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Nakaganda A, Spencer A, Mpamani C, Nassolo C, Nambooze S, Wabinga H, Gemmell I, Jones A, Orem J, Verma A. Estimating regional and national cancer incidence in Uganda: a retrospective population-based study, 2013-2017. BMC Cancer 2024; 24:787. [PMID: 38956523 PMCID: PMC11218197 DOI: 10.1186/s12885-024-12543-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 06/20/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Cancer is becoming a major health problem in Uganda. Cancer control requires accurate estimates of the cancer burden for planning and monitoring of the cancer control strategies. However, cancer estimates and trends for Uganda are mainly based on one population-based cancer registry (PBCR), located in Kampala, the capital city, due to a lack of PBCRs in other regions. This study aimed at estimating cancer incidence among the geographical regions and providing national estimates of cancer incidence in Uganda. METHODS A retrospective study, using a catchment population approach, was conducted from June 2019 to February 2020. The study registered all newly diagnosed cancer cases, in the period of 2013 to 2017, among three geographical regions: Central, Western and Eastern regions. Utilizing regions as strata, stratified random sampling was used to select the study populations. Cases were coded according to the International Classification of Diseases for Oncology (ICD-0-03). Data was analysed using CanReg5 and Microsoft Excel. RESULTS 11598 cases (5157 males and 6441 females) were recorded. The overall national age-standardized incidence rates (ASIR) were 82.9 and 87.4 per 100,000 people in males and females respectively. The regional ASIRs were: 125.4 per 100,000 in males and 134.6 per 100,000 in females in central region; 58.2 per 100,000 in males and 56.5 per 100,000 in females in Western region; and 46.5 per 100,000 in males and 53.7 per 100,000 in females in Eastern region. Overall, the most common cancers in males over the study period were cancers of the prostate, oesophagus, Kaposi's sarcoma, stomach and liver. In females, the most frequent cancers were: cervix, breast, oesophagus, Kaposi's sarcoma and stomach. CONCLUSION The overall cancer incidence rates from this study are different from the documented national estimates for Uganda. This emphasises the need to enhance the current methodologies for describing the country's cancer burden. Studies like this one are critical in enhancing the cancer surveillance system by estimating regional and national cancer incidence and allowing for the planning and monitoring of evidence-based cancer control strategies at all levels.
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Affiliation(s)
- Annet Nakaganda
- Uganda Cancer Institute, Kampala, Uganda.
- University of Manchester, Manchester Academic Health Sciences Centre , Manchester, UK.
| | - Angela Spencer
- University of Manchester, Manchester Academic Health Sciences Centre , Manchester, UK
| | | | | | - Sarah Nambooze
- Kampala Cancer Registry, Kampala, Uganda
- Makerere University College of Health Sciences, Kampala, Uganda
| | - Henry Wabinga
- Kampala Cancer Registry, Kampala, Uganda
- Makerere University College of Health Sciences, Kampala, Uganda
| | - Isla Gemmell
- University of Manchester, Manchester Academic Health Sciences Centre , Manchester, UK
| | - Andrew Jones
- University of Manchester, Manchester Academic Health Sciences Centre , Manchester, UK
| | | | - Arpana Verma
- University of Manchester, Manchester Academic Health Sciences Centre , Manchester, UK
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Ramadhar A, Miller PN, Muchengeti M, Kagura J, Chu K, Gaskill C. Gastric cancer in Sub-Saharan Africa - a systematic review of primary data. Ecancermedicalscience 2024; 18:1680. [PMID: 38566758 PMCID: PMC10984845 DOI: 10.3332/ecancer.2024.1680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Indexed: 04/04/2024] Open
Abstract
Introduction Gastric cancer (GC) is the third leading cause of global cancer-related mortality. Despite the shifting burden of GC to low-and middle-income countries, the data regarding incidence, treatment, and outcomes in these settings are sparse. The primary aim of this systematic review was to aggregate all available data on GC in sub-Saharan Africa (SSA) to describe the variability in incidence across the region. Methods Studies reporting population-based primary data on GC in SSA were considered. The inclusion was limited to primary studies published between January 1995 and March 2022 which comprised of adult patients in SSA with GC. Studies without accessible full text in either French or English language were excluded. Unadjusted GC incidence rates with their standard errors for each study were recalculated from the crude numerators and denominators provided in individual studies. Results A total of 5,626 articles were identified in the initial search, of which, 69 studies were retained. Reported incidence rates ranged from a high of 5.56 GC cases per 100,000 in Greater Meru Kenya to a low of 0.04 GC cases per 100,000 people in Benin City Nigeria. The overall crude pooled incidence was 1.20 GC cases per 100, 000 (95%CI 1.15-1.26) with a variability of 99.83% (I2 p < 0.001). From the 29 high-quality population-based registry studies the crude pooled incidence was 1.71 GC cases per 100,000 people (95%CI 1.56-21.88) with a variability of 99.60%. Conclusion This systemic review demonstrates that GC incidence is highly variable across SSA. The limited data on GC treatment, mortality, and survival presents a significant challenge to providing a complete epidemiologic description of the burden of GC in SSA. There is a need for further robust data collection, exploration, and research studies on cancer care in SSA, with continued assessment of primary data availability.
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Affiliation(s)
- Anishka Ramadhar
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Phoebe N Miller
- University of California San Francisco, San Francisco, CA, USA
| | - Mazvita Muchengeti
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa
| | - Juliana Kagura
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Kathryn Chu
- Stellenbosch University, Faculty of Medicine and Health Sciences, Cape Town, South Africa
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Yorke J, Brenu SG, Awoonor-Williams R, Tabiri S, Seidu AS, Yamoah FA, Akpaloo J, Der EM, Adjei E, Okyere I, Ihekanandu KK, Bonsu EBO, Kyei I, Mensah S, Adinku MO, Yorke DA, Agyapong AO, Aitpillah FSK, Agyei MK, Oppong-Nkrumah NA, Annan KD, Ellis TAF, Danso P, Buckman TA, Acheampong E. A gist on an obscure neoplasm in Ghana: gastrointestinal stromal tumours. BMC Res Notes 2023; 16:318. [PMID: 37932827 PMCID: PMC10629135 DOI: 10.1186/s13104-023-06593-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/24/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Gastrointestinal Stromal Tumour is a rare but potentially curable tumour of the gastrointestinal tract accounting for up to 1% of all gastrointestinal tumours. The discovery of Imatinib mesylate, a novel tyrosine kinase inhibitor has improved the chances even for unresectable, recurrent, or metastatic diseases. METHODS This study sought to document the clinical and pathological characteristics of GISTs from two tertiary hospitals in Ghana that have undergone immunohistochemistry confirmation between 2014 and 2021. RESULTS The median age of the subjects was 50 years with most of them (28.0%) being above 61 years. There were more females than males (64.0% vs. 36.0%). Abdominal mass and abdominal pain made up the majority of the clinical presentations. The majority of the subjects had partial gastrectomy (32.0%) which was followed by wedge resection (28.0%). Appendectomy and sleeve gastrectomy were the least performed procedures (8% each). Four of the 25 patients (16.0%) had resections of involved contiguous organs done with splenectomy being the most common procedure. The majority of GISTs were found in the stomach (68.0%) followed by the appendix (12.0%) and small bowel (12.0%). Gastrointestinal bleeding (55.8%) and abdominal pain (38.5%) were the most reported symptoms. Free resection margins were observed in 84.0% of the subjects and only 3/25 (12.0%) experienced tumour recurrence. CONCLUSION GIST is a potentially curable tumour that once was obscure but currently gaining popularity. Surgical resection offers the hope of a cure for localized disease while targeted therapies is a viable option for recurrent, metastatic, or unresectable tumours.
