Ezeome E R
Surgical Oncology Unit, Oncology center University of Nigeria Teaching Hospital, Enugu, Nigeria.
Niger J Clin Pract. 2010 Sep;13(3):311-6.
To assess the delays and define the causes of delay in presentation and treatment of breast cancer patients in Enugu, Nigeria.
A cross-sectional survey of breast cancer patients using a semi structured questionnaire.
Surgical Oncology unit, University of Nigeria Teaching Hospital Enugu, (UNTH-E), Nigeria.
164 consecutively presenting breast cancer patients seen between June 1999 and May 2005.
Most of the patients (82.3%) reported for initial evaluation at a modern health facility while 17.5% reported first to alternative practitioners. Forty six patients (26.4%) presented within a month of noticing the symptoms while 72 (45.3%) delayed more than 3 months. In contrast, 18 (17%) were seen at the site of definitive treatment within one month of seeking help at the initial hospital while 73.4% had a delay of more than 3 months after the initial hospital contact. Institutional or physician induced delays were present in 46.2% of the cases while patient related delays were present in 79.2% of cases. Only use of alternative practitioners for initial treatment was significantly related to delays of more than three months before presentation (p = 0.017).
For breast cancer prevention programs in Nigeria to succeed, they must in addition to breast awareness and screening programs, address the institutional bottlenecks, the dearth of knowledge among primary care physicians and improve referrals from alternative practitioners and prayer houses.
评估尼日利亚埃努古乳腺癌患者就诊及治疗的延误情况并确定延误原因。
采用半结构化问卷对乳腺癌患者进行横断面调查。
尼日利亚埃努古尼日利亚大学教学医院外科肿瘤病房（UNTH-E）。
1999年6月至2005年5月间连续就诊的164例乳腺癌患者。
大多数患者（82.3%）在现代医疗机构进行初次评估，而17.5%的患者首先就诊于替代疗法从业者。46例患者（26.4%）在发现症状后1个月内就诊，而72例（45.3%）延误超过3个月。相比之下，18例（17%）在初次就诊医院寻求帮助后1个月内在最终治疗地点就诊，而73.4%的患者在初次医院就诊后延误超过3个月。46.2%的病例存在机构或医生导致的延误，79.2%的病例存在患者相关的延误。仅初次治疗使用替代疗法从业者与就诊前超过三个月的延误显著相关（p = 0.017）。
为使尼日利亚的乳腺癌预防项目取得成功，除了提高乳房意识和筛查项目外，还必须解决机构瓶颈、初级保健医生知识匮乏的问题，并改善来自替代疗法从业者和祈祷场所患者的转诊情况。
