treatment intervals in women with breast cancer in sub-Saharan Africa to contribute to the reorientation of health policies in the region. PubMed, ScienceDirect, African Journals Online, Mendeley, ResearchGate and Google Scholar were searched to identify relevant studies published between 2010 and July 2020. We performed a qualitative synthesis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Related health system factors were extracted and classified according to the World Health Organization's six health system building blocks. The quality of qualitative and quantitative studies was assessed by using the Critical Appraisal Skills Program Quality-Assessment Tool and the National Institute of Health Quality Assessment Tool, respectively. In addition, we used the Confidence in the Evidence from Reviews of Qualitative Research tool to assess the evidence for each qualitative finding. From 14,184 identified studies, this systematic review included 28 articles. We identified a total of 36 barriers and 8 facilitators that may influence diagnostic and treatment intervals in women with breast cancer. The principal health system factors identified were mainly related to human resources and service delivery, particularly difficulty accessing health care, diagnostic errors, poor management, and treatment cost. The present review shows that diagnostic and treatment intervals among women with breast cancer in sub-Saharan Africa are influenced by many related health system factors. Policy makers in sub-Saharan Africa need to tackle the financial accessibility to breast cancer treatment by adequate universal health coverage policies and reinforce the clinical competencies for health workers to ensure timely diagnosis and appropriate care for women with breast cancer in this region.
Sections du résumé
BACKGROUND
Breast cancer patients in sub-Saharan Africa experience long time intervals between their first presentation to a health care facility and the start of cancer treatment. The role of the health system in the increasing treatment time intervals has not been widely investigated. This review aimed to identify existing information on health system factors that influence diagnostic and treatment intervals in women with breast cancer in sub-Saharan Africa to contribute to the reorientation of health policies in the region.
METHODS
PubMed, ScienceDirect, African Journals Online, Mendeley, ResearchGate and Google Scholar were searched to identify relevant studies published between 2010 and July 2020. We performed a qualitative synthesis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Related health system factors were extracted and classified according to the World Health Organization's six health system building blocks. The quality of qualitative and quantitative studies was assessed by using the Critical Appraisal Skills Program Quality-Assessment Tool and the National Institute of Health Quality Assessment Tool, respectively. In addition, we used the Confidence in the Evidence from Reviews of Qualitative Research tool to assess the evidence for each qualitative finding.
RESULTS
From 14,184 identified studies, this systematic review included 28 articles. We identified a total of 36 barriers and 8 facilitators that may influence diagnostic and treatment intervals in women with breast cancer. The principal health system factors identified were mainly related to human resources and service delivery, particularly difficulty accessing health care, diagnostic errors, poor management, and treatment cost.
CONCLUSION
The present review shows that diagnostic and treatment intervals among women with breast cancer in sub-Saharan Africa are influenced by many related health system factors. Policy makers in sub-Saharan Africa need to tackle the financial accessibility to breast cancer treatment by adequate universal health coverage policies and reinforce the clinical competencies for health workers to ensure timely diagnosis and appropriate care for women with breast cancer in this region.
