Cancer care challenges in developing countries.
BACKGROUND
Health systems in Sub-Saharan Africa are not prepared for the rapid rise in cancer rates projected in the region over the next decades. More must be understood about the current state of cancer care in this region to target improvement efforts. Yaounde General Hospital (YGH) currently is the only site in Cameroon (population: 18.8 million) where adults can receive chemotherapy from trained medical oncologists. The experiences of patients at this facility represent a useful paradigm for describing cancer care in this region.


METHODS
In July and August 2010, our multidisciplinary team conducted closed-end interviews with 79 consecutive patients who had confirmed breast cancer, Kaposi sarcoma, or lymphoma.


RESULTS
Thirty-five percent of patients waited >6 months to speak to a health care provider after the first sign of their cancer. The delay between first consultation with a health care provider and receipt of a cancer diagnosis was >3 months for 47% of patients. The total delay from the first sign of cancer to receipt of the correct diagnosis was >6 months for 63% of patients. Twenty-three percent of patients traveled for >7 hours to reach YGH, and 40% of patients interviewed spent >$200 on a single round of chemotherapy.


CONCLUSIONS
Cancer patients experienced numerous geographic and health care system challenges, resulting in significant delays in receiving diagnosis and treatment, even for cancers highly amenable to early intervention. This unacceptable and unethical situation is likely explained by limited knowledge about cancer among patients and health care professionals, government neglect, poverty, and reliance on traditional healers.
School of Medicine, University of California-San Diego, San Diego, CA 92093, USA. adprice@ucsd.edu
Adi J
AJ
Price
Paul
P
Ndom
Etienne
E
Atenguena
Jean Pierre
JP
Mambou Nouemssi
Robert W
RW
Ryder
D000328:Adult; D017954:Africa South of the Sahara; D000368:Aged; D057210:Delayed Diagnosis; D003695:Delivery of Health Care; D003906:Developing Countries; D005260:Female; D015438:Health Behavior; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D012017:Referral and Consultation; D055815:Young Adult