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Affiliation(s)
- Joseph Yorke
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | - Stephen Tabiri
- Department of Surgery, School of Medical Sciences, University of Development Studies, Tamale, Ghana
| | | | | | - Joseph Akpaloo
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Ernest Adjei
- Directorate of Pathology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Isaac Okyere
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | - Ishmael Kyei
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Samuel Mensah
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Michael Ofoe Adinku
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | - Francis Somiah-Kwaw Aitpillah
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Martin Kofi Agyei
- Directorate of Internal Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | | | | | | | - Patrick Danso
- Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Tonnies Abeku Buckman
- Department of Medical Laboratory Science, KAAF University College, Fetteh-Kakraba, Gomoa East District, Gomoa-East, Ghana.
| | - Emmanuel Acheampong
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Yorke AA, Quaye ANM, Hasford F, Addison ECDK. The State of Clinical Medical Physics and Education in Ghana. Int J Radiat Oncol Biol Phys 2023; 116:717-722. [PMID: 37355308 DOI: 10.1016/j.ijrobp.2023.01.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 06/26/2023]
Affiliation(s)
- Afua A Yorke
- Department of Radiation Oncology, Fred Hutch Cancer Center, University of Washington, Seattle, Washington.
| | | | - Francis Hasford
- Graduate School of Nuclear and Allied Sciences, Atomic Campus, University of Ghana, Kwabenya-Accra, Ghana
| | - Eric C D K Addison
- Oncology Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana; Graduate School of Nuclear and Allied Sciences, Atomic Campus, University of Ghana, Kwabenya-Accra, Ghana; Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Agyemang LS, Wagland R, Foster C, McLean C, Fenlon D. To disclose or not to disclose: an ethnographic exploration of factors contributing to the (non) disclosure of Ghanaian women's breast cancer diagnosis to social networks. BMC Womens Health 2023; 23:366. [PMID: 37430247 DOI: 10.1186/s12905-023-02508-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 06/24/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Although there may be theoretical support linking positive health outcomes with cancer disclosure to social networks, women from contexts such as Ghana where cancer is not openly talked about may have concerns around breast cancer disclosure. Women may not be able to share their experiences about their diagnosis, which may prevent them from receiving support. This study aimed to obtain the views of Ghanaian women diagnosed with breast cancer about factors contributing to (non) disclosure. METHODS This study is based on secondary findings from an ethnographic study that employed participant observation and semi-structured face to face interviews. The study was conducted at a breast clinic in a Teaching Hospital in southern Ghana. 16 women diagnosed with breast cancer (up to stage 3); five relatives nominated by these women and ten healthcare professionals (HCPs) participated in the study. Factors contributing to breast cancer (non) disclosure were explored. Data were analysed using a thematic approach. RESULTS The analysis indicated that most of the women and family members were very reticent about breast cancer disclosure and were secretive with distant relatives and wider social networks. Whilst remaining silent about their cancer diagnosis helped women protect their identities, prevented spiritual attack, and bad advice, the need for emotional and financial support for cancer treatment triggered disclosure to close family, friends, and pastors. Some women were discouraged from persevering with conventional treatment following disclosure to their close relatives. CONCLUSIONS Breast cancer stigma and fears around disclosure hindered women from disclosing to individuals in their social networks. Women disclosed to their close relatives for support, but this was not always safe. Health care professionals are well placed to explore women's concerns and facilitate disclosure within safe spaces to enhance engagement with breast cancer care services.
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Affiliation(s)
- Linda Serwaa Agyemang
- Department of Nursing Science, Faculty of Health and Social Science, Bournemouth University, Bournemouth, UK.
| | - Richard Wagland
- Centre for Psychosocial Research in Cancer, Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Claire Foster
- Centre for Psychosocial Research in Cancer, Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Chris McLean
- Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Deborah Fenlon
- Department of Nursing, College of Human and Health Science, University of Swansea, Swansea, UK
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Asare M, Agyei-Baffour P, Koranteng A, Commeh ME, Fosu ES, Elizondo A, Sturdivant RX. Assessing the Efficacy of the 3R (Reframe, Reprioritize, and Reform) Communication Model to Increase HPV Vaccinations Acceptance in Ghana: Community-Based Intervention. Vaccines (Basel) 2023; 11:890. [PMID: 37242995 PMCID: PMC10223469 DOI: 10.3390/vaccines11050890] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/20/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
The study examined whether the 3R (reframe, prioritize, and reform) communication model intervention can impact parents' and adolescents' HPV vaccination acceptability. We used face-to-face methods to recruit participants from three local churches in the Ashanti Region of Ghana. Participants completed pre- and post-intervention assessments based on the validated Theory of Planned Behavior survey. We organized two face-to-face presentations for parents and adolescents separately for parents (n = 85) and adolescents (n = 85). Participants' post-intervention vs. pre-intervention scores for attitude (mean = 35.46 ± SD = 5.46 vs. mean = 23.42 ± SD = 8.63), knowledge (M = 28.48 ± SD = 5.14 vs. M = 16.56 ± SD = 7.19), confidence (M = 8.96 ± SD = 3.43 vs. M = 6.17 ± SD = 2.84), and intention for vaccine acceptance (M = 4.73 ± SD = 1.78 vs. M = 3.29 ± SD = 1.87) increased significantly (p < 0.001). The intervention showed that for every one-unit increase in the participants' self-confidence and attitude scores, the odds of the HPV vaccination acceptability increased by 22% (95% CI: 10-36) and 6% (95% CI: 0.1-12), respectively. Intention for vaccine acceptance, F (1167) = 6.89, and attitude toward vaccination, F (1167) = 19.87, were significantly higher among parents than adolescents (p < 0.001), after controlling for the baseline scores. These findings suggest that the intervention targeting parents' and adolescents' attitudes and knowledge has the potential to increase HPV vaccination acceptance in Ghana.
