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Breast Cancer: Why Do Nigerian Women Present Late to the Hospital?

A new study suggests that low level of awareness may not be the main reason for delay in seeking treatment for breast cancer. The outcome of Breast Cancer depends largely on the time of presentation. Despite this many women with breast cancer in Nigeria present late and with advanced disease which is a source of concern. According to the study, efforts should be made to look beyond ‘level of awareness’ in improving early presentation.

This study involved a systematic review of fifty-one studies published in the Ethiopian Journal of Health Science.

The studies involved 19, 598 participants consisting of 17,086 laypersons and  2, 512 healthcare professionals. Although up to 80% of the participants had good knowledge of what breast cancer is, its treatment and outcomes, less than 25% had performed any form of breast cancer screening or examination.

To reduce the rate of dying from breast cancer in Nigeria (which has the third highest rates of death globally), millions of dollars have been pumped into increasing the level of awareness of breast cancer and it screening. Worldwide, the month of October is designated as Breast Cancer Awareness month.

Unfortunately, this does not appear to be making a significant impact on how often women screen themselves for breast cancer and how early a diagnosis is made. For instance, in Northern, 9 out 10 women with breast cancer still present with advanced stage of the disease.

Why are Nigerian women presenting late for Breast Cancer diagnosis?

  • Fear –Many are afraid the doctors may offer surgery such as mastectomy or other forms of treatment that are culturally unacceptable. Many are also afraid of embarrassment and divorce.
  • Preference for alternative therapy-Some prefer herbal products, spiritual healing, food supplements to medications and treatment at the hospital.
  • Poverty- Some women lack the funds to seek proper treatment. In view of these, they
  • Ignorance-Many believe that breast cancer will always involve pain. Some do not feel that changes in the breast or appearance of lumps warrant further evaluation from healthcare professionals. According to the authors, poor sense of susceptibility, poor sense of fatality and poor knowledge of benefit of screening contribute to delay in seeking treatment.
  • Access to treatment facilities-This affects those in rural areas where access to basic facilities  and health centers are really limited. In some instances, persons refuse to accept the diagnosis because they mistrust hospital staff.

 

Some of these reasons are common across African countries.  For instance, in a recent study in South Africa, the reasons cited for late presentation were fear of losing a breast, not knowing the severity of the disease and seeing a traditional healer before going to the hospital.

What are the warning signs of Breast cancer?

According to the American Cancer Society, these are:

  • Pain in the Nipple of Breast
  • Swelling of all or part of a breast (even without a lump)
  • Skin irritation of dimpling
  • Nipple turning inward
  • Any changes in the color, thickness or discharge the Nipple
  • Nipple discharge

Generally, any unusual ache, pain or in the breast may require further examination by your doctor. Note that these aches may occur occasionally. If it appears to be coming from deep within the bones, it may be an early warning sign of cancer.

Do NOT rely only on mammogram because it is limited in detecting cancer. It may be more helpful to know your breast health and take action whenever you note any changes that occur.

Read more: Cancer-Facts, Causes, Prevention and Treatment

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