A systematic review of barriers to early presentation and diagnosis with breast cancer among black women

Jones, Claire E.L.; Maben, Jill; Jack, Ruth H.; Davies, Elizabeth A.; Forbes, Lindsay J.L.; Lucas, Grace; Ream, Emma

Abstract

Objective: To explore barriers to early presentation and diagnosis with breast cancer among black women. Design: Systematic review. Methods: We searched multiple bibliographic databases (January 1991-February 2013) for primary research, published in English, conducted in developed countries and investigating barriers to early presentation and diagnosis with symptomatic breast cancer among black women (≥18 years). Studies were excluded if they did not report separate findings by ethnic group or gender, only reported differences in time to presentation/diagnosis, or reported on interventions and barriers to cancer screening. We followed Cochrane and PRISMA guidance to identify relevant research. Findings were integrated through thematic synthesis. Designs of quantitative studies made meta-analysis impossible. Results: We identified 18 studies (6183 participants). Delay was multifactorial, individual and complex. Factors contributing to delay included: poor symptom and risk factor knowledge; fear of detecting breast abnormality; fear of cancer treatments; fear of partner abandonment; embarrassment disclosing symptoms to healthcare professionals; taboo and stigmatism. Presentation appears quicker following disclosure. Influence of fatalism and religiosity on delay is unclear from evidence in these studies. We compared older studies (≥10 years) with newer ones (

Citation

Jones, C. E., Maben, J., Jack, R. H., Davies, E. A., Forbes, L. J., Lucas, G., & Ream, E. (2014). A systematic review of barriers to early presentation and diagnosis with breast cancer among black women. BMJ Open, 4(2), Article e004076. https://doi.org/10.1136/bmjopen-2013-004076

• Journal Article Type: Article
• Acceptance Date: Jan 14, 2014
• Online Publication Date: Feb 12, 2014
• Publication Date: Mar 4, 2014
• Deposit Date: Apr 26, 2021
• Publicly Available Date: Apr 27, 2021
• Journal: BMJ Open
• Electronic ISSN: 2044-6055
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 4
• Issue: 2
• Article Number: e004076
• DOI: https://doi.org/10.1136/bmjopen-2013-004076
• Public URL: https://nottingham-repository.worktribe.com/output/3223728
• Publisher URL: https://bmjopen.bmj.com/content/4/2/e004076