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Affiliation(s)
- Matthew Asare
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX 76798, USA;
| | - Peter Agyei-Baffour
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi P.O. Box UPO-1279, Ghana; (P.A.-B.); (A.K.)
| | - Adofo Koranteng
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi P.O. Box UPO-1279, Ghana; (P.A.-B.); (A.K.)
| | - Mary E. Commeh
- Non-Communicable Disease Control, Ghana Health Services, Accra P.O. Box MB-582, Ghana;
| | - Emmanuel Sarfo Fosu
- Department of Statistical Science, College of Arts & Sciences, Baylor University, Waco, TX 76798, USA; (E.S.F.); (R.X.S.)
| | - Anjelica Elizondo
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX 76798, USA;
| | - Rodney X. Sturdivant
- Department of Statistical Science, College of Arts & Sciences, Baylor University, Waco, TX 76798, USA; (E.S.F.); (R.X.S.)
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Shumba S, Kayamba V. Analysis of the proportion of university teaching hospital gastric cancer data included in the Zambia national cancer registry. Afr Health Sci 2023; 23:438-443. [PMID: 37545961 PMCID: PMC10398468 DOI: 10.4314/ahs.v23i1.46] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND The exact prevalence of gastric cancer in Zambia is unknown. The aim of this study was to determine the proportion of gastric cancer cases seen at the largest hospital in Zambia, whose records were included in the Zambia National Cancer Registry (ZNCR). METHODS We reviewed gastric cancer records between January 2015 and December 2017 from the University Teaching Hospital, Cancer Diseases Hospital and ZNCR. Statistical analysis was done using Stata version 15. RESULTS We reviewed 94 patient records (42 were females) with a mean age of 59 years (standard deviation, 14.9). Histologically, the majority of the cases were adenocarcinoma (84%). Of the reviewed records, only 39/94 (42%) had their data included in the ZNCR. Median time to from endoscopic diagnosis to histopathological confirmation was 11 days (inter-quartile range; 7-20). Median time from histological confirmation to the Cancer Diseases Hospital for therapy was 8 days (IQR 2-19). Overall median survival time for gastric cancer patients was 290 days (CI 95%, 112 - 1225). CONCLUSIONS Data on gastric cancer reported in the ZNCR are an underestimate of the true disease burden and there is need to strengthen data collection strategies for gastric cancer in Zambia.
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Affiliation(s)
- Samson Shumba
- University of Zambia School of Public Health, Department of Epidemiology and Biostatistics, Lusaka, Zambia
| | - Violet Kayamba
- Tropical Gastroenterology and Nutrition Group, University of Zambia School of Medicine, PO Box 50398, Lusaka, Zambia
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Nartey Y, Amo-Antwi K, Hill PC, Dassah ET, Asmah RH, Nyarko KM, Agambire R, Konney TO, Yarney J, Damale N, Cox B. Human papillomavirus genotype distribution among women with and without cervical cancer: Implication for vaccination and screening in Ghana. PLoS One 2023; 18:e0280437. [PMID: 36656844 PMCID: PMC9851533 DOI: 10.1371/journal.pone.0280437] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/01/2023] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Determining the high-risk human papillomavirus (HR-HPV) genotypes burden in women with and without cervical cancer afford a direct comparison of their relative distributions. This quest is fundamental to implementing a future population-based cervical cancer prevention strategy in Ghana. We estimated the cervical cancer risk by HPV genotypes, and the HPV vaccine-preventable proportion of cervical cancer diagnosed in Ghana. MATERIALS AND METHODS An unmatched case-control study was conducted at the two largest cervical cancer treatment centres in Ghana from 1st October 2014 to 31st May 2015. Cases were women diagnosed with cervical cancer and controls were women without cervical cancer who were seeking care at the two hospitals. Nested multiplex polymerase chain reaction (NM-PCR) was used to detect HPV infection in cervical samples. Logistic regression was used to determine the association between the risk of cervical cancer and identified HPV infection. P ≤0.05 was considered statistically significant. RESULTS HPV deoxyribonucleic acid (DNA) data were analysed for 177 women with cervical cancer (cases) and 201 without cancer (controls). Cervical cancer was diagnosed at older ages compared to the age at which controls were recruited (median ages, 57 years vs 34 years; p < 0.001). Most women with cervical cancer were more likely to be single with no formal education, unemployed and less likely to live in metropolitan areas compared to women without cervical cancer (all p-value <0.001). HPV DNA was detected in more women with cervical cancer compared to those without cervical cancer (84.8% vs 45.8%). HR-HPV genotypes 16, 18, 45, 35 and 52 were the most common among women with cervical cancer, while 66, 52, 35, 43 and 31 were frequently detected in those without cancer. HPV 66 and 35 were the most dominant non-vaccine genotypes; HPV 66 was more prevalent among women with cervical cancer and HPV 35 in those without cervical cancer. Cervical cancer risk was associated with a positive HPV test (Adjusted OR (AOR): 5.78; 95% CI: 2.92-11.42), infection with any of the HR-HPV genotypes (AOR: 5.56; 95% CI: 3.27-13.16) or multiple HPV infections (AOR: 9.57 95% CI 4.06-22.56). CONCLUSION Women with cervical cancer in Ghana have HPV infection with multiple genotypes, including some non-vaccine genotypes, with an estimated cervical cancer risk of about six- to ten-fold in the presence of a positive HPV test. HPV DNA tests and multivalent vaccine targeted at HPV 16, 18, 45 and 35 genotypes will be essential in Ghana's cervical cancer control programme. Large population-based studies are required in countries where cervical cancer is most prevalent to determine non-vaccine HPV genotypes which should be considered for the next-generation HPV vaccines.
