BACKGROUND Early diagnosis is a key determinant of breast cancer prognosis and survival. More than half of breast cancer cases are diagnosed at an advanced stage in Ethiopia, and the barriers to early diagnosis in this country are not well understood. We aimed to identify the perceived barriers to early diagnosis of breast cancer from the perspective of patients and health care providers in south and southwestern Ethiopia. METHODS A qualitative study was conducted from March to April 2018 using in-depth interviews of breast cancer patients and breast cancer health care providers from six public hospitals located in urban and rural areas of south and southwestern Ethiopia. All participants provided verbal consent before participating. A thematic analysis was performed using Open Code 4.02. RESULTS Twelve breast cancer patients and thirteen health care providers were included in the study. Patient and health-system related barriers to early diagnosis of breast cancer were identified. Patient-related barriers were lack of knowledge and awareness of breast cancer, belief in traditional medicine and religious practices for treatment, and lack of social and financial support to seek care at a medical facility. Health-system related barriers were misdiagnosis of breast cancer, long distance to referral facilities, high cost of diagnostic services, long waiting time for diagnostic tests, and lack of screening and diagnostic tests in local facilities. CONCLUSIONS Early diagnosis of breast cancer is affected by multiple barriers in south and southwestern Ethiopia. Awareness campaigns and education about the disease, prevention, and early detection are needed to increase early diagnosis of breast cancer. Opportunities exist to improve early diagnosis and timely treatment in rural areas.

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埃塞俄比亚南部和西南部对乳腺癌早期诊断的认识障碍：定性研究。

背景技术早期诊断是乳腺癌预后和生存的关键决定因素。在埃塞俄比亚，一半以上的乳腺癌病例被诊断为晚期，在这个国家，早期诊断的障碍尚不十分清楚。我们旨在从埃塞俄比亚南部和西南部的患者和医疗保健提供者的角度，找出对乳腺癌进行早期诊断的公认障碍。方法2018年3月至2018年4月进行了定性研究，对埃塞俄比亚南部和西南部城市和农村地区六家公立医院的乳腺癌患者和乳腺癌医疗保健提供者进行了深入访谈。所有参与者在参与之前均提供了口头同意。使用Open Code 4.02进行了主题分析。结果该研究包括12名乳腺癌患者和13名医疗保健提供者。确定了与患者和卫生系统相关的乳腺癌早期诊断障碍。与患者有关的障碍包括对乳腺癌的了解和认识不足，对传统医学的信仰以及治疗的宗教习惯以及缺乏在医疗机构寻求护理的社会和经济支持。与卫生系统有关的障碍包括乳腺癌的误诊，到转诊机构的距离太远，诊断服务的成本高，诊断测试的等待时间长以及在当地机构中缺乏筛查和诊断测试。结论埃塞俄比亚南部和西南部的多重障碍影响了乳腺癌的早期诊断。关于疾病，预防，为了及早发现乳腺癌，需要及早发现。存在改善农村地区早期诊断和及时治疗的机会。