title: A study of patients who appear with far advanced cancer at Yaounde General Hospital, Cameroon, Africa.
abstract: BACKGROUND
  This is a preliminary study to identify patients with cancer who appeared with very advanced disease and to report the common reasons for their delay. It was undertaken because the numbers of such patients appeared to be increasing.
  
  
  METHODS
  A convenience sample of 20 patients were identified by the oncologist (P.N.) as appearing with very late stage disease or appearing and not returning until a late stage. They were interviewed by the psychologist (A.E.) to determine: symptom onset; treatment sought; reasons for seeking consultation; beliefs, fears, and level of information about cancer; and willingness to be treated.
  
  
  RESULTS
  The primary reasons given for waiting so long to seek care were: inability to pay for medical care (10); inadequate diagnosis by general doctors leading to time lost before coming for consultation; (9); beliefs, fears, cultural factors, ignorance (9). More than one factor could be identified in half the patients.
  
  
  CONCLUSIONS
  Understanding the factors that influence delay is important to improving the outcomes for cancer patients. Factors that contribute to delay in developing countries appear to be largely the paucity of appropriate health care, coupled with poor information, and beliefs and fears about cancer.
authors.affiliation: Oncology Division, Yaounde General Hospital, Cameroon. acebessem@yahoo.com
authors.forename: AnnCommy
authors.initials: A
authors.lastname: Ekortarl
authors.forename: Paul
authors.initials: P
authors.lastname: Ndom
authors.forename: Alexandra
authors.initials: A
authors.lastname: Sacks
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy; D002163:Cameroon / Q000453:epidemiology; D002391:Catchment Area, Health; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000453:epidemiology* / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012514:Sarcoma, Kaposi / Q000523:psychology* / Q000628:therapy