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.
Highlights
Breast cancer is often diagnosed at an advanced stage in Cameroon
We measured time elapsed between the awareness of first signs of disease and the initial consultation, time lapse between the initial consultation and pathological diagnosis of breast cancer, interval between pathological diagnosis and treatment onset, time elapsed between the initial consultation and management and time elapsed from awareness of first signs of disease to treatment onset
The variables of interest sought included socio-demographic status, clinical and histopathological aspects, consultation delays, the delay to diagnosis, treatment delays, the health system delay and the overall delay
Summary
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. Breast cancer is a public health problem because of its frequency and severity. Breast cancer survival has gradually improved in developed countries over the years. In developing countries, breast cancer is often in an advanced stage at the time of diagnosis and the survival rate is generally low [5] [6] [7]. In 2016, a hospital series collected in Cameroon at the Yaoundé General Hospital (YGH) estimated the overall 5-year survival rate for breast cancer at 30% [8]
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