Ntekim Atara, Folasire Ayorinde, Odukoya Oluwaponmile A, Sowunmi Anthonia, Alabi Adewunmi
Department of Radiation Oncology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Department of Radiation Biology, Radiotherapy & Radiodiagnosis, College of Medicine, University of Lagos, Lagos, Nigeria.
BMC Cancer. 2025 Jan 6;25(1):11. doi: 10.1186/s12885-024-13420-1.
The mortality from breast cancer (BC) is still high in Nigeria and other low-and medium-income countries (LMICs) especially among adolescents and young adults. This is partly due to late presentation for diagnosis and treatment. It is recommended that to optimize the effectiveness of treatment, the total time which is the interval from symptom onset to initiation of treatment, should be less than 90 days as recommended by the World Health Organization (WHO). The aim of this study was to determine the extent of delays in accessing care and possible reasons for such delays among young adult females with breast cancer in Nigeria.
A mixed-method convergent parallel study design was used. The study was conducted at two academic hospitals in southwest Nigeria. Data were collected using a semi-structured assessment tool and an in-depth interview guide. Both the quantitative and qualitative data were collected concurrently. This approach was adopted to aid in the collection of different but complimentary data at the study sites to enrich the interpretation of the results.
A total of 46 female participants were recruited into the quantitative component of the study, and the mean age was 34.2 ± 4.4 years. Most had higher education, were married, and were in a lower earning bracket. Majority participants had low knowledge of symptoms and signs of breast cancer. As low as 7 (15.2%) patients had the time between symptom discovery and treatment initiation [Total Treatment Time (TT)] within 90 days (median 281.5; range 31-5260). Twenty-seven (58.6%) participants had diagnostic interval within 60 days (median 40 days [Inter Quartile Range (IQR) 7-4745 days]. Most participants interviewed 39 (85%) knew that breast lump was a possible sign of breast cancer while a sizable number 19 (41%) could not name risk factors for breast cancer. Family history was the most recognised risk factor for breast cancer by 21(46%) of participants interviewed.
Breast health awareness is low among adolescents and young adults with breast cancer in Nigeria, as most participants 33(72%) lacked knowledge of early symptoms and signs of breast cancer. Very few 7(15%) of the participants commenced treatment within the WHO recommended 90 days of noticing breast symptoms. Sixty percent of the participants met the diagnostic interval of within 60 days as against recommended 80%. There is need to intensify the education of young Nigerian females on breast cancer and the importance of breast self-examination.
在尼日利亚和其他中低收入国家（LMICs），乳腺癌（BC）的死亡率仍然很高，尤其是在青少年和年轻成年人中。部分原因是诊断和治疗的就诊时间较晚。世界卫生组织（WHO）建议，为了优化治疗效果，从症状出现到开始治疗的总时间间隔应少于90天。本研究的目的是确定尼日利亚年轻成年女性乳腺癌患者获得医疗服务的延迟程度以及此类延迟的可能原因。
采用混合方法收敛平行研究设计。该研究在尼日利亚西南部的两家学术医院进行。使用半结构化评估工具和深入访谈指南收集数据。定量和定性数据同时收集。采用这种方法有助于在研究地点收集不同但互补的数据，以丰富结果的解释。
共有46名女性参与者被纳入研究的定量部分，平均年龄为34.2±4.4岁。大多数人受过高等教育，已婚，收入较低。大多数参与者对乳腺癌的症状和体征了解甚少。只有7名（15.2%）患者在症状发现和治疗开始之间的时间[总治疗时间（TT）]在90天内（中位数281.5；范围31 - 5260）。27名（58.6%）参与者的诊断间隔在60天内（中位数40天[四分位间距（IQR）7 - 4745天]）。接受访谈的大多数参与者39名（85%）知道乳房肿块可能是乳腺癌的迹象，而相当一部分19名（41%）无法说出乳腺癌的危险因素。21名（46%）接受访谈的参与者认为家族史是最被认可的乳腺癌危险因素。
在尼日利亚患有乳腺癌的青少年和年轻成年人中，乳房健康意识较低，因为大多数参与者33名（72%）缺乏乳腺癌早期症状和体征的知识。只有极少数7名（15%）参与者在发现乳房症状后的WHO建议的90天内开始治疗。60%的参与者达到了60天内的诊断间隔，而建议的比例为80%。有必要加强对尼日利亚年轻女性的乳腺癌教育以及乳房自我检查的重要性。