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Affiliation(s)
- Yvonne Nartey
- Department of Adult Health, School of Nursing and Midwifery, University of Ghana, Accra, Ghana
- * E-mail: ,
| | - Kwabena Amo-Antwi
- School of Medicine and Dentistry, Kwame Nkrumah University of Science & Technology/Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Philip C. Hill
- Centre for International Health, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Edward T. Dassah
- School of Medicine and Dentistry, Kwame Nkrumah University of Science & Technology/Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Richard H. Asmah
- Department of Biomedical Sciences, University of Health & Allied Sciences, School of Basic and Biomedical Sciences, Ho, Volta region, Ghana
| | - Kofi M. Nyarko
- Disease Control and Prevention Department, Ghana Health Service, Accra, Ghana
| | - Ramatu Agambire
- Department of Nursing, Garden City University College, Kumasi-Ghana, Ghana
| | - Thomas O. Konney
- School of Medicine and Dentistry, Kwame Nkrumah University of Science & Technology/Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Joel Yarney
- National Centre for Radiotherapy and Nuclear Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | - Nelson Damale
- Department of Obstetrics and Gynaecology, Korle Bu Teaching Hospital, Accra, Ghana
| | - Brian Cox
- Hugh Adam Cancer Epidemiology Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Boamah Mensah AB, Mensah KB, Aborigo RA, Bangalee V, Oosthuizen F, kugbey N, Clegg-Lamptey JN, Virnig B, Kulasingam S, Ncama BP. Breast cancer screening pathways in Ghana: applying an exploratory single case study methodology with cross-case analysis. Heliyon 2022; 8:e11413. [DOI: 10.1016/j.heliyon.2022.e11413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 09/24/2022] [Accepted: 10/31/2022] [Indexed: 11/09/2022] Open
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Omosun A, Abayomi A, Ogboye O, Lajide D, Oladele D, Popoola A, Banjo AA, Chugani B, Mabadeje B, Abdur-Razaak H, Wellington O, Andu L, Adepase A, Adesina F, Olonire O, Fetuga A, Onasanya O, Awosika F, Folarin-Williams O, Anya SE. Distribution of Cancer and Cancer Screening and Treatment Services in Lagos: A 10-Year Review of Hospital Records. JCO Glob Oncol 2022; 8:e2200107. [PMID: 36265096 PMCID: PMC9812459 DOI: 10.1200/go.22.00107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
PURPOSE In Lagos State, Nigeria, the population distribution of cancers is poorly described because studies are conducted at a few tertiary hospitals. Therefore, this study aims to map all health facilities where cancer screening takes place and describe the cases of cancer screened for and treated. METHODS A cross-sectional survey to identify facilities involved in screening and management of cancers was performed followed by extraction of data on individual cases of cancer screened for and treated at these facilities from 2011 to 2020. All health care facilities in the state were visited, and the survey was performed using standardized national tools modified to capture additional information on cancer screening and treatment. Data analysis was performed using STATA version 14 and R version 3.6.3. RESULTS Cervical cancer was the commonest cancer, accounting for 55% of 2,420 cancers screened, followed by breast (41%), prostate (4%), and colorectal cancers (0.2%). Of the 7,682 cancers treated among Lagos residents, the top five were breast (45%), colorectal (8%), cervical (8%), prostate (5%), and ovarian (4%). The female:male ratio of cancer cases was 3:1. The peak age for cancer among females and males was in the 40- to 49-year age group and 60- to 69-year age group, respectively. The Ikorodu local government area had the highest rate of reported cancer per million population. CONCLUSION Cancer screening is poor with a significant gap in screening for breast cancer since it is the commonest cancer in the state. The findings indicate the urgent need for the establishment of organized screening programs for the predominant cancers in the state and the prioritization of cancer research that addresses key policy and program questions.
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Affiliation(s)
- Adenike Omosun
- Lagos State Ministry of Health, Ikeja, Lagos State, Nigeria,Health Service Commission, Lagos Island, Lagos State, Nigeria,Adenike Omosun, MBBS, MPH, FMCPH, Health Service Commission, 1, Ganui Smith Street, Lagos Island, 100221, Lagos State, Nigeria; e-mail:
| | - Akin Abayomi
- Lagos State Ministry of Health, Ikeja, Lagos State, Nigeria
| | | | - Dayo Lajide
- Lagos State Ministry of Health, Ikeja, Lagos State, Nigeria
| | - David Oladele
- Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Abiodun Popoola
- Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria
| | | | - Bindiya Chugani
- Lakeshore Cancer Centre, Victoria Island, Lagos State, Nigeria
| | | | | | | | - Lateefah Andu
- Lagos State Ministry of Health, Ikeja, Lagos State, Nigeria
| | - Abiola Adepase
- Lagos State Ministry of Health, Ikeja, Lagos State, Nigeria
| | - Funke Adesina
- Lagos State Ministry of Health, Ikeja, Lagos State, Nigeria
| | - Olorunfemi Olonire
- Health Facility Monitoring and Accreditation Agency, Ikeja, Lagos State, Nigeria
| | - Adedoyin Fetuga
- Health Service Commission, Lagos Island, Lagos State, Nigeria
| | | | - Flora Awosika
- Lagos State Ministry of Health, Ikeja, Lagos State, Nigeria
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Urinary PCA3 a Superior Diagnostic Biomarker for Prostate Cancer among Ghanaian Men. DISEASE MARKERS 2022; 2022:1686991. [PMID: 36246565 PMCID: PMC9568348 DOI: 10.1155/2022/1686991] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022]
Abstract
Introduction. Prostate cancer is one of the most commonly diagnosed cancers in men. Prostate-specific antigen (PSA) has been the biomarker of choice for screening and diagnosis of prostate cancer. However, inefficiencies exist with its diagnostic capabilities. This study thus evaluated the diagnostic and prognostic potential of urinary PCA3 as an alternative biomarker for prostate cancer in the Ghanaian population. Methods. A hospital-based cross-sectional study was conducted at the Urology Department of the 37 Military Hospital, Accra, Ghana. A total of 237 participants aged 40 years and above with any form of suspected prostate disorder were recruited into the study after written informed consent was obtained. Total serum PSA levels was measured using the electrochemiluminescence method and transrectal ultrasound-guided systematic core needle biopsies were obtained from each study participant. Receiver operating characteristic curve (ROC) analysis was used to evaluate the diagnostic accuracies of serum PSA, DRE, and PCA3 as diagnostic tools for prostate cancer. These three diagnostic tools were also evaluated in various combinations to ascertain the combinations with the best diagnostic accuracy. Results. Prostate cancer was diagnosed in 26.6% of the participants. Benign prostate hyperplasia and prostatitis were diagnosed in 48.5% and 24.9% participants, respectively. DRE had a sensitivity of 93.7% and a specificity of 12.1%. PSA had a sensitivity of 92.1% and a specificity of 16.1%. PCA3 had a sensitivity of 57.1% and a specificity of 85.6% and showed a better accuracy (
) compared to PSA (
) and DRE (
) as individual diagnostic tools. The combination of DRE+PCA3 score had the best diagnostic accuracy (
) with a sensitivity and specificity of 60.3% and 80.5%, respectively. Conclusion. The urinary PCA3 assay showed a better diagnostic performance compared to serum PSA and DRE. PCA3 as a stand-alone and in combination with DRE could be a suitable complimentary marker in diagnosis and management of prostate cancer.
