Tackling the Silent Epidemic of Breast Cancer in Vietnam: A qualitative study examining barriers to early diagnosis

Abstract: The increasing number of women being diagnosed with advanced stages of breast cancer in low- and middle-income countries is demanding an improvement in early detection strategies. This thesis examines the barriers to early diagnosis in Hanoi, Vietnam by analysing patients’ paths from symptom recognition to initiation of treatment. Semi-structured qualitative interviews with 20 breast cancer patients are used to acquire individual perspectives and experiences of access, diagnostic and treatment delays and barriers creating these delays. A socio-ecological lens is used to analyse the barriers in relation to different levels of influence. In addition, two key-informant interviews are used to provide information about barriers at the policy level. The results indicate that several barriers exist, several of them cross-cutting across different levels of influence, potentially creating access and diagnostic delay. Low awareness among patients and health practitioners; stigma and misconceptions about breast cancer; financial and logistical barriers as well as sociocultural barriers are identified as the main barriers to early diagnosis.