Health system factors that influence diagnostic and treatment intervals in women with breast cancer in sub-Saharan Africa: a systematic review

作者：Gloria Yawavi Gbenonsi, Mouna Boucham, Zakaria Belrhiti, Chakib Nejjari, Inge Huybrechts, Mohamed Khalis · 发表于：BMC Public Health · 年份：2021 · DOI：10.1186/s12889-021-11296-5 · 被引用次数：66 · 研究领域：Global Cancer Incidence and Screening、Advances in Oncology and Radiotherapy、Economic and Financial Impacts of Cancer

BACKGROUND: Breast cancer patients in sub-Saharan Africa experience long time intervals between their first presentation to a health care facility and the start of cancer treatment. The role of the health system in the increasing treatment time intervals has not been widely investigated. This review aimed to identify existing information on health system factors that influence diagnostic and treatment intervals in women with breast cancer in sub-Saharan Africa to contribute to the reorientation of health policies in the region. METHODS: PubMed, ScienceDirect, African Journals Online, Mendeley, ResearchGate and Google Scholar were searched to identify relevant studies published between 2010 and July 2020. We performed a qualitative synthesis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Related health system factors were extracted and classified according to the World Health Organization's six health system building blocks. The quality of qualitative and quantitative studies was assessed by using the Critical Appraisal Skills Program Quality-Assessment Tool and the National Institute of Health Quality Assessment Tool, respectively. In addition, we used the Confidence in the Evidence from Reviews of Qualitative Research tool to assess the evidence for each qualitative finding. RESULTS: From 14,184 identified studies, this systematic review included 28 articles. We identified a total of 36 barriers and 8 facilitator...