Delayed Presentation to the Hospital and Its Contributing Factors Among Patients with Breast Cancer in Harar, Eastern Ethiopia: A Facility-based Cross-sectional Study

Background: Breast cancer has remained as a major cause of death and a growing public health challenge in developing countries. Nevertheless, there is a paucity of research evidence on breast cancer patients’ presentation and contributing factors for the delay in Eastern Ethiopia. Hence, this study aimed to assess delay in presentation and contributing factors among patients with breast cancer who visited Oncology Unit at tertiary Hospital in Harar, Eastern Ethiopia. Methods: An institution-based cross-sectional study was conducted with newly diagnosed breast cancer patients at the Oncology Units of Hiwot-Fana Comprehensive Specialized University Hospital from January 2022 to June 2023. Data were collected from July 5 to October 30, 2023, using a structured tool, and entered into SPSS version 26 for cleaning and analysis. Descriptive statistics were applied to compute the socio-demographic and clinical characteristics of the patients. Logistic regression was carried out to examine factors associated with patient delay in presentation. AOR at a 95% confidence interval and P-value <0.05 was used to declare a significant association. Results: From the total of 206 patients included in the study, 98.5% of them were females and 1.5% were males with the median age of 43 years. Three-fourth (76.7%) of the study participants were presented after 3 months of experiencing sign and symptoms which ranged from 3-15 months and a median time of presentation was 6 months. Of these, 84% of the patients diagnosed advanced-stage breast cancer. among Being residents of rural setting of Ethiopia (AOR=7.63; 95% CI=1.97-29.44), being illiterate (AOR=5.23; 95% CI=1.05-26.18), having a painless lump (AOR=6.83; 95% CI=1.85-25.14), travel distance ≥5 km from the Hospital (AOR=4.08; 95% CI=1.06-15.78), and having history of traditional medicine use (AOR=4.53; 95% CI=1.02-20.22) were the factors contributing to delayed presentation to the Oncology Unit or Hospital. Patients who have ever heard of breast cancer were less likely to delay in presentation (AOR=0.13; 95% CI=0.04-0.44). Conclusion: Breast cancer patients delayed presentation was found to be common in Eastern Ethiopia. Patients lived in rural area, illiterate, having a painless lump, far distance form health facility, have not ever heard about breast cancer, and relay on traditional medicine were associated with delays in presentation. Therefore, concerned stakeholders should strengthen awareness creation to minimize the dalliance of the patients in seeking health care.