Public Health, College of Medicine and Health Sciences, Adigrat University, Adigrat, Tigray, Ethiopia.
Preventive Medicine, Addis Ababa University School of Public Health, Addis Ababa, Ethiopia.
BMJ Open. 2019 Apr 9;9(4):e027034. doi: 10.1136/bmjopen-2018-027034.
Cancer is an emerging public health problem in Ethiopia, with breast and cervical cancers accounting for over half of all newly diagnosed cancers in women. The majority of women with breast and cervical cancer are diagnosed at late stage of the disease and most patients do not receive care consistent with global standards. However, little is known about the health-seeking behaviours, barriers to early detection and treatment, patient-reported outcomes, financial burden and survival of women with breast and cervical cancer in the country. Therefore, this study aims to document the experience of women with breast and cervical cancer from recognition of symptoms to diagnosis, treatment and survivorship/mortality in Addis Ababa city, Ethiopia.
A prospective follow-up study using mixed methods (both quantitative and qualitative) will be employed. All women newly diagnosed with breast and cervical cancer from 1 January, 2017 to 30 June 2018 in Addis Ababa will be included in the study. Interviewer-administered questionnaires will be used to collect information about medical consultations after recognition of symptoms, health-seeking behaviours, treatment received, barriers to early detection and treatment, and survivorship care. In-depth interview will be conducted on purposefully selected women with breast and cervical cancer. The primary outcomes of the study are time intervals (patient and diagnostic waiting times), stage at diagnosis and survival. Multivariable analysis will be employed to determine the contributions of independent variables on the outcomes of interest. HRs with 95% CIs will be calculated for time-to-event outcomes. Qualitative data will be analysed using thematic analysis.
This protocol is ethically approved by Institutional Review Board of Addis Ababa University. Verbal informed consent will be obtained from study participants. Results will be disseminated in international peer-reviewed journals and presented in relevant conferences.
癌症是埃塞俄比亚新出现的公共卫生问题，乳腺癌和宫颈癌占女性新诊断癌症的一半以上。大多数患有乳腺癌和宫颈癌的女性在疾病晚期被诊断出来，大多数患者没有接受符合全球标准的治疗。然而，对于该国患有乳腺癌和宫颈癌的女性的求诊行为、早期检测和治疗障碍、患者报告的结果、经济负担和生存情况知之甚少。因此，本研究旨在记录埃塞俄比亚亚的斯亚贝巴市女性从出现症状到诊断、治疗和生存/死亡的经历。
将采用前瞻性随访研究，结合定量和定性方法（即混合方法）。将纳入 2017 年 1 月 1 日至 2018 年 6 月 30 日期间在亚的斯亚贝巴新诊断为乳腺癌和宫颈癌的所有女性。将使用访谈者管理的问卷收集有关症状出现后医疗咨询、求诊行为、接受的治疗、早期检测和治疗障碍以及生存护理的信息。将对有乳腺癌和宫颈癌的女性进行有针对性的深入访谈。研究的主要结局是时间间隔（患者和诊断等待时间）、诊断时的分期和生存。将采用多变量分析来确定独立变量对感兴趣结局的贡献。将计算时间事件结局的 HRs 及其 95%CI。将使用主题分析对定性数据进行分析。
本方案已获得亚的斯亚贝巴大学机构审查委员会的伦理批准。将从研究参与者处获得口头知情同意。研究结果将在国际同行评审期刊上发表，并在相关会议上展示。
