Integrative Review of Literature on the Determinants of Health Outcomes of Women Living with Breast Cancer in Canada and Nigeria from 1990-2014: A Comparative Study

Background and Aim: Globally, breast cancer is the most common cancer among women. The stage of the disease at diagnosis is a core determinant of its health outcome. In low to middle-income countries like Nigeria, advanced stage of disease presentation for medical care represents a significant problem. While mortality rates from breast cancer are declining in developed countries like Canada, they are increasing in developing countries like Nigeria. It is well documented that presentation for medical care at the early stages of the disease improves outcome. Knowledge of the factors that impact seeking medical care after breast cancer symptom discovery in women and knowledge of the factors that impact participation in breast health activities by women is important in reducing breast cancer-related mortality. Methods and Design: This integrative review critically examined the determinants of health outcomes of women living with breast cancer in Canada and Nigeria from 1990-2014. Specifically, it examined the factors that impact seeking medical care after breast cancer symptom discovery in women. It also explored the factors that impact participation in breast health activities by women in the two countries from 1990 to 2014. A total of 303 articles were identified and retrieved by searching the following databases: CINAHL, MEDLINE, and EMBASE. Grey literature from relevant organizations websites were identified using Google Scholar. Among the 303 articles identified, 55 met the inclusion criteria. Results and Conclusion: Findings from the articles that met the inclusion criteria showed that Canadians have a high level of breast health awareness. The findings also suggest that women in Nigeria have rather poor knowledge of breast health awareness and breast cancer. In Nigeria, presentation with an advanced stage of the disease made survival very low. This also compromises the quality of life of the patients. The major factors responsible for the late presentations were a lack of breast cancer awareness and education. Other social factors that mitigate against early presentations for medical care include misconceptions about breast cancer treatment and outcomes. In line with the findings of this study, it is recommended that wide spread culturally sensitive, linguistically appropriate, health education programs to teach breast health awareness should be developed and disseminated. Such health awareness programs should be targeted at women through various channels such as the media, the television, and radio. Also, within the hospital, the developed education programs should be integrated into the existing women health education programs. Non-government and other charitable organizations can also make significant contributions to breast health awareness through sponsoring health talks and workshops targeted at relevant segments of the population. Key search words: Breast cancer, breast neoplasm, diagnosis, prevention and control, health knowledge, patient attitude and practice, breast self-examination, awareness, patient education as topic, mass screening, early detection of cancer, Nigeria, Canada.