Abstract

In primary care settings, general practitioners (GPs) frequently face challenges in identifying the early symptoms of breast cancer. This study aimed to explore, in depth, the perspectives of GPs regarding the identification and interpretation of early-stage breast cancer symptoms during the early detection process in primary care facilities. This study used a qualitative approach based on a case study. Data were collected through in-depth interviews with GPs at primary health care and private clinics in Depok City, Indonesia, complemented by observations and documentation. The data was analyzed using the Miles and Huberman method. The questionnaire assessment and focus group discussion findings revealed that only 3.8% of GPs demonstrated good responses of understanding early and late-stage breast cancer symptoms. Most participants (82.7%) provided fair responses, whereas 13.5% provided poor responses, indicating significant gaps in clinical understanding and highlighting the need for improved training and clearer diagnostic guidance. In conclusion, GPs in primary care facilities tend to have general knowledge of breast cancer but lack the ability to distinguish specific early-stage symptoms from those of more advanced stages.

References

1. Ferlay J, Ervik M, Lam F, et al. Cancer statistic for the year 2020: An overview. Int J Cancer. 2021; 149 (4): 778–789. DOI: 10.1002/ijc.33588.

2. Uwimana A, Dessalegn S, Vianney Dusengimana JM, et al. Integrating breast cancer early detection into a resource-constrained primary health care system: Health care workers’ experiences in Rwanda. JCO Glob Oncol. 2022; 8: e2200181. DOI: 10.1200/GO.22.00181.

3. Zeichner SB, Montero AJ. Detecting cancer: Pearls for the primary care physician. Cleve Clin J Med. 2016; 83 (7): 515–523. DOI: 10.3949/ccjm.83a.15124.

4. Green T, Atkin K, Macleod U. Cancer detection in primary care: Insights from general practitioners. Br J Cancer. 2015; 112 (Suppl 1): S41–S49. DOI: 10.1038/bjc.2015.41.

5. Abda N, Najdi A, El Fakir S, et al. Knowledge, attitudes, and preventive practice towards breast cancer among general practitioner health professionals in Morocco. APJCP. 2017; 18 (4): 963-968. DOI: 10.22034/APJCP.2017.18.4.963.

6. Fouladi N, Pourfarzi F, Daneshian A, et al. Mediating factors in early diagnosis of breast cancer: From initial changes in health to breast cancer detection. Asian Pac J Cancer Prev. 2018; 19 (10): 2751. DOI: 10.22034/APJCP.2018.19.10.2751.

7. McLeod DK, Pullon SR, Kenealy T, et al. Issues relating to early detection and diagnosis of breast cancer in New Zealand general practice. N Z Med J. 1999; 112 (1095): 341–344.

8. Kalache A, Roberts M, Stratton I. Breast cancer: Views of general practitioners on its detection and treatment. J R Coll Gen Pract. 1984; 34 (262): 250.

9. Miles M, Huberman A, Saldana J. Qualitative data analysis: A methods sourcebook. 3rd ed. Thousand Oaks, CA: SAGE Publication; 2014.

10. Kementerian Kesehatan Republik Indonesia. Pedoman Nasional Pelayanan Kedokteran: Tata Laksana Kanker Payudara. Jakarta: Kementerian Kesehatan Republik Indonesia; 2020.

11. Koo MM, von Wagner C, Abel GA, et al. Typical and atypical presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a national audit of cancer diagnosis. Cancer Epidemiol. 2017; 48: 140–146. DOI: 10.1016/j.canep.2017.04.010.

12. Foo D, Rhee J. Factors influencing early presentation to general practitioners for non-screen detected breast cancer. Aust J Gen Pract. 2022; 51 (8): 595–603. DOI: 10.31128/AJGP-10-21-6216.

13. Somanna SN, Nandagudi Srinivasa M, Chaluvarayaswamy R, et al. Time interval between self-detection of symptoms to treatment of breast cancer. Asian Pac J Cancer Prev. 2020; 21 (1): 169–174. DOI: 10.31557/APJCP.2020.21.1.169.

14. Icanervilia AV, Choridah L, Van Asselt ADI, et al. Early detection of breast cancer in Indonesia: Barriers identified in a qualitative study. Asian Pac J Cancer Prev. 2023; 24 (8): 2749–2755. DOI: 10.31557/APJCP.2023.24.8.2749.

15. Tshabalala G, Blanchard C, Mmoledi K, et al. A qualitative study to explore healthcare providers’ perspectives on barriers and enablers to early detection of breast and cervical cancers among women attending primary healthcare clinics in Johannesburg, South Africa. PLOS Glob Public Health. 2023; 3 (5): e0001826. DOI: 10.1371/journal.pgph.0001826.

16. Karavska A, Kizub D, Dzhemiliev A, et al. Factors affecting breast cancer screening in Ukraine. JCO Glob Oncol. 2024; 10 (Suppl 1): 75–76. DOI: 10.1200/GO-24-65000.

17. Bongaerts THG, Büchner FL, Nierkens V, et al. Perceptions and beliefs of general practitioners on their role in the cancer screening programmes in the Netherlands: A mixed-methods study. BMC Prim Care. 2024; 25: 129. DOI: 10.1186/s12875-024-02394-5.

18. Martin AN, Kaneza KM, Kulkarni A, et al. Cancer control at the district hospital level in Sub-Saharan Africa: An educational and resource needs assessment of general practitioners. J Glob Oncol. 2019; 5: 1–8. DOI: 10.1200/JGO.18.00126.

19. Devi G, Fish L, Bennion A, et al. Assessing knowledge and barriers at the primary care provider level that contribute to disparities in inflammatory breast cancer diagnosis and treatment. Res Sq. 2022; rs.3.rs-2302308. DOI: 10.21203/rs.3.rs-2302308/v1.

20. Ras T, Adeleke O, Moodley J. The role of primary care practitioners in cancer control in South Africa: A systems-based case study. South African Health Rev. 2024; 26. DOI: 10.61473/001c.119020.

21. Esteban-Vasallo MD, Aerny-Perreten N, García-Riolobos C, et al. Influence of primary care professionals on early detection of breast cancer: Different perception between family physicians and nursing professionals. Eur J Cancer Prev. 2017; 26 (1): 48–54. DOI: 10.1097/CEJ.0000000000000216.

22. Azriful A, Alam S, Siddiq MA. Early detection program for breast and cervical cancer in Indonesia: How is implementation? Al-Sihah Public Health Sci J. 2022; 14 (2): 211–224. DOI: 10.24252/al-sihah.v14i2.33508.

23. Putri SRS, Nuzula R. A scoping review: Accuracy in early detection of breast cancer using a clinical breast examination method. J Public Health Sci. 2022; 1 (1): 30–37. DOI: 10.56741/jphs.v1i01.50.

24. Zavaroni M, Oudé-Engberink A, Antoine V. French general practitioners’ attitude towards breast cancer in older women: A qualitative study. J Geriatr Oncol. 2021; 12 (7): 1076–1084. DOI: 10.1016/j.jgo.2021.05.009.

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