Identifiants
pubmed: 34229634
doi: 10.1186/s12889-021-11296-5
pii: 10.1186/s12889-021-11296-5
pmc: PMC8259007
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1325Références
PLoS Med. 2009 Jul 21;6(7):e1000097
pubmed: 19621072
BMC Public Health. 2019 Jan 24;19(1):109
pubmed: 30678659
Health Care Women Int. 2015;36(5):543-57
pubmed: 24750095
Health Promot Int. 2015 Sep;30(3):647-57
pubmed: 24474424
BMC Womens Health. 2017 Feb 21;17(1):13
pubmed: 28222726
Oncologist. 2019 Dec;24(12):e1371-e1380
pubmed: 31387949
J Oncol. 2019 Dec 11;2019:5690938
pubmed: 31885578
Br J Surg. 2000 Jul;87(7):914-9
pubmed: 10931028
PLoS One. 2019 Aug 1;14(8):e0220769
pubmed: 31369640
BMJ Open. 2019 Nov 11;9(11):e032228
pubmed: 31719089
Gynecol Obstet Fertil. 2013 Dec;41(12):696-700
pubmed: 24210776
Breast. 2011 Apr;20 Suppl 2:S51-3
pubmed: 21295480
BMC Cancer. 2018 Mar 21;18(1):312
pubmed: 29562894
Lancet. 2010 Oct 2;376(9747):1186-93
pubmed: 20709386
Am J Public Health. 2000 Jan;90(1):130-4
pubmed: 10630153
J Glob Oncol. 2019 Nov;5:1-13
pubmed: 31774713
Asian Pac J Cancer Prev. 2019 Dec 01;20(12):3711-3721
pubmed: 31870113
Ann Surg Oncol. 2015 Sep;22(9):2902-11
pubmed: 25652051
Rev Epidemiol Sante Publique. 2015 Jun;63(3):191-201
pubmed: 25975777
Int J Cancer. 2021 Jan 15;148(2):340-351
pubmed: 32663320
Breast Care (Basel). 2018 Mar;13(1):39-43
pubmed: 29950966
J Cancer Epidemiol. 2019 Aug 7;2019:2407138
pubmed: 31485229
Oncologist. 2019 Dec;24(12):1549-1556
pubmed: 31601730
Geospat Health. 2018 May 07;13(1):622
pubmed: 29772881
BMC Womens Health. 2020 Feb 27;20(1):38
pubmed: 32103774
J Cancer Educ. 2019 Dec;34(6):1225-1230
pubmed: 31435911
Lancet Glob Health. 2016 Dec;4(12):e923-e935
pubmed: 27855871
J Health Psychol. 2021 Mar;26(3):357-366
pubmed: 30497300
BMC Public Health. 2020 Jun 19;20(1):962
pubmed: 32560711
Cancer. 2020 May 15;126 Suppl 10:2353-2364
pubmed: 32348567
BMJ Open. 2016 Jan 04;6(1):e009905
pubmed: 26729392
Glob Public Health. 2015;10(3):331-44
pubmed: 25443995
PLoS Med. 2015 Oct 27;12(10):e1001895
pubmed: 26506244
Cancer. 2008 Oct 15;113(8 Suppl):2282-96
pubmed: 18837020
Patient Educ Couns. 2017 Jan;100(1):167-173
pubmed: 27528411
PLoS One. 2018 Feb 2;13(2):e0192071
pubmed: 29394271
Public Health. 2017 Nov;152:58-74
pubmed: 28843410
Oncologist. 2015 Jul;20(7):780-8
pubmed: 26032138
Niger J Clin Pract. 2015 Mar-Apr;18(2):287-91
pubmed: 25666009
BMC Cancer. 2016 Jun 07;16:356
pubmed: 27268201
Oncologist. 2018 Dec;23(12):1446-1452
pubmed: 29959283
Oncologist. 2016 Jun;21(6):739-44
pubmed: 27091419
Br J Cancer. 2012 Mar 27;106(7):1262-7
pubmed: 22415239
Global Health. 2018 Jan 23;14(1):9
pubmed: 29361954
PLoS One. 2018 Nov 29;13(11):e0207928
pubmed: 30496219
Breast. 2011 Apr;20 Suppl 2:S20-9
pubmed: 21376593
Ann Epidemiol. 2017 Oct;27(10):659-671.e7
pubmed: 29128086
Cancer. 2019 Nov 15;125(22):3985-3992
pubmed: 31398265
Br J Med Med Res. 2014 May 1;4(13):2599-2610
pubmed: 25984460
CA Cancer J Clin. 2018 Nov;68(6):394-424
pubmed: 30207593
World J Clin Oncol. 2014 Aug 10;5(3):465-77
pubmed: 25114860
Breast Cancer Res. 2019 Aug 13;21(1):93
pubmed: 31409419