Affiliation:
1. Chidinma Anakwenze, MD Anderson Cancer Center, Houston, TX; Rohini Bhatia, University of Rochester School of Medicine and Dentistry, Rochester, NY; William Rate, Georgetown University School of Medicine, Washington, DC; Lame Bakwenabatsile, Ari Ho-Foster, and Surbhi Grover, Botswana-University of Pennsylvania Partnership, Gaborone, Botswana, and Philadelphia, PA; Kebatshabile Ngoni, Mohan Narasimhamurthy, and Doreen Ramogola-Masire, University of Botswana; Surbhi Grover, Princess Marina Hospital,...
Abstract
Purpose Botswana, a country with a high prevalence of HIV, has an increasing incidence of cancer-related mortality in the post–antiretroviral therapy era. Despite universal access to free health care, the majority of Botswana patients with cancer present at advanced stages. This study was designed to explore the factors related to advanced-stage cancer presentation in Botswana. Methods Patients attending an oncology clinic between December 2015 and January 2017 at Princess Marina Hospital in Gaborone, Botswana, completed a questionnaire on sociodemographic and clinical factors as well as cancer-related fears, attitudes, beliefs, and stigma. Odds ratios (ORs) were calculated to identify factors significantly associated with advanced stage (stage III and IV) at diagnosis. Results Of 214 patients, 18.7% were men and 81.3% were women. The median age at diagnosis was 46 years, with 71.9% of patients older than 40 years. The most commonly represented cancers included cervical (42.3%), breast (16%), and head and neck (15.5%). Cancer stages represented in the study group included 8.4% at stage I, 19.2% at stage II, 24.1% at stage III, 11.9% at stage IV, and 36.4% at an unknown stage. Patients who presented at advanced stages were significantly more likely to not be afraid of having cancer (OR, 3.48; P < .05), believe that their family would not care for them if they needed treatment (OR, 6.35; P = .05), and believe that they could not afford to develop cancer (OR, 2.73; P < .05). The perception that symptoms were less serious was also significantly related to advanced stage ( P < .05). Patients with non–female-specific cancers were more likely to present in advanced stages (OR, 5.67; P < .05). Conclusion Future cancer mortality reduction efforts should emphasize cancer symptom awareness and early detection through routine cancer screening, as well as increasing the acceptability of care-seeking, especially among male patients.
Publisher
American Society of Clinical Oncology (ASCO)
Cited by
24 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献