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dc.contributor.authorSharma, Ketan
dc.contributor.authorCostas, Ainhoa
dc.contributor.authorShulman, Lawrence Nathan
dc.contributor.authorMeara, John Gerard
dc.date.accessioned2013-04-22T13:50:20Z
dc.date.issued2012
dc.identifier.citationSharma, Ketan, Ainhoa Costas, Lawrence N. Shulman, and John G. Meara. 2012. A systematic review of barriers to breast cancer care in developing countries resulting in delayed patient presentation. Journal of Oncology 2012:121873.en_US
dc.identifier.issn1687-8450en_US
dc.identifier.issn1687-8469en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:10579103
dc.description.abstractBackground: Within the developing world, many personal, sociocultural, and economic factors cause delayed patient presentation, a prolonged interval from initial symptom discovery to provider presentation. Understanding these barriers to care is crucial to optimizing interventions that pre-empt patient delay. Methods: A systematic review was conducted querying: PubMed, Embase, Web of Science, CINAHL, Cochrane Library, J East, CAB, African Index Medicus, and LiLACS. Of 763 unique abstracts, 122 were extracted for full review and 13 included in final analysis. Results: Studies posed variable risks of bias and produced mixed results. There is strong evidence that lower education level and lesser income status contribute to patient delay. There is weaker and, sometimes, contradictory evidence that other factors may also contribute. Discussion. Poverty emerges as the underlying common denominator preventing earlier presentation in these settings. The evidence for sociocultural variables is less strong, but may reflect current paucity of high-quality research. Conflicting results may be due to heterogeneity of the developing world itself. Conclusion: Future research is required that includes patients with and without delay, utilizes a validated questionnaire, and controls for potential confounders. Current evidence suggests that interventions should primarily increase proximal and affordable healthcare access and secondarily enhance breast cancer awareness, to productively reduce patient delay.en_US
dc.language.isoen_USen_US
dc.publisherHindawi Publishing Corporationen_US
dc.relation.isversionofdoi:10.1155/2012/121873en_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3432397/pdf/en_US
dash.licenseLAA
dc.titleA Systematic Review of Barriers to Breast Cancer Care in Developing Countries Resulting in Delayed Patient Presentationen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalJournal of Oncologyen_US
dash.depositing.authorCostas, Ainhoa
dc.date.available2013-04-22T13:50:20Z
dc.identifier.doi10.1155/2012/121873*
dash.contributor.affiliatedShulman, Lawrence
dash.contributor.affiliatedCostas-Chavarri, Ainhoa
dash.contributor.affiliatedMeara, John


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