Understanding Delays in Breast Cancer Diagnosis: Insights from Bangladesh

Abstract Background This study investigates factors contributing to delays in breast cancer diagnosis in Bangladesh and their impact on cancer staging. Early detection is crucial for effective treatment, yet many women in low- and middle-income countries (LMICs) are diagnosed at advanced stages, resulting in poorer outcomes. Methods A cross-sectional study was conducted at two major cancer care facilities in Dhaka. Women aged 18 and older with suspected or confirmed breast cancer were included. Data were collected using a structured questionnaire on sociodemographic and clinical variables. Total delay, defined as the time from symptom recognition to treatment initiation, was categorized into patient delay (symptom recognition to first medical consultation) and provider delay (first consultation to treatment start). Logistic regression analyses identified factors associated with these delays. Results Among 355 participants, 55.7% experienced total delays of over four months, with the highest delays in stage III cases (51.5%). Key factors contributing to patient delay included low education (Adjusted Odds Ratio [AOR]: 1.96, 95% CI: 1.04–3.74), low monthly income (AOR: 1.45, 95% CI: 1.22–1.90), and absence of breast pain (AOR: 0.55, 95% CI: 0.32–0.94). Provider delays were significantly associated with rural residence (AOR: 3.07, 95% CI: 1.49–6.98), and presence of nipple discharge (AOR: 2.92, 95% CI: 1.04–8.06). Total delays were most prevalent among patients from the Rangpur division (AOR: 6.07, 95% CI: 1.76–8.02), rural areas (AOR: 2.04, 95% CI: 1.17–3.61), and those with lower education. Additionally, nearly 80% of patients delayed seeking medical attention due to the belief that symptoms would resolve spontaneously, while 75% cited negligence and 65.5% reported financial barriers. Conclusions Significant delays in breast cancer diagnosis in Bangladesh are driven by socio-economic factors and inadequate healthcare access. Increasing public awareness, especially in rural areas, and improving healthcare accessibility are essential to facilitate early detection. Expanding screening programs and training healthcare providers in early cancer detection are critical to improving patient outcomes.