Identifying smoker subgroups with low readiness to quit: a cluster analysis of perceived lung cancer and asthma risk profiles.

Globally, breast cancer is the most commonly diagnosed cancer among women, with an estimated 2.3 million women newly diagnosed in 2020 []. In Africa, the breast cancer incidence is lower compared to high-income countries, but mortality rates are higher due to late-stage presentation and limited access to early detection and treatment services [, ]. Sub-Saharan Africa faces particular challenges with breast cancer. The region accounts for a significant proportion of the cancer burden in Africa, with late-stage diagnosis being prevalent []. In addition, palliative care services are insufficient, often provided by non-governmental organizations and community health workers rather than being fully integrated into national health systems []. This scarcity of services results in high symptom burden and limited access to pain management and other supportive care []. In Ghana, breast cancer is the leading cause of cancer deaths among women []. The incidence rate is increasing, with approximately 4,600 newly diagnosed women and 2,000 deaths reported in 2020 []. Palliative care services are in the early stages of development. The few available services are concentrated in urban areas, leaving many rural patients without access to necessary care []. Efforts are being made to integrate palliative care into the national health system, but challenges such as funding, education, and cultural acceptance remain significant barriers []. Providing palliative care is essential as it aims to enhance the quality of life for patients and their families facing life-threatening illness, through the prevention and relief of suffering. It involves early identification, impeccable assessment, and treatment of pain and other problems, physical, psychosocial, and spiritual []. Palliative chemotherapy, while often essential in managing symptoms and progression of disease, can lead to a range of unrelenting life experiences for patients such as fatigue, nausea and vomiting, pain, anxiety and depression, social isolation and low self-esteem []. However, poverty can hinder consenting to palliative chemotherapy and compliance with treatment as many households are not able to afford the costs involved [].