A Survey of the Cardiology Care Delivered to Cancer Patients in Nigeria

Abstract

BACKGROUND: The incidence of cardiovascular disease is on the rise and this is no less so amongst the population of individuals who are affected by cancer as improvement over the years in cancer treatment options have brought about improved outcomes in terms of overall patient survival and outcomes but has additionally also illuminated the side effects of these cancer treatment as patients live longer to manifest them thereby increasing morbidity and mortality. In Nigeria, there is paucity of data on cardio-oncology and this study will be the first documented study assessing the level of knowledge and the activity of cardiology care provided to oncology patients who develop cardiovascular disease in Nigeria and will therefore serve as a template towards the development of cardio-oncology services in Nigeria. METHODS: The survey was questionnaire-based involving cardiologist in Nigeria. They first part assessed the demographic characteristics of participants. The second part of the questionnaire assessed participants’ self-admitted expertise in the management of cardiovascular conditions complicating cancer treatment. RESULTS: There were more male (57.14%) than female (42.86%) respondents. More than two-thirds of respondents (71.4%, n=55) were aged 30-44 year. Cumulatively, the South-south and South-western regions accounted for over two-thirds of responses (72.43%, n=55). Over three-thirds of respondents (83.12%, n=) worked at teaching hospitals. Majority (89.5%, n=68) of ambulatory cancer patients in need of cardiology care received this service in a general cardiology clinic with only 10.5% (n=8) receiving care at a cardio-oncology centre. Majority of respondents (67.1%, n=51) dId not receive referrals from general practitioners or other specialists to evaluate cardiac problems in patients who had received cancer treatment. 80.5% of participants (n=62) said that they either did not know about the ESC position paper or knew about it but did not apply its suggestions to their practice. CONCLUSION: Most cancer patients requiring cardiovascular care are seen in the general cardiology clinic of Government owned hospitals in Nigeria. Although the knowledge of cardiologists in the management of cardiovascular complications of cancer patients is adequate, referral from General Practitioners is low. The ESC position paper on cardio-oncology is poorly known and utilized by cardiologist in the care of cancer patients with cardiovascular complications with the field of cardio-oncology generally regarded as a new topic in cardiology requiring more information on its dissemination and acceptance. This survey therefore makes obvious the dearth of knowledge regarding cardio-oncology that is prevalent in Nigeria. It is hoped that this will ignite a change in this aspect. There is therefore an urgent need to for all stakeholders to join force together towards the development of cardio-oncology skills and services in Nigeria.