{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T17:48:38Z","timestamp":1783446518091,"version":"3.55.0"},"reference-count":37,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T00:00:00Z","timestamp":1666310400000},"content-version":"unspecified","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Dr Elizabeth Davies","award":["no award\/grant number"],"award-info":[{"award-number":["no award\/grant number"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,8,21]]},"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify factors related to women\u2019s delay in presenting with breast cancer symptoms to improve diagnosis in the occupied Palestinian territory (oPt).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Two government cancer hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A consecutive sample of 130 Palestinian women living in Gaza with newly diagnosed breast cancer were approached in the waiting rooms of cancer hospitals in Gaza between 1 January 2017 and 31 December 2017. 120\u2009women took part and returned the completed questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Clinical information about breast cancer was collected from hospital cancer records. An interval of 3\u2009months or more between women\u2019s self-discovery of symptoms and their first presentation to a medical provider was considered as a delay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>94% (122\/130) of women attending cancer hospitals in Gaza agreed to take part in the study. Their mean age was 51 years (range: 23\u201372), 33.6% (31\/122) had a family history of breast cancer and 74.5% (41\/55) of those whose cancer stage was known had been diagnosed at stage III or IV. Around one-half (62\/122) said they had not recognised the seriousness of their breast changes but only 20% (24\/122) of women delayed seeking healthcare by 3\u2009months and more. The two only factors associated to late presentation were that the woman considered their symptoms not serious (p&lt;0.001) and lack of pain (p=0.012). Lower socioeconomic status, older age, lower education and negative family history of breast cancer were not statistically associated with women\u2019s delay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Women\u2019s awareness about the seriousness of breast changes and the critical importance of seeking prompt diagnosis needs to be improved using context-relevant and evidence-based awareness campaigns. This should be accompanied with training of female nurses on promoting early detection and improvement in diagnostic facilities to ensure timely diagnosis of cancer in the oPt.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-061847","type":"journal-article","created":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T10:03:42Z","timestamp":1666346622000},"page":"e061847","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Factors affecting delay in the presentation of breast cancer symptoms among women in Gaza, occupied Palestinian territory: a cross-sectional survey"],"prefix":"10.1136","volume":"12","author":[{"given":"Samira S","family":"Abo Al-Shiekh","sequence":"first","affiliation":[{"name":"Mammography Department, Ministry of Health, Gaza, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasser 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