Factors Contributing towards Delayed Diagnosis of Cervical Cancer: a cross-sectional study of cervical cancer patients admitted at MNH and Health Care providers in Magu District
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Date
2001
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Publisher
University of Dar es Salaam
Abstract
Objective: To identify factors contributing to late presentation of patients with cervical cancer to health care facilities. To determine the level of knowledge of health care providers on cervical cancer and the availability of basic facilities for gynaecological examination in the primary health care facilities. Study design: A cross-sectional study. Setting: Conducted in two parts. First part at Muhimbili National Hospital (MNH) and the second part in Magu district involving the district hospital and primary health care facilities. Population: First part included two hundred and three women with cancer of the cervix who were admitted at MNH from 1st August to November 2000. The second part included 54 health care providers working in Magu district. Results: Two hundred and three patients with cervical cancer were included in the study out of which 78.3% had advanced stage of the disease. All patients were symptomatic. The median durations that elapsed between experiencing first symptoms and reporting to a modern health care facility were 4(2,9) months and 4(1,12) months in the early and delayed groups respectively. Socio-demographic characteristics were not significantly associated with early diagnosis. The first person consulted and the advices given were not associated with early diagnosis of the disease (X2=3.13;df=4:p=0.537 and X2=1.02;df=3;p=0.796 respectively). The symptoms that they presented with at MNH were not significantly associated with early diagnosis. Study on knowledge of cancer of the cervix from primary health care settings was conducted on 54 health care providers from Magu district. Out of these, 22 (40.7%) health care providers had heard of a pap smear with the level of awareness being highest among the higher cadres (X2=19.6;df=2p=0.001). Their level of knowledge on cancer of the cervix ranged from 1 to 13 on a score scale of "0 to 17" (mean score 4.63). The knowledge on symptoms, risk factors and control were significantly higher in higher cadres than in lower cadres while that on treatment was not significantly different (p=0.5194). All health care facilities had almost all basic facilities for gynaecologic examination except light source, which was present in only 44.2% of the facilities. Conclusion: Most patients presented with advanced stages of cancer of the cervix at MNH. The Socio-demographic characteristics, first person consulted and duration that passed before reporting to modern health care facilities was not different in the early and delayed diagnosed groups. Most patients in both groups failed to recognize the abnormal nature of the symptoms, which contributed to longer durations before reporting to modern health care facilities. Study on knowledge of cervical cancer among health care providers in Magu district showed that knowledge on the disease was very low. The availability of basic gynaecological examination facilities was encouraging. Recommendation: The community at large should be made aware of the disease and the importance of reporting early to modern health care services. Continuing education and training of health care providers on cancer of the cervix should be instituted. More studies are recommended on women's perception of symptoms referable to cancer of the cervix in the Community.
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Keywords
Cancer diagnosis, Cervical cancer, Muhimbili (MNH)
Citation
Pembe, A. B. (2001) Factors Contributing towards Delayed Diagnosis of Cervical Cancer: a cross-sectional study of cervical cancer patients admitted at MNH and health care providers in Magu district, Masters’ dissertation, University of Dar es Salaam. Available at (http://41.86.178.3/internetserver3.1.2/detail.aspx)