# Facilitators and Barriers to Seeking Early Diagnosis and Treatment for Breast Cancer Among Patients Attending a Tertiary Care Hospital

## TL;DR

This study explores why many Indian women delay breast cancer diagnosis and treatment, highlighting the role of education, cultural beliefs, and financial barriers.

## Contribution

The study identifies specific socio-cultural and economic factors influencing delays in breast cancer care in India.

## Key findings

- Illiteracy and being a housewife were strong predictors of delayed care.
- Emotional distress and financial constraints were major barriers to early diagnosis.
- Healthcare provider recommendations and government awareness programs helped reduce delays.

## Abstract

Introduction and aim: Breast cancer is the most common cancer among women in India, where a substantial proportion of cases are diagnosed at advanced stages, resulting in preventable morbidity and mortality. This study aimed to identify facilitators and barriers influencing early diagnosis and treatment to inform strategies that promote timely care.

Material and methods: A cross-sectional study was conducted from 2023 to 2025 in the Departments of Community Medicine and Radiotherapy at Sarojini Naidu Medical College, Agra. A total of 95 women aged ≥18 years registered for anti-cancer management were enrolled using consecutive sampling. Data were collected through a pretested semi-structured questionnaire and review of medical records. Factors influencing healthcare-seeking behavior were examined using the social ecological model and force field analysis. Statistical analysis included bivariate comparisons and multivariate logistic regression to identify independent predictors of delay.

Results: Most participants were middle-aged, married, housewives (75.8%), and from low-income households. Significant factors associated with delay included first point of care, primary barrier type, cultural/regional beliefs, and use of indigenous medicine (p<0.05). Major barriers were emotional distress (58.9%), lack of personal transport (66.3%), belief that symptoms would resolve (41.1%), social stigma (40%), and financial or administrative constraints. Facilitators included healthcare provider recommendations (58.9%), government awareness programs (65.3%), family support (62.1%), and preference for female doctors. Awareness of breast cancer screening and breast self-examination practices was significantly associated with reduced delay (p<0.01). Multivariate analysis identified illiteracy (OR: 5.2) and being a housewife (OR: 9.7) as independent predictors of delay.

Conclusion: Delays in breast cancer care are strongly influenced by educational status, gender roles, and socio-cultural beliefs. Enhancing women’s autonomy, expanding awareness initiatives, and strengthening health system support are critical to promoting early diagnosis and improving outcomes.