Yehoda Martei

Date of Award

January 2011

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Beth A. Jones

Subject Area(s)

Medicine

Abstract

ABSTRACT

EFFECT OF SOCIO-CULTURAL BELIEFS ON LATE STAGE PRESENTATION OF BREAST CANCER AMONG GHANAIAN WOMEN. Yehoda M. Martei; Verna Vanderpuye; and Beth A. Jones.

Yale University, School of Medicine, New Haven, CT.

New data emphasizes the increasing burden of cancer in the developing world, which has led to an increasing move to prioritize cancer care on the global health agenda. Breast cancer is the leading cause of cancer mortality among women globally. In Ghana, most women present with advanced stage breast cancer. There is currently no national screening program, and insight into why women present late stage is limited. The aim of this study is to characterize why women present with advanced stage breast cancer in Ghana.

We used a Qualitative study based on in-person and in-depth interviews with 31 breast cancer patients seen at the Korle-bu Teaching Hospital in Ghana. The interview data was transcribed, and coded based on the Grounded theory method. Data was organized using NVivo 9 software.

Five recurrent themes emerged from our study with four explicitly related to late stage at presentation: 1) Study participants expressed some awareness of breast cancer, but with varying depths of knowledge; 2) most patients present late because they do not associate a "painless" breast lump with possible breast malignancy; 3) women with a confirmed breast cancer diagnosis, delay treatment because of the fear of mastectomy; 4) religion plays an important supportive role for breast cancer patients. 5) A fifth factor was not explicitly related to delayed presentation. Breast cancer treatment presents a significant financial burden but was not stated as an explicit reason for delayed presentation. We concluded that despite efforts to increase awareness, there are still significant knowledge gaps, and social and cultural factors that need to be addressed to enable patients translate this information to their personal health. The church's current role can be leveraged to augment current efforts to increase breast cancer awareness and utilization of the current services available. Successful design and implementation of cancer programs hinge on attention to socio-cultural influences on advanced stage presentation.

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This is an Open Access Thesis.

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