Determinants of stage at diagnosis of breast cancer in Nigerian women: sociodemographic, breast cancer awareness, health care access and clinical factors

被引:36
作者
Jedy-Agba, Elima [1 ]
McCormack, Valerie [2 ]
Olaomi, Oluwole [3 ]
Badejo, Wunmi [3 ]
Yilkudi, Monday [4 ]
Yawe, Terna [4 ]
Ezeome, Emmanuel [5 ]
Salu, Iliya [6 ]
Miner, Elijah [7 ]
Anosike, Ikechukwu [8 ]
Adebamowo, Sally N. [9 ]
Achusi, Benjamin [10 ]
dos-Santos-Silva, Isabel [1 ]
Adebamowo, Clement [11 ,12 ]
机构
[1] London Sch Hyg & Trop Med, Fac Epidemiol & Populat Hlth, Dept Noncommunicable Dis Epidemiol, London, England
[2] Int Agcy Res Canc, Sect Environm & Radiat, Lyon, France
[3] Natl Hosp Abuja, Abuja, Nigeria
[4] Univ Abuja, Teaching Hosp, Gwagwalada, Nigeria
[5] Univ Nigeria, Teaching Hosp, Enugu, Nigeria
[6] Asokoro Dist Hosp, Abuja, Nigeria
[7] Garki Hosp, Abuja, Nigeria
[8] Wuse Gen Hosp, Abuja, Nigeria
[9] Natl Human Genome Res Inst, Ctr Res Genom & Global Hlth, Bethesda, MD USA
[10] Fed Staff Hosp, Abuja, Nigeria
[11] Univ Maryland, Inst Human Virol, Baltimore, MD 21201 USA
[12] Marlene & Stewart Greenebaum Comprehens Canc Ctr, Baltimore, MD USA
关键词
Breast cancer; Stage; Stage at diagnosis; Awareness; Nigeria; SUB-SAHARAN AFRICA; DISPARITIES; SURVIVAL; DELAYS;
D O I
10.1007/s10552-017-0894-y
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose Advanced stage at diagnosis is a common feature of breast cancer in Sub-Saharan Africa (SSA), contributing to poor survival rates. Understanding its determinants is key to preventing deaths from this cancer in SSA. Methods Within the Nigerian Integrative Epidemiology of Breast Cancer Study, a multicentred case-control study on breast cancer, we studied factors affecting stage at diagnosis of cases, i.e. women diagnosed with histologically confirmed invasive breast cancer between January 2014 and July 2016 at six secondary and tertiary hospitals in Nigeria. Stage was assessed using clinical and imaging methods. Ordinal logistic regression was used to examine associations of sociodemographic, breast cancer awareness, health care access and clinical factors with odds of later stage (I, II, III or IV) at diagnosis. Results A total of 316 women were included, with a mean age (SD) of 45.4 (11.4) years. Of these, 94.9% had stage information: 5 (1.7%), 92 (30.7%), 157 (52.4%) and 46 (15.3%) were diagnosed at stages I, II, III and IV, respectively. In multivariate analyses, lower educational level (odds ratio (OR) 2.35, 95% confidence interval: 1.04, 5.29), not believing in a cure for breast cancer (1.81: 1.09, 3.01), and living in a rural area (2.18: 1.05, 4.51) were strongly associated with later stage, whilst age at diagnosis, tumour grade and oestrogen receptor status were not. Being Muslim (vs. Christian) was associated with lower odds of later stage disease (0.46: 0.22, 0.94). Conclusion Our findings suggest that factors that are amenable to intervention concerning breast cancer awareness and health care access, rather than intrinsic tumour characteristics, are the strongest determinants of stage at diagnosis in Nigerian women.
引用
收藏
页码:685 / 697
页数:13
相关论文
共 46 条
[1]   Determinants of advanced stage presentation of breast cancer in 87,969 Brazilian women [J].
Abrahao, Karen de Souza ;
Bergmann, Anke ;
de Aguiar, Suzana Sales ;
Santos Thuler, Luiz Claudio .
MATURITAS, 2015, 82 (04) :365-370
[2]   Breast-cancer screening with trained volunteers in a rural area of Sudan: a pilot study [J].
Abuidris, Dafalla Omer ;
Elsheikh, Ahmed ;
Ali, Majdeldien ;
Musa, Hassan ;
Elgaili, Elgaili ;
Ahmed, Anas O. ;
Sulieman, Imadeldien ;
Mohammed, Sulma Ibrahim .
LANCET ONCOLOGY, 2013, 14 (04) :363-370
[3]  
Amoran Olorunfemi Emmanuel, 2015, Niger Med J, V56, P185, DOI 10.4103/0300-1652.160362
[4]  
Anyanwu SNC, 2000, E AFR MED J, V77, P539
[5]   Acceptance and adherence to treatment among breast cancer patients in Eastern Nigeria [J].
Anyanwu, Stanley N. C. ;
Egwuonwu, Ochonma A. ;
Ihekwoaba, Eric C. .
BREAST, 2011, 20 :S51-S53
[6]   Knowledge, Attitude and Practices of Women Towards Breast Cancer in Benin City, Nigeria [J].
Azubuike, S. O. ;
Okwuokei, S. O. .
ANNALS OF MEDICAL AND HEALTH SCIENCES RESEARCH, 2013, 3 (02) :155-160
[7]  
Baxter N, 2001, CAN MED ASSOC J, V164, P1837
[8]   Poor hormone receptor expression in East African breast cancer: Evidence of a biologically different disease? [J].
Bird, P. A. ;
Hill, A. G. ;
Houssami, N. .
ANNALS OF SURGICAL ONCOLOGY, 2008, 15 (07) :1983-1988
[9]   Breast cancer in Sub-Saharan Africa: opportunities for prevention [J].
Brinton, Louise A. ;
Figueroa, Jonine D. ;
Awuah, Baffour ;
Yarney, Joel ;
Wiafe, Seth ;
Wood, Shannon N. ;
Ansong, Daniel ;
Nyarko, Kofi ;
Wiafe-Addai, Beatrice ;
Clegg-Lamptey, Joe Nat .
BREAST CANCER RESEARCH AND TREATMENT, 2014, 144 (03) :467-478
[10]  
Clegg-Lamptey Jna, 2007, Ghana Med J, V41, P72