Barriers to early presentation of self-discovered @entity0 in XXXX : a qualitative multicentre study.

@entity1 @entity0 @entity5 @entity158 @entity7643
OBJECTIVE: To explore and compare barriers to early presentation of self-discovered @entity0 in @entity7643 . DESIGN: A qualitative interview study with thematic analysis of transcripts. @entity1 : 67 @entity1 with self-discovered breast symptoms were included in the analysis. Of these, 36% were of Malay ethnicity, 39% were Chinese and 25% Indian, with an average age of 58   years (range 24-82   years). The number of @entity1 diagnosed at early stages of @entity5 almost equalled those at advanced stages. Approximately three-quarters presented with a painless lump, one-quarter experienced a @entity158 lump and 10% had atypical symptoms. SETTING: University hospital setting in @entity7643 . RESULTS: @entity1 revealed barriers to early presentation not previously reported: the poor quality of online website information about breast symptoms, financial issues and the negative influence of relatives in both countries, while perceived poor quality of care and services in state-run hospitals and misdiagnosis by healthcare professionals were reported in Malaysia. The pattern of presentation by ethnicity remained unchanged where more Malay delayed help-seeking and had more @entity5 compared to Chinese and Indian @entity1 . CONCLUSIONS: There are few differences in the pattern of presentation and in the reported barriers to seek medical care after symptom discovery between @entity7643 despite their differing economic status. Strategies to reduce delayed presentation are: a need to improve knowledge of disease, symptoms and causes, quality of care and services, and quality of online information; and addressing fear of diagnosis, treatment and hospitalisation, with more effort focused on the Malay ethnic group. Training is needed to avoid missed diagnoses and other factors contributing to delay among health professionals.
