Access to Breast Cancer Care in Jos, North Central

Abstract

Aims: This paper seeks to evaluate the extent to which breast cancer patients from two tertiary health care centers in Jos were able to access the different components of breast cancer care. Background: Breast cancer in low- and middle-income countries is associated with poor outcomes when compared with high-income countries. Numerous studies have identified factors responsible for this, one of them being a lack of access to the various components of breast cancer care. Breast cancer care requires a multimodal approach involving prevention, early detection, diagnosis and treatment, rehabilitation and palliative care. Access to the various modalities of care is key to a good outcome. Study Design: This study is a retrospective study. Place and Duration of the Study: The study was carried out at Jos University Teaching Hospital, and FOMAS Hospital which are both tertiary health care centers located in the city of Jos, Plateau State, Nigeria. The study spanned January 2016 to June 2019.We applied descriptive statistics for data analysis. Methodology: We included all patients who were diagnosed with breast cancer between January 2016 and December 2017. Patients were followed up for a minimum of one and a half years (from January 2018 to June 2019). The project team performed a review of medical records and charts for data elements which included; sex, age, site of tumor, stage of tumor at presentation, and access to the different treatment modalities. Data was entered into a pre-designed proforma and analyzed on the SPSS 20 Chicago, Illinois. We applied descriptive statistics to the demographic data and clinical information of patients. Results: The total number of patients was 110. Forty-four (40%) patients had access to immunohistochemistry (IHC). Eighty-nine (81%) patients were eligible for chemotherapy. Twenty-one (19%) patients were not fit for chemotherapy. Ten (9%) patients received radiotherapy.  A total of 73 (66%) patients had different forms of breast surgeries. Three (3%) patients declined surgery, while 34 (31%) were not fit for surgery. Thirty-four (31%) patients were treated with hormonal therapy. Conclusion: This study examined access to the various components of breast cancer care within two tertiary health centers. It shows that in our environment, there is limited access to immunohistochemistry, chemotherapy, radiotherapy and targeted therapy.