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Okonta KE, Okonta EM. Profile of Lung Cancer in two Niger Delta States of Nigeria: An Evaluation of 43 Cases. Niger Med J 2022; 63:373-377. [PMID: 38867745 PMCID: PMC11165322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Abstract
Background The data on the epidemiology of lung cancer in Niger delta states is scarce. Therefore, this study aims to determine the epidemiological profile of lung cancer in two Niger Delta states in Nigeria. Methodology This was a retrospective analysis of all patients managed for histologically diagnosed lung cancer from Jan 2014 to Dec 2019 at two tertiary hospitals in Niger Delta states of Nigeria. The demographics, diagnoses, results of investigations, and outcomes were analysed using descriptive statistics. Results Forty-three patients were reviewed with a male-to-female ratio of 1.5:1 and an age range between 13-89 years with a mean of 53.5+17.0 years. The following number of patients; 1(2.3%), 26(60.5%), 4 (9.3%) and 12(27.9%) were distributed according into the following age groups ;< 20, 20-59, 60-64 and >65 respectively. Eleven (25.6%) patients were smokers. The commonest symptoms were dyspnoea in 39(90.7%), cough in 35(81.4%), weight loss in 29(67.4%), chest pain in 28(65.1%), and change in voice (hoarseness of voice) in 8(18.6%); while the signs were respiratory distress in 33(76.7%), digital clubbing in 8(18.6%), superior vena cava syndrome in 2(4.7%).The left lung was commonly affected in 24(55.8%) patients, and the left upper lobe was the most common in 21 (20.2%), while the right upper lobe was the least in 13(12.6%) patients. The histological types were Adenocarcinoma in 26(60.5%), squamous cell carcinoma in 15(34.9%) patients, and small cell carcinoma in 2(4.7%) patients. Fifteen (34.9%) patients had elevated platelets. The modalities of pathologic diagnoses were: Mini-Thoracotomy10 (23.3%), Tru-cut biopsy 28 (65.1%), and Bronchoscopy 5 (11.6%).The mortality rate after six months following lung cancer diagnosis was 7(16.2%). Conclusion In our environment, lung cancer may have a bimodal distribution, peaking in the middle age group and elderly patients who were mainly non-smokers. Elevation of platelets was observed in a significant number of patients.
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Affiliation(s)
- Kelechi E. Okonta
- Cardiothoracic Surgery Unit, Department of Surgery, University of Port-Harcourt, Port-Harcourt, Rivers State, Nigeria
| | - Emeka M. Okonta
- Department of Human Anatomy, College of Basic Medical Sciences, Bingham University, Karu, Nasarawa State, Nigeria
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Narh CT, Der JB, Ofosu A, Blettner M, Wollschlaeger D. Describing and Modeling the Burden of Hospitalization of Patients With Neoplasms in Ghana Using Routine Health Data for 2012-2017. JCO Glob Oncol 2022; 8:e2100416. [PMID: 36037414 PMCID: PMC9470136 DOI: 10.1200/go.21.00416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The increasing cancer burden calls for reliable data on current and future associated hospitalizations to enable health care resource planning, especially in low- and middle-income countries. We provide nationwide estimates of the current and future burden of hospitalization because of neoplasms in Ghana. Other data sets are useful to estimate epidemiologic trends in settings where cancer registries are not available.![]()
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Affiliation(s)
- Clement T. Narh
- Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
- School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Joyce B. Der
- School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Anthony Ofosu
- Ghana Health Service, Private Mail Bag, Ministries, Accra, Ghana
| | - Maria Blettner
- Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Daniel Wollschlaeger
- Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
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14
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Amo-Antwi K, Agambire R, Konney TO, Nguah SB, Dassah ET, Nartey Y, Appiah-Kubi A, Tawiah A, Tannor EK, Peprah A, Ansah MB, Sam D, Akakpo PK, Ankobea F, Djokoto RM, Idun MYK, Opare-Addo HS, Opoku BK, Odoi AT, Johnston C. Health-related quality of life among cervical cancer survivors at a tertiary hospital in Ghana. PLoS One 2022; 17:e0268831. [PMID: 35657957 PMCID: PMC9165899 DOI: 10.1371/journal.pone.0268831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 05/10/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Cervical cancer is the second most common female cancer in Ghana. The disease and its treatment significantly affect survivors’ health-related quality of life (HRQoL). We determined the overall quality of life (QoL) and identified its predictors among cervical cancer survivors after treatment. Materials and methods A hospital-based cross-sectional analytical study was conducted on 153 disease-free cervical cancer survivors who completed curative treatment between January 2004 and December 2018 at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana. We used the European Organization for Research and Treatment of Cancer core-30 item (EORTC QLQ-C30) and cervical cancer module (EORTC QLQ-CX24) to assess the survivors’ overall QoL. QoL domain scores were dichotomised as affected or unaffected by disease and its treatment. Significant differences between the affected and unaffected groups within each QoL domain were determined using the student T-test. We used Kruskal-Wallis and Dunn’s tests to examine the difference in QoL domains between treatment types, with significance based on Bonferroni corrections. Multivariable logistic regression was performed to identify predictors of overall QoL. A p-value of less than 0.05 was considered statistically significant. Results One hundred and fifty-three (153) women having a mean age of 58.3 (SD 11.4) years were studied. The overall QoL score was 79.6 (SD 16.0), and 74.5% of survivors reported good QoL score within the median follow up time of 41.8 months (interquartile range [IQR], 25.5–71.1 months) after cervical cancer diagnosis. Although the majority (66.0–84.3%) of the QoL functioning scale were unaffected, about a fifth (22.2%) to a third (34.5%) of the subjects had perceptual impairment in cognitive and role functioning. Financial difficulties, peripheral neuropathy and pain were most common symptoms reported as affected. A third of the survivors were worried that sex would be painful, and 36.6% indicated that their sexual activity as affected. The overall QoL scores for survivors who had surgery, chemoradiation and radiation-alone were 86.1 (SD 9.7), 76.9 (SD 17.7), and 80.7 (SD 14.7), respectively (p = 0.025). The predictors of survivor’s overall QoL were loss of appetite [Adjusted Odd Ratio (AOR) = 9.34, 95% Confidence Interval (CI) = 2.13–35.8, p = 0.001], pain (AOR = 3.53, 95% CI = 1.25–9.31, p = 0.017) and body image (AOR = 5.89, 95% CI = 1.80–19.27, p = 0.003). Conclusion About 75% of the survivors had a good overall quality of life. Primary surgical treatment affords the best prospects for quality of life with the least symptom complaints and financial burden. Loss of appetite, pain or diminution in body image perception predicted the overall quality of life of cervical cancer survivors after treatment.
