Appendix A.

Examples of the search string used in MEDLINE

1. (breast OR mammary) ADJ3 (neoplasm* OR cancer* OR tumo?r* OR carcinoma)

2. exp Breast Neoplasms

3. 1 OR 2

4. (delay* OR late OR poor) ADJ1 (presentation OR attendance OR diagnosis OR stage OR detection OR prognosis)

5. exp Delayed Diagnosis

6. exp Prognosis

7. exp Early Diagnosis

8. 4 OR 5 OR 6 OR 7

9. (determinant* OR factor* OR reason* OR barrier* OR attitude* OR belie* OR awareness OR knowledge OR fear* OR cultur* OR perception*)

10. (uptake OR utilization OR access OR accept* OR intent* OR distance OR transport* visit* OR presentation*) ADJ3 (health care centre OR hospital OR clinic OR health service OR doctor OR physician OR mammogram* OR screening OR exam*)

11. exp “Behavior and Behavior Mechanisms”

12. exp Attitude to Health

13. exp Socioeconomic Factors

14. exp Health Status Disparities

15. exp Communication Barriers

16. OR/9-15

17. Africa OR Algeria OR Angola OR Benin OR Botswana OR Burkina Faso OR Burundi OR Cameroon OR Cape Verde OR Central African Republic OR Chad OR Democratic Republic of the Congo OR Djibouti OR Egypt OR Equatorial Guinea OR Eritrea OR Ethiopia OR Gabon OR Gambia OR Ghana OR Guinea-Bissau OR Guinea OR Ivory Coast OR Kenya OR Lesotho OR Liberia OR Libya OR Madagascar OR Malawi OR Mali OR Mauritania OR Mauritius OR Morocco OR Mozambique OR Namibia OR Niger OR Nigeria OR Republic of Congo OR Rwanda OR Senegal OR Sierra Leone OR Somalia OR South Africa OR South Sudan OR Sudan OR Swaziland OR Tanzania OR Togo OR Tunisia OR Uganda OR Zambia OR Zimbabwe

18. exp Africa

19. 17 OR 18

20. 3 AND 8 AND 16 AND 19