Delayed health-seeking behavior and its associated factors among cancer patients in Ethiopia: A systematic review and meta-analysis, 2025

BACKGROUND: Delayed Health-seeking behavior among cancer patients is a major contributor to late diagnosis, poor prognosis, and high mortality, particularly in low-resource settings like Ethiopia. However, evidence on the magnitude and determinants of delayed care-seeking remains fragmented. OBJECTIVE: This systematic review and meta-analysis aimed to estimate the pooled prevalence of delayed Health-seeking behavior among cancer patients in Ethiopia and to identify associated factors influencing delays. METHODS: This study employed a systematic review and meta-analysis design to assess delayed Health-seeking behavior and its influencing factors among cancer patients in Ethiopia. A systematic search was conducted in PubMed, Scopus, Web of Science, CINAHL, AJOL, Google Scholar, and Ethiopian University repositories until April 27, 2025. The data were extracted from March 10-20 and analyzed from March 21-30, with report generation till April 27, 2025, using R software. Meta-analysis was performed using a random-effects model, with forest plots illustrating pooled prevalence and associated factors. Heterogeneity was assessed using the I² statistic, and study quality was evaluated using a validated tool. RESULTS: Seven studies conducted across multiple regions of Ethiopia were included in the final analysis with a total of 2,641 participants. The pooled prevalence of delayed Health-seeking behavior among cancer patients was 54% (95% CI: 39%-68%). Meta-analysis of associated factors showed that rural residence was significantly associated with delayed Health-seeking behavior, with patients residing in rural areas having more than threefold higher odds of delay (AOR = 3; 95% CI: 1.81-4.19), poor knowledge about cancer was strongly associated with delay, with nearly seven times higher odds among patients with poor knowledge compared to those with adequate knowledge (AOR = 6.63; 95% CI: 2.21-11.05), lack of cancer awareness was also a significant predictor of delayed Health-seeking behavior (AOR = 2.63; 95% CI: 1.75-3.51), and patients without pain were over three times more likely to delay Healthcare(AOR = 3.38; 95% CI: 2.44-4.67) were factors associated with delayed Health-seeking behavior. CONCLUSIONS: Our review showed that half of the cancer patients in Ethiopia experienced delayed health-seeking behavior. Delayed care-seeking was associated with rural residence, poor knowledge, limited awareness of cancer, and absence of pain symptoms. Targeted interventions, including public awareness campaigns, expansion of healthcare services in rural areas, and financial support initiatives, are urgently needed to reduce delays and improve early cancer diagnosis and outcomes. PROSPERO REGISTRATION NUMBER: CRD420251037845.