An Empirical Study of Factors Associated with Delayed Diagnosis in Women Presenting with Breast Symptoms to Radiology Departments in North West Nigeria

Delayed breast cancer diagnosis, defined as a time interval exceeding three months from symptom onset to definitive radiological or pathological diagnosis, is the primary driver of advanced-stage presentation and poor survival outcomes in North West Nigerian women with breast cancer. Identifying the patient-level, healthcare system-level, and imaging access factors contributing to diagnostic delay in this region fills a critical evidence gap. This study empirically examines factors associated with delayed breast cancer diagnosis among women presenting with breast symptoms to radiology departments in Kano, Kaduna, and Zamfara States. A case-control design is applied to 200 women with confirmed delayed diagnosis and 200 age-matched controls with timely diagnosis, recruited from radiology departments at teaching hospitals in each state. A structured interviewer-administered questionnaire collects data on symptom recognition interval, healthcare-seeking interval, referral interval, and imaging access interval, alongside sociodemographic, knowledge, and healthcare access variables. Conditional logistic regression in SPSS identifies independent predictors of delay. Available breast cancer delay literature from North West Nigeria identifies lack of breast cancer awareness, financial barriers to mammography, and physician diagnostic delay as the three strongest independent predictors of delayed diagnosis. The Three Delays Framework adapted for diagnostic imaging access provides the analytical reference. Findings are expected to identify patient and system delay components requiring prioritised intervention. Recommendations address community breast health education, subsidised mammography, and clinical breast examination referral standards in North West Nigeria. Keywords: breast cancer diagnostic delay, radiology, North West Nigeria, case-control study, healthcare access.