Predictors of advanced-stage presentation among breast and cervical cancer patients in Ethiopia

Breast and cervical cancers are the most common causes of cancer incidence and mortality in women in Africa. Women with breast and cervical cancers in Sub-Saharan Africa (SSA) are frequently diagnosed at advanced stages. Delays in health seeking, diagnosis and treatment are contributing factors to high mortality in Ethiopia. This study aimed to assess predictors of advanced stage presentation among breast and cervical cancer patients attending public hospitals in Addis Ababa, Ethiopia. A cross-sectional study was conducted with a total of 418 patients at Tikur Anbessa specialized hospital and Saint Pauls Hospital Millennium Medical College from October to November 2021. Stages III and IV were considered advanced stages. Data were collected by reviewing medical records and in face-to-face interviews with a structured questionnaire. Bivariate and multivariate analyses were performed to examine the association between independent and outcome variables. A total of 269 patients with breast cancer and 149 patients with cervical cancer were included in the study, and the mean age was 44 years (SD = 10.9 years) and 50 years (SD = 11.2) years, respectively. About 66.9% of breast cancers and 71.1% of cervical cancers were diagnosed at an advanced disease stage. Rural residence (AOR = 2.041, 95% CI: 1.108-3.758), indirect referral (AOR = 3.8, 95% CI: 1.485-9.946), financial difficulty (AOR = 10, 95% CI: 1.859-56.495) and no prior advise/awareness about screening (AOR = 4.029 95%CI: 1.658-10.102) were independent predictors of advanced-stage presentation. This study revealed a high prevalence of advanced-stage breast and cervical cancer diagnosis in Ethiopia, similar to data collected 10 years ago, despite the introduction of a cancer control plan in 2015. For better implementation, interventions should aim to improve referral pathways, adapt screening and early detection services and increase cancer awareness at the community level in a culturally accepted way.