Delay in Diagnosis and Treatment of Breast Cancer among the Patients Attending a Public and Private Hospital

Abstract

Background: Breast cancer is the most common malignancy and the leading cause of cancer-related mortality among women worldwide. Delay in diagnosis and treatment is associated with advanced stage at presentation and poor prognosis. Methods: A cross-sectional study was conducted among 236 women with diagnosed breast cancer attending a public hospital (National Institute of Cancer Research and Hospital, NICRH) and a private hospital (Ahsania Mission Cancer Hospital). Participants were selected using purposive sampling. Data were collected through face‑to‑face interviews using a pretested semi‑structured questionnaire. Delays were categorized as patient delay, diagnosis delay, treatment delay, system delay, and total delay. Associations were assessed using Pearson's chi‑square test. Results: Mean age of participants was 45.42±8.52 years; 41.5% had primary education, 89.8% were housewives, and 22.5% had a monthly family income of 6000–10,000 BDT. Most (66.5%) resided in urban areas. More than half of the respondents experienced patient delay (mean 4.5 months). Mean treatment delay was 2.10±2.30 months (nearly half of respondents), diagnosis delay 1.6±1.96 months (nearly half), system delay 3.80±4.00 months (nearly two‑thirds), and total delay 7.58±6.65 months (nearly two‑thirds). When comparing public vs. private hospital, statistically significant differences were observed for treatment delay (p=0.004), diagnosis delay (p=0.004), and system delay (p<0.001); all delays were longer in the public hospital. Multiple factors contributed to delays, and total delay showed a highly significant association with the responsible factors. Conclusion: Delays in breast cancer diagnosis and treatment are substantial, particularly in public hospital settings. Public health education, reliable referral pathways, health system strengthening, and screening programs are needed to reduce the burden of delayed presentation.