title: [79 cases of invasive cancer of the cervix uteri in the Department of Oncology in Antananarivo. Can diagnostic delays be improved?].
abstract: The frequency of invasive cervical carcinoma in Western countries is currently decreasing. The development of methods of early diagnosis has improved the prognosis of the disease. In Madagascar, like in other African countries, invasive cervical carcinoma is the first genital cancer affecting women. The diagnosis comes late. Actions can be taken to improve the prognosis through early diagnosis of invasive cervical carcinoma. Our purpose was to analyze the main causes leading to these delays in diagnosis and to evaluate possibilities for improvement. This study was retrospective, consecutive and open wide not random, dealing with 79 cases of invasive cervical carcinoma, all confirmed by a histological examination, picked from the Department of Oncology at Antananarivo within a period of 24 months from the 1st of January 1990 through the 1st of January 1992. The Department of Oncology at Antananarivo is the only anti-cancer center available on the island. The position for an oncologist was occupied form 1984 to 1988 by a French doctor under the Technical Cooperation Agreement with France. Since then, no oncologist has been practicing in Madagascar. We evaluated the different reasons that could explain the delays in diagnosis and suggested possible actions to remedy the problem. We selected medical, human and technical, as well as geographical and social criteria for evaluation. Diagnosis was delayed too much (on average, about 8.48 +/- 7.12 months), possibly due to the above mentioned criteria.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Hôpital de Nosy Be, Madagascar.
authors.forename: S
authors.initials: S
authors.lastname: Ratinahirana
authors.forename: P V
authors.initials: PV
authors.lastname: Razanamparany
authors.forename: B
authors.initials: B
authors.lastname: Razafintsalama
authors.forename: A
authors.initials: A
authors.lastname: Randriamampandry
authors.forename: J
authors.initials: J
authors.lastname: Ravaoarison
authors.forename: L
authors.initials: L
authors.lastname: Rabarijaona
authors.forename: J
authors.initials: J
authors.lastname: Ranjatoarivelo
authors.forename: N
authors.initials: N
authors.lastname: Andriamanalina
mesh_terms: D002173:Cancer Care Facilities; D005260:Female; D006266:Health Education; D006801:Humans; D008270:Madagascar; D008403:Mass Screening; D008495:Medical Oncology / Q000193:education; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010817:Physician-Patient Relations; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000517:prevention & control; D000078329:Workforce
vernacular_title: Etude de 79 dossiers de cancers invasifs du col utérin dans le Service de cancérologie d'Antananarivo. Peut-on améliorer les délais diagnostiques?