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Affiliation(s)
- Kwabena Amo-Antwi
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- * E-mail: ,
| | - Ramatu Agambire
- Department of Nursing, Garden City University College, Kumasi, Ghana
| | - Thomas O. Konney
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Samuel B. Nguah
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Edward T. Dassah
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Yvonne Nartey
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
| | - Adu Appiah-Kubi
- School of Medical Sciences, University of Health and Allied Sciences, Ho, Ghana
| | | | - Elliot K. Tannor
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Amponsah Peprah
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Daniel Sam
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Patrick K. Akakpo
- School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Frank Ankobea
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Rex M. Djokoto
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Henry S. Opare-Addo
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Baafour K. Opoku
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Alexander T. Odoi
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Carolyn Johnston
- University of Michigan, Ann Arbor, Michigan, United States of America
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Azene ZN, Tsegaye L, W/Gebriel M, Tadesse A, Tadele A, Aynalem GL, Andualem Z, Taye BT. Risky Sexual Practice and Associated Factors Among Youth Preparatory Students in Gondar City, Northwest Ethiopia. Front Public Health 2022; 10:843359. [PMID: 35586000 PMCID: PMC9108279 DOI: 10.3389/fpubh.2022.843359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 03/29/2022] [Indexed: 11/21/2022] Open
Abstract
Background Risky sexual practices can negatively affect the health of youths by predisposing them to a variety of sexually transmitted infections, including HIV/AIDS and unwanted pregnancy, which, in turn, would lead to serious lifelong deleterious health, social, and economic consequences. While youths tend to be less well-informed and require more information, little has been known in Ethiopia. Therefore, this study aimed to assess the prevalence of risky sexual practices and associated factors among youth students in Gondar city, northwest Ethiopia. Methods A cross-sectional study was conducted among 414 regularly attending youth students in Gondar city from April to May 2019. A simple random sampling technique was used to select the study participants. Data were collected by using a pre-tested, structured, and self-administered questionnaire. Bivariable and multivariable logistic regression analyses were employed, and a multivariable binary logistic regression model was used to identify the effect of independent variables on the outcome variable at p < 0.05 with its 95%CI. Result The prevalence of risky sexual practices was 49.3%. Peer pressure (AOR = 1.99, 95%CI: 1.21, 3.26), drinking alcohol (AOR = 4.88 95%CI: 3.06, 7.79), and watching pornography (AOR = 2.82, 95%CI: 1.74, 4.56) were positively associated with the risky sexual practice of youths. Whereas, age, gender, and pocket money did not have any association with risky sexual practice in this study. Conclusion In this study, the prevalence of risky sexual practices was found to be high. Thus, multisector collaboration efforts are needed from parents, schools, health facilities, and the government to tackle the exposure of in-school youth toward peer pressure, drinking alcohol, and watching pornographic films, which in turn helps to bring about healthy sexual practices among them.
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Affiliation(s)
- Zelalem Nigussie Azene
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Lanchisl Tsegaye
- Department of Midwifery, College of Medicine and Health Sciences, Dilla, Ethiopia
| | - Mekdes W/Gebriel
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adamu Tadesse
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abreham Tadele
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getie Lake Aynalem
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zewudu Andualem
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Birhan Tsegaw Taye
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
- *Correspondence: Birhan Tsegaw Taye
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Olecki EJ, Ssentongo P, Dao J, Wong WG, Stahl KA, Ofosu-Akromah R, Amponsah-Manu F, Pameijer C. Burden of cancer in the general surgical population in the eastern region of Ghana. BMJ Open 2022; 12:e051741. [PMID: 35351698 PMCID: PMC8966531 DOI: 10.1136/bmjopen-2021-051741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To estimate the surgical burden of malignant disease in the Eastern Region of Ghana. DESIGN Descriptive cross-sectional study. SETTING Regional hospital in the eastern region of Ghana. PARTICIPANTS Patients treated by the surgery department at Eastern Regional Hospital in Koforidua, Ghana. INTERVENTIONS None. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome was incidence of malignancy and secondary outcome descriptive differences between patients who had a benign indication for surgery compared with those with a malignant indication for surgery. RESULTS A total of 1943 inpatient surgical procedures were performed from 2015 to 2017 with 13.4% (261) of all procedures ultimately performed for malignancy. Of all breast procedures performed, 95.2% of procedures resulted in a malignant diagnosis. The remaining subtypes of procedures had rates ranging from <1% to 41.2% of procedures performed for malignant disease. Additionally, this study found over 13% of patients admitted to the surgical service for breast cancer ultimately did not undergo a surgical procedure. CONCLUSION This is the first study investigating the burden of malignant disease in the Eastern Region of Ghana. We found a substantial prevalence of malignant disease in the surgical population in this region. This information can be used to aid in future medical resource planning in this region.
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Affiliation(s)
| | - Paddy Ssentongo
- Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Joseph Dao
- Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - William G Wong
- Department of General Surgery, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Kelly A Stahl
- Department of General Surgery, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | | | | | - Colette Pameijer
- Department of General Surgery, Penn State College of Medicine, Hershey, Pennsylvania, USA
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17
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Owusu Ansah K, Dey NEY, Adade AE, Agbadi P. Determinants of life satisfaction among Ghanaians aged 15 to 49 years: A further analysis of the 2017/2018 Multiple Cluster Indicator Survey. PLoS One 2022; 17:e0261164. [PMID: 35061700 PMCID: PMC8782464 DOI: 10.1371/journal.pone.0261164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 11/26/2021] [Indexed: 11/19/2022] Open
Abstract
The inclusion of life satisfaction in government policies as a tracker of the social and economic progress of citizens has been recommended. This has encouraged the scientific investigation of life satisfaction levels of people in tandem with factors responsible for these levels. Only a few studies have attempted to do this in Ghana with mixed findings. This study, therefore, extends previous literature by examining the determinants of life satisfaction among Ghanaians in two ways: a full sample and a gender-stratified sample. We analysed cross-sectional data from the 2017/2018 Ghana Multiple Indicator Cluster Survey Six (MICS 6). A sample of 20,059 women and men of ages ranging from 15 to 49 years participated in this study. The Cantril's Self-Anchoring Ladder Life Satisfaction scale was used to capture the life satisfaction of participants alongside relevant sociodemographic questions. About 35% of participants reported they were satisfied in life with males reporting more suffering levels [39.59%; 95% CI:36.38, 42.88] and females more thriving levels [36.41%; 95% CI:35.01, 37.84]. In the full sample multivariable model, gender, age, parity, education, marital status, wealth index, and region of residence were significantly associated with life satisfaction. Gender variations were also found across these associations. These findings collectively provide useful information for policymakers and practitioners to optimize interventions for the Ghanaian population aimed at improving life satisfaction. Evidence from this study also calls on the government of Ghana to begin tracking the life satisfaction of her citizens.
