Delay between Breast Cancer Detection and Arrival at Specialist Clinic Preliminary Revelations of Multicentered Survey in Nigeria
Delay between breast cancer detection and arrival at specialist
clinic. Preliminary revelations of multicenter survey in Nigeria
Background: Level of breast cancer awareness and rate of
late presentation usually have inverse relationship. The parallel relationship witnessed
in Nigeria is a paradox requiring urgent intervention.
Aim: To understand the
paradox, we described the patient’s journey from lump detection to arrival at the specialist clinic. Barring
awareness, identifying where the major delays still resided will help to re-direct
our strategies in the control of breast cancer scourge.
Method: Cross-sectional multicenter questionnaire based survey
conducted in surgery outpatient clinics of 10 tertiary institutions in North
central and Southwestern Nigeria. Face-to-face interview was conducted using pretested
questionnaire. Data was analyzed using SPSS, version 18. p-value was set at 0.05.
Results: One hundred newly diagnosed women responded in this preliminary
analysis. Age ranged 26-80 years (mean 50.5± 13.2). Eighty-one (81%) were aware
of breast cancer before detecting their lump(s). Eighty-eight (88%) had lumps ≤5cm
at detection. Sixty-nine (69%) (p= 0.0001) visited the first orthodox personnel
when their lumps were ≤5cm. Only 39(39%) arrived at specialist clinic when their
lumps were ≤5cm. Ninety-five respondents (95%) (p=0.0001) visited orthodox personnel
first to seek treatment. The first personnel was general practitioner 72% of the
times (p=0.0001) (see figure 2). Fifty-eight (58%) consulted the first orthodox
personnel within 8 weeks (p=0.133). Only 26% arrived at a specialist clinic within
8 weeks (p=0.0001). Mean interval from detection to first personnel was shorter
(61 days) than mean interval between first personnel and specialist clinic (157
Conclusion: The longest stretch of journey was between the first
orthodox consultation and the specialist clinic.
Keywords: breast cancer, detection, Journey to specialist clinic.
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