HEALTH SEEKING BEHAVIOURS FOR BREAST CANCER AMONG BREAST CANCER PATIENTS AT THE KOMFO ANOKYE TEACHING HOSPITAL KUMASI GHANA

ABSTRACT

Background: Globally, breast cancer is a major public health problem in terms of morbidity and mortality. In Ghana, breast cancer constitutes 15% of all cancers and 40% of female cancers and is reported to be the second commonest cancer among women in Ghana. Over 60% of breast cancer patients present late with advanced stages of breast cancer despite the many awareness campaigns to promote early reporting and detection. This study therefore sought to find out and document reasons for these phenomena. Methods: The study was a qualitative exploratory study using in-depth interviews to elicit information from patients, care givers, health workers and traditional healers. The study was conducted at the Komfo Anokye Teaching Hospital (KATH). All participants were purposively selected from breast cancer patients, health workers and caregivers at the Oncology Directorate at KATH. Ethical approval was sought from the GHS Ethics review committee. Interviews were audio-taped, transcribed verbatim, imported into NVIVO 7 and coded. Results were analysed and presented under themes as narratives and supported with quotes.

Results: This study found that breast cancer patients prior to their diagnosis, had poor knowledge of breast cancer However, following their attendance to the oncology clinic at KATH, their knowledge improved tremendously. Screening methods such as breast-self examination (BSE) were not used frequently. Some participants had delayed going to the hospital because of lack of knowledge, fear of the diagnosis and fear of death, misinterpretation of the signs, economic or financial difficulties, the influence of lay beliefs and advice from the community coupled with health worker‘s disinterest in breast cancer. In some cases, however, suggestions from relatives and close associates led to a timely medical consultation. Poor clinical practices by some health workers coupled with a rare involvement of decision makers and significant others regarding issues having to do with the creation of awareness about breast cancer, discouraged patients from seeking and adhering to appropriate therapy. It was also found that a good number of the patients though resorted to the hospital as the first point of call in seeking healthcare for breast cancer they did so at an advanced stage.

Conclusions: Awareness and knowledge of breast cancer was found to be poor among patients prior to their diagnosis, and although this has generally improved after the diagnosis, knowledge on the risk factors for developing breast cancer is still very poor. There was limited use of screening methods and a generally delay in seeking of medical attention. The need for increased awareness and use of screening practices was identified to be critical for early diagnosis of the disease and for improved outcomes of breast cancer management in Kumasi.

Key words: Breast cancer, health seeking behaviour, late presentation, Komfo-Anokye Teaching Hospital, Kumasi, Ghana.