Factors associated with anticipated delay in seeking care for breast cancer symptoms among women attending gynecologic outpatient services in Ilubabor Zone, Southwest Ethiopia: a convergent mixed-methods study

Anticipated delay in seeking healthcare for breast cancer symptoms contributes to late-stage diagnosis and poor outcomes, particularly in resource-limited settings. Evidence on the magnitude of, and factors associated with, such delay remains limited in Southwest Ethiopia. To determine the prevalence of anticipated delay (> 3 months) and identify associated factors among women attending selected public gynecologic outpatient services in Ilubabor Zone, Southwest Ethiopia, 2026. A facility-based convergent mixed-methods study was conducted from January to March 2026 among 465 women attending gynecologic outpatient services. The quantitative component used a cross-sectional design with systematic sampling and interviewer-administered questionnaires, while 28 women participated in in-depth interviews. Data were analyzed using descriptive statistics and multivariable logistic regression. Adjusted odds ratios with 95% confidence intervals identified significant factors. Qualitative data were analyzed thematically and integrated with quantitative findings. The prevalence of anticipated delay was 59.4% (95% CI: 54.8–63.9%). After adjustment, six variables remained independently associated with anticipated delay: inability to read and write (AOR = 4.35, 95% CI: 2.18–8.68), history of visiting traditional healers (AOR = 3.28, 95% CI: 2.01–5.35), poor knowledge of breast cancer symptoms (AOR = 2.45, 95% CI: 1.53–3.92), lack of breast self-examination practice (AOR = 3.67, 95% CI: 2.05–6.57), painless breast symptoms (AOR = 3.36, 95% CI: 1.98–5.70), and absence of axillary swelling (AOR = 4.85, 95% CI: 2.61–9.02). Age 40 years or older, rural residence, and travel distance greater than 5 km showed strong crude associations with anticipated delay but did not remain statistically significant after adjustment for other factors (AOR = 3.12, 95% CI: 0.98–4.94, p = 0.07; AOR = 2.98, 95% CI: 0.94–4.83, p = 0.08; and AOR = 3.05, 95% CI: 0.92–5.11, p = 0.061, respectively). Qualitative findings revealed normalization of symptoms, anticipated psychosocial consequences, structural barriers, and cultural preference for traditional care as key themes underlying anticipated delay. A high prevalence of anticipated delay was observed, associated with interrelated socio-demographic, knowledge-related, cultural, and structural factors. Targeted education, improved access to services, promotion of breast self-examination, and culturally sensitive community engagement are essential to reduce delay and improve early breast cancer detection.