Abstract 7113: Barriers to cancer diagnosis and treatment among women in low- and low-middle-income countries
Authors: Sylvester Antwi, Kwabena Agbedinu, Livingstone Aduse-Poku, Foster Amponsah, Harriet Larrious-Lartey, Samuel Mensah, Josephine Nsaful, Patrick Akakpo, Veneranda Nyarko, Michael Nortey, Alex Mremi, Theresia Mwakyembe, Valerie Ofori Aboah, Moses Dokurugu, Mohammed Sheriff, Nelson Affram, Evelyn M. Jiagge
Journal: Cancer Research (2025)

Abstract Introduction: Globally, the risk of death from cancer is higher in lower to middle income countries despite a reported lower incidence in these countries. This is attributed not only to biological factors, but to limited access to resources for screening, diagnosis, and treatment. We conducted a scoping review to identify barriers to cancer diagnosis and treatment among women in low- and low-middle-income countries, focusing on breast, colorectal, lung, cervix uteri, thyroid, corpus uteri, and stomach cancers. Methods: Using the Joanna Briggs Institute approach and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews, we systematically searched PubMed, Embase, Cochrane Library, PsycInfo, CINAHL, Scopus, and Web of Science. Eligible studies, published in English, reported barriers to cancer care in low- and low-middle-income countries. Screening and data extraction were conducted in Covidence by two independent reviewers. A total of 29 studies involving 7031 participants were included, employing quantitative, qualitative, and mixed methods designs. Results: Most studies (79.3%) were conducted in low-middle-income countries, with Sub-Saharan Africa (82.76%) as the predominant region. Breast cancer was the most studied cancer type (59.38%). On average, diagnosis occurred 7.39 months after symptom onset, and treatment began 4.9 months later. Patients traveled an average of 62 km (172.5 minutes) to health facilities. The most common barriers to cancer care were financial difficulties (71.45%), healthcare system challenges (55.17%), health literacy gaps (51.72%), geographical barriers (68.5%), and sociocultural factors. Financial challenges, reported in 65.52% of studies, included limited resources, high costs, and socioeconomic strain. Healthcare system issues, documented in 55.17% of studies, involved resource shortages, misdiagnosis, and delayed referrals. Geographical barriers, noted in 34.48%, included long travel distances and transportation costs. Health literacy gaps, reported in 51.72% of studies, stemmed from inadequate awareness and education among patients and providers. Sociocultural and stigma-related barriers, highlighted in 41.38% of studies, included cultural beliefs, fear of stigma, and spiritual attributions of illness. Conclusion: This review underscores the multifaceted barriers to cancer care in low-resource settings, emphasizing the need for interventions addressing financial, health system, educational, and sociocultural challenges. Enhanced healthcare infrastructure, community education, and socioeconomic support are critical to improving cancer outcomes in these regions. Citation Format: Sylvester Antwi, Kwabena Agbedinu, Livingstone Aduse-Poku, Foster Amponsah, Harriet Larrious-Lartey, Samuel Mensah, Josephine Nsaful, Patrick Akakpo, Veneranda Nyarko, Michael Nortey, Alex Mremi, Theresia Mwakyembe, Valerie Ofori Aboah, Moses Dokurugu, Mohammed Sheriff, Nelson Affram, Evelyn M. Jiagge. Barriers to cancer diagnosis and treatment among women in low- and low-middle-income countries [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 7113.