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This cross-sectional study quantified the patient interval (symptoms to first healthcare visit) and the diagnostic interval (symptoms to diagnosis) for breast, cervical and colorectal cancer in Zimbabwe and South Africa, and identified associated factors. Among 1021 participants, recall of symptoms and risks was low. Patient intervals were typically shorter than diagnostic intervals, and barriers and provider type strongly influenced timing.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/time-to-diagnosis-for-breast-cervical-and-colorectal-cancer-in-zimbabwe-and-south-africa-a-cross-sectional-study/351065/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/time-to-diagnosis-for-breast-cervical-and-colorectal-cancer-in-zimbabwe-and-south-africa-a-cross-sectional-study/351065.png","ImageObject",300,407,{"name":92,"@type":93},"Asher","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-26","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":19},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What intervals were measured in this study?","Question",{"text":112,"@type":113},"The study measured the patient interval (time from symptoms to the first healthcare visit) and the diagnostic interval (time from symptoms to diagnosis).","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were factors associated with the intervals analyzed?",{"text":117,"@type":113},"Cox regression was used to identify factors associated with the patient interval and the diagnostic interval.",{"name":119,"@type":110,"acceptedAnswer":120},"What influenced the diagnostic interval the most?",{"text":121,"@type":113},"Diagnostic intervals were longer in less-resourced regions and increased with the number of healthcare visits before diagnosis; shorter intervals were observed when the first provider was a clinic doctor or specialist rather than a clinic nurse.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},351065,1790207474,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":19,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},687197207639,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Original research  \nTime to diagnosis for breast, cervical and colorectal cancer in Zimbabwe and South Africa: a cross-sectional study  \nJennifer Moodley  ,1 Suzanne E Scott  ,2 Sarah Day,1 Bothwell T Guzha,3 Zvavahera M Chirenje,4 John E Ataguba,5,6 Dharmishta Parmar,2  \nEkaterina Pazukhina,2 Jonathan Myles,2 Valerie A Sills,2 Sudarshan Govender,1 Fiona M Walter,2 on behalf of the AWACAN-ED collaborator team  \nTo cite: Moodley J, Scott SE, Day S, et al. Time to diagnosis for breast, cervical and colorectal cancer in Zimbabwe and South Africa: a crosssectional study. BMJ Glob Health 2026;11:e021889 . doi:10 . 1136/ bmjgh-2025-021889  \nHandling editor Kerry Scott ► Additional supplemental material is published online only.  \nTo view, please visit the journal online ([https://doi.org/10.1136/](https://doi.org/10.1136/)[ ](https://doi.org/10.1136/)[bmjgh-2025-021889](bmjgh-2025-021889)) .  \nReceived 22 August 2025 Accepted 3 January 2026  \n© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group. For numbered affiliations see end of article.  \nCorrespondence to  \nProfessor Jennifer Moodley; [jennifer.moodley@uct.ac.za](jennifer.moodley@uct.ac.za)  \nABSTRACT  \nIntroduction Shorter time to diagnosis may lead to better cancer outcomes in Southern Africa. This study measured the time from symptoms to first healthcare visit (patient interval; PI) and diagnosis (diagnostic interval; DI) and associated factors for breast, cervical and colorectal cancer in Zimbabwe and South Africa (SA) .  \nMethods A cross-sectional survey collected data on socio-demographics, cancer awareness, barriers to seeking care, symptoms, healthcare visits and diagnosis after recent cancer diagnosis. Cox regression was used to determine factors associated with PI and DI.  \nResults This study included 1021 participants (Zimbabwe 396, SA 625) . Symptom and risk factor recall was low. Median PIs were shorter than DIs across cancers and regions. For breast cancer, those reporting more healthseeking barriers had longer PIs (Zimbabwe HR 0 .801, 95% CI 0.703 to 0 .913; SA HR 0 .885, 95% CI 0.817 to 0.958), while greater emotional response to symptoms was associated with a shorter PI (Zimbabwe HR 1 . 194, 95% CI 1.101 to 1.295; SA HR 1 . 145, 95% CI 1.079 to 1 .216) . Interpreting a cervical symptom as serious (Zimbabwe) was associated with a shorter PI. DIs were longer in less-resourced regions and increased with number of healthcare visits before diagnosis. Significantly shorter DIs occurred when the first provider was a clinic doctor or specialist compared with a clinic nurse.  \nConclusions Efforts to improve timely cancer diagnosis in Zimbabwe and SA should focus on supporting  \nprimary healthcare providers in managing and referring symptomatic patients, enhancing cancer symptom awareness and interpretation, and addressing barriers to care.  \nINTRODUCTION  \nCancer is an increasing public health challenge in Southern Africa. In 2022, 1 109 209 new cases and 711429 deaths were reported.1 By 2045, new cases are predicted to increase by 107% and deaths by 91%, placing strain on individuals, communities and healthcare systems.2 Rising incidence and mortality are attributed to the high prevalence of risk  \n\n| WHAT IS ALREADY KNOWN ON THIS TOPIC |\n| --- |\n| ⇒ Advanced-stage presentation is the dominant pattern for breast, cervical and colorectal cancer in Southern Africa.\u003Cbr>⇒ International evidence shows that shorter time to diagnosis is associated with better outcomes, yet little is known about these intervals in Southern Africa.\u003Cbr>WHAT THIS STUDY ADDS |\n| ⇒ This study provides much-needed high quality data on the time from, and factors associated with symptom awareness to presentation to healthcare (patient interval) and to diagnosis (diagnostic interval) for patients with breast, cervical and colorectal cancer in urban and rural regions in two Southern African countries.\u003Cbr>⇒ We found that patients had limited knowledge of cancer sy","cbCaicrI6Yojgv2t","https://ap.wps.com/l/cbCaicrI6Yojgv2t","pdf",491895,13,"English","# Abstract\n## Introduction\n## Methods\n## Results\n## Conclusions\n# What is already known on this topic\n# What this study adds\n# How this study might affect research, practice or policy","[{\"question\":\"What intervals were measured in this study?\",\"answer\":\"The study measured the patient interval (time from symptoms to the first healthcare visit) and the diagnostic interval (time from symptoms to diagnosis).\"},{\"question\":\"How were factors associated with the intervals analyzed?\",\"answer\":\"Cox regression was used to identify factors associated with the patient interval and the diagnostic interval.\"},{\"question\":\"What influenced the diagnostic interval the most?\",\"answer\":\"Diagnostic intervals were longer in less-resourced regions and increased with the number of healthcare visits before diagnosis; shorter intervals were observed when the first provider was a clinic doctor or specialist rather than a clinic nurse.\"}]","Time to diagnosis for breast, cervical and colorectal cancer in Zimbabwe and South Africa: a cross-sectional study | PDF",1790092457,33]