TITLE:
Consultation, Diagnosis and Treatment Delays for Breast Cancer among Patients Followed up at the Yaoundé General Hospital, Cameroon
AUTHORS:
Jean Dupont Kemfang Ngowa, Angèle Kabeyene, Richard Ngarvounsia, Etienne Atenguena, Yvan Sinclair Ngaha Tchawe, Anny Ngassam, Christiane Nsahlai, Junie Metogo, Jovanny Fouogue Tsuala, Pierre Marie Tebeu
KEYWORDS:
Breast Cancer, Delay in Consultation, Delay in Diagnosis, Delay in Treatment
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.10 No.11,
November
16,
2020
ABSTRACT: Introduction: Breast cancer is often diagnosed at an advanced
stage in Cameroon. The objective was to analyse consultation, diagnosis and
treatment delays for breast cancer among patients followed up at the Yaoundé
General Hospital (YGH) in Cameroon. Materials and Methods: This was a cross-sectional study carried out from
the files of patients followed up for breast cancer at the YGH from January 1,
2014 to April 30, 2018. A total of 183 patients were included. We measured time
elapsed between the awareness of first signs of disease and the initial
consultation (consultation delays), time lapse between the initial consultation
and pathological diagnosis of breast cancer (diagnosis delays), interval
between pathological diagnosis and treatment onset (treatment delays), time
elapsed between the initial consultation and management (health system delays)
and time elapsed from awareness of first signs of disease to treatment onset
(overall delays). Results: The delays (median, IIQ) were: (5.1 months; IIQ: 1.7 - 12.4), (25 days;
IIQ: 10 - 67), (27 days; IIQ: 13 - 63), (2.2 months; IIQ: 1.2 - 5.8) and (9.9
months; IIQ: 4.4 - 17.6) respectively for
consultation, diagnosis, treatment, health system and overall delays. The risks
associated with a delay in initial consultation of greater than 3 months were (OR;
95% CI): unschooled patients (2.01; 1.66 - 2.40); monthly income below the
minimum wage (2.70; 1.81 - 5.96); unemployment (2.14; 1.02 - 3.24) and absence
of a family history of cancer (2.44; 1.66 - 6.10). The main reasons for a late
first consultation were: ignorance (60.2%), financial challenges (17.6%) and a
preference for alternative treatment (11.1%). Conclusion: The
consultation, diagnosis and treatment delays for breast cancer are very often
long in our setting than those reported in developed countries. Both patients’
and institutional factors are demonstrated. There is a need to increase public
awareness on the value of early diagnosis of breast cancer. Also, health system
should be improved to enable early diagnosis and treatment of this affection.