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Affiliation(s)
| | | | | | - Pascal Agbadi
- Department of Sociology and Social Policy, Lingnan University, Hong Kong, SAR, China
- Department of Nursing, Kwame Nkrumah University of Science and Technology, PMB, Kumasi, Ghana
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Arhin N, Ssentongo P, Taylor M, Olecki EJ, Pameijer C, Shen C, Oh J, Eng C. Age-standardised incidence rate and epidemiology of colorectal cancer in Africa: a systematic review and meta-analysis. BMJ Open 2022; 12:e052376. [PMID: 35039287 PMCID: PMC8765019 DOI: 10.1136/bmjopen-2021-052376] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES Colorectal cancer (CRC) is the second-leading cause of cancer deaths globally, with low-income and middle-income countries (LMICs) disproportionately affected. Estimates of CRC rates in LMIC are scarce. We aimed to (1) estimate sex-specific incidence of CRC, (2) estimate temporal trend and (3) determine regional variations of CRC rates on the African continent. DESIGN Systematic review and meta-analysis METHODS: PubMed (MEDLINE), OVID (MEDLINE), Scopus and Cochrane Library databases were systematically searched from inception to 12 December 2020. We included population-based studies that reported the incidence or prevalence estimates of CRC in Africa. Studies not conducted in humans or did not directly report the rates of CRC were excluded. Random effects model was used to pool the estimates. The methodological quality of studies was assessed with the Newcastle-Ottawa Scale. OUTCOME MEASURES Overall and sex-specific annual age-standardised incidence rates (ASIR) of CRC per 100 000 population. RESULTS The meta-analysis included 14 studies consisting of 3365 individuals with CRC (mean age, 58 years, 53% male). The overall ASIR of CRC in Africa per 100 000 population was 5.25 (95% CI 4.08 to 6.75). The rates were slightly higher in males (4.76) than in females (4.18), but not significantly different. Subgroup analysis indicated greater point estimates in North Africa (8.66) compared with sub-Saharan Africa (5.91); and higher estimates in Eastern (8.29) and Northern (8.66) Africa compared with Western (3.55) and Southern (3.57) Africa, but not statistically significant. The overall trend in ASIR has remained constant at nearly 5 per 100 000 population for the last 6 decades. CONCLUSION CRC estimates in Africa are heterogeneous and could be underestimated. High-quality data collection systems such as population-based cancer registries may facilitate accurate estimation of country-specific rates and provide critical information which would be lucrative to the consideration of resources needed for screening, early detection, treatment and improving overall patient outcomes.
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Affiliation(s)
- Nina Arhin
- Department of Medicine, Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Paddy Ssentongo
- Department of Public Health Sciences, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Morris Taylor
- Department of Public Health Sciences, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
| | | | - Colette Pameijer
- Department of Surgery, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Chan Shen
- Department of Surgery, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
| | - John Oh
- Department of Surgery, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Cathy Eng
- Department of Medicine, Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Mensah KB, Boamah Mensah AB, Wiafe E, Padayachee N, Aduse Poku AY, Dwobeng Amo B, Hoyte Williams M, Bangalee V, Oosthuizen F. Impact of brief educational intervention on knowledge of cancer among community pharmacists. J Oncol Pharm Pract 2021; 28:1771-1780. [PMID: 34569362 DOI: 10.1177/10781552211041977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Community pharmacists may play a vital role in early detection and prevention of cancer. Findings from our pre-assessment studies showed that the Ghanaian community have inadequate knowledge of cancer. We assessed the impact of a brief educational intervention on knowledge level of cancer among Ghanaian community pharmacists. METHOD The study was a descriptive interventional study. Knowledge of cancer, signs and symptoms, risk factors and cancer screening tests were assessed before in a pre-assessment study and after a brief online education in our current study. A total of 435 community pharmacists were recruited in both studies. RESULTS The mean ± SD total knowledge score of cancer increased from 9.03 ± 2.65 to 12.97 ± 1.43 out of a maximum score of 15 points. The mean ± SD total knowledge score of signs and symptoms of cancer increased from 4.15 ± 2.14 to 6.86 ± 0.76 out of a maximum score of 7 points. For the total knowledge score of causes and risk factors of cancer, the mean ± SD score increased from 8.13 ± 3.31 to 11.59 ± 0.87 out of a maximum score of 12 points. Lastly, the mean ± SD total knowledge score of cancer screening tests increased from 9.04 ± 5.01 to 16.39 ± 0.86 out of a maximum score of 18 points. CONCLUSION There were overall statistically significant improvements of participants knowledge in all aspects of cancer in this study compared to the pre-assessment study. Our study presents evidence of the effectiveness of a brief educational intervention tailor-made for Ghanaian community pharmacists.
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Affiliation(s)
- Kofi Boamah Mensah
- Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, 260806Kwame Nkrumah University of Science and Technology, Ghana.,72753University of KwaZulu-Natal, Discipline of Pharmaceutical Sciences, College of Health Sciences, South Africa
| | - Adwoa Bemah Boamah Mensah
- Department of Nursing, Faculty of Allied Health Sciences, 260806Kwame Nkrumah University of Science and Technology, Ghana
| | | | - Neelaveni Padayachee
- Department of Pharmacy and Pharmacology, 37708University of Witwatersrand, South Africa
| | | | | | | | - Varsha Bangalee
- 72753University of KwaZulu-Natal, Discipline of Pharmaceutical Sciences, College of Health Sciences, South Africa
| | - Frasia Oosthuizen
- 72753University of KwaZulu-Natal, Discipline of Pharmaceutical Sciences, College of Health Sciences, South Africa
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Subedi R, Dhimal M, Budukh A, Chapagain S, Gyawali P, Gyawali B, Dahal U, Dikshit R, Jha AK. Epidemiologic Pattern of Cancer in Kathmandu Valley, Nepal: Findings of Population-Based Cancer Registry, 2018. JCO Glob Oncol 2021; 7:443-452. [PMID: 33788597 PMCID: PMC8081507 DOI: 10.1200/go.20.00574] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Although cancer is an important and growing public health issue in Nepal, the country lacked any population-based cancer registry (PBCR) until 2018. In this study, we describe the establishment of the PBCR for the first time in Nepal and use the registry data to understand incidence, mortality, and patterns of cancer in the Kathmandu Valley (consisting of Kathmandu, Lalitpur, and Bhaktapur districts), which comprises 10.5% of the estimated 29 million population of Nepal in 2018. MATERIALS AND METHODS The PBCR collects information from facilities and communities through the active process. The facilities include cancer or general hospitals, pathology laboratories, hospice, and Ayurvedic centers. In the communities, the field enumerators or female community health volunteers collected the data from the households. In addition, the Social Security and Nursing Division under the Department of Health Services, which provides subsidy for cancer treatment of underprivileged patients, was another major source of data. The collected data were verified for residence, accuracy, and completeness and then entered and analyzed using CanReg5 software. RESULTS In the Kathmandu Valley, the PBCR registered 2,156 new cancer cases with overall age-adjusted incidence rate for all cancers of 95.7 per 100,000 population (95.3 for males and 98.1 for females). The age-adjusted mortality rate for males was 36.3 (n = 365) and for females 27.0 (n = 305) per 100,000 population. We found that the commonest cancers in males were lung and stomach, whereas in females, they were breast and lung cancer. Gallbladder cancer was among the top five common cancers in both sex. CONCLUSION These findings provide a milestone to understand the cancer burden in the country for the first time using the PBCR and will be helpful to develop and prioritize cancer control strategies.
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Affiliation(s)
- Ranjeeta Subedi
- Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
| | - Meghnath Dhimal
- Environmental Health Sciences, Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
| | - Atul Budukh
- Epidemiology, Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, India
| | - Sandhya Chapagain
- Radiation Oncology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - Pradeep Gyawali
- Clinical Pharmacology, Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
| | - Bishal Gyawali
- Departments of Oncology and Public Health Sciences, Division of Cancer Care and Epidemiology, Queen's University, Kingston, Canada
| | - Uma Dahal
- Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
| | - Rajesh Dikshit
- Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, India
| | - Anjani Kumar Jha
- Radiation Oncology, Nepal Health Research Council (NHRC), Ramshahpath, Kathmandu, Nepal
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Gaskill CE, Gyedu A, Stewart B, Quansah R, Donkor P, Mock C. Improving Global Surgical Oncology Benchmarks: Defining the Unmet Need for Cancer Surgery in Ghana. World J Surg 2021; 45:2661-2669. [PMID: 34152449 DOI: 10.1007/s00268-021-06197-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The Lancet Commission on Global Surgery (LCoGS) recommended an annual surgical rate at which low- and middle-income countries (LMICs) could achieve most of the population-wide benefits of surgery. However, condition-specific guidelines were not proposed. To inform rates of surgery for cancer, we sought to assess the current met and unmet need for oncologic surgery in Ghana. METHODS Data on all operations performed in Ghana over a one-year period (2014-15) were obtained from representative samples of 48/124 first-level and 12/16 referral hospitals and scaled-up for nationwide estimates. Procedures for cancer were identified by indication. Using modified LCoGS methodology with disease prevalence, Ghana's annual rate of cancer surgery was compared to that of New Zealand to quantify current unmet needs. RESULTS 232,776 surgical procedures were performed in Ghana; 2,562 procedures (95%UI 1878-3255) were for cancer. Of these, 964 (37%) were surgical biopsies. The annual rate of procedures treating cancer was 2115 surgeries/100,000 cancer cases, or 21% of the New Zealand benchmark. Cervical, breast, and prostate cancer were found to meet 2.1%, 17.2%, and 32.1% of their respective surgical need. CONCLUSIONS There is a large unmet need for cancer surgery in Ghana. Cancer surgery constitutes under 2% of the total surgeries performed in Ghana, an important proportion of which are used for biopsies. Therapeutic operative rate is deficient across most cancer types, and may lag behind improvements in screening efforts. As cancer prevalence and diagnosis increase in LMICs, cancer-specific surgical capacity must be increased to meet these evolving needs.
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Affiliation(s)
- Cameron E Gaskill
- Department of Surgery, University of Washington, Seattle, WA, USA.
- Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA.
| | - Adam Gyedu
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Barclay Stewart
- Department of Surgery, University of Washington, Seattle, WA, USA
- Harborview Injury Prevention and Research Center, Seattle, WA, USA
| | - Robert Quansah
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Peter Donkor
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charles Mock
- Department of Surgery, University of Washington, Seattle, WA, USA
- Harborview Injury Prevention and Research Center, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
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Aikins M, Tabong PTN, Salari P, Tediosi F, Asenso-Boadi FM, Akweongo P. Positioning the National Health Insurance for financial sustainability and Universal Health Coverage in Ghana: A qualitative study among key stakeholders. PLoS One 2021; 16:e0253109. [PMID: 34129630 PMCID: PMC8205146 DOI: 10.1371/journal.pone.0253109] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 05/28/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The National Health Insurance Scheme (NHIS) was introduced in 2003 to reduce "out-of-pocket" payments for health care in Ghana. Over a decade of its implementation, issues about the financial sustainability of this pro-poor policy remains a crippling fact despite its critical role to go towards Universal Health Coverage. We therefore conducted this study to elicit stakeholders' views on ways to improve the financial sustainability of the operations of NHIS. METHODS Twenty (20) stakeholders were identified from Ministry of Health, Ghana Health Services, health workers groups, private medical practitioners, civil society organizations and developmental partners. They were interviewed using an interview guide developed from a NHIS policy review and analysis. All interviews were recorded and transcribed verbatim. The data were analysed thematically with the aid of NVivo 12 software. RESULTS Stakeholders admitted that the NHIS is currently unable to meet its financial obligations. The stakeholders suggested first the adoption of capitation as a provider payment mechanism to minimize the risk of providers' fraud and protection from political interference. Secondly, they indicated that rapid releases of specific statutory deductions and taxes for NHIS providers could reduce delays in claims' reimbursement which is one of the main challenges faced by healthcare providers. Aligning the NHIS with the Community-based Health Planning and Services and including preventive and promotive health is necessary to position the Scheme for Universal Health Coverage. CONCLUSION The Scheme will potentially achieve UHC if protected from political interference to improve the governance and transparency that affects the finances of the scheme and the expansion of services to include preventive and promotive services and cancers.
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Affiliation(s)
- Moses Aikins
- Department of Health Policy Planning and Management, School of Public Health, University of Ghana, Legon, Accra
| | - Philip Teg-Nefaah Tabong
- Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Legon, Accra
| | - Paola Salari
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Fabrizio Tediosi
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Patricia Akweongo
- Department of Health Policy Planning and Management, School of Public Health, University of Ghana, Legon, Accra
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Ayettey Anie H, Yarney J, Sanuade O, Awasthi S, Ndanu TA, Parekh AD, Aidoo C, Dadzie MA, Vanderpuye V, Yamoah K. Neoadjuvant or Adjuvant Chemotherapy for Breast Cancer in Sub-Saharan Africa: A Retrospective Analysis of Recurrence and Survival in Women Treated for Breast Cancer at the Korle Bu Teaching Hospital in Ghana. JCO Glob Oncol 2021; 7:965-975. [PMID: 34156868 PMCID: PMC8457842 DOI: 10.1200/go.20.00664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/23/2021] [Accepted: 05/17/2021] [Indexed: 12/03/2022] Open
Abstract
PURPOSE It is established that addition of systemic therapy to locoregional treatment for breast cancer improves survival. However, reliable data are lacking about the outcomes of such treatment in women with breast cancer in low middle-income countries. We compared the outcomes of treatment in patients who had received neoadjuvant chemotherapy (NACT) or adjuvant chemotherapy and examined the factors associated with breast cancer recurrence and survival at the National Radiotherapy Oncology and Nuclear Medicine Centre, Korle Bu Teaching Hospital, Ghana. METHODS This was a retrospective cohort study. The medical charts of women with breast cancer managed at the National Radiotherapy Oncology and Nuclear Medicine Centre from 2005 to 2014 were reviewed. A total of 388 patients with a median follow-up of 48 months were included in the study. Logistic regression was used to estimate the risk of recurrence. Survival was estimated using cox proportional hazards model. All models were adjusted with clinicopathologic variables. A P value of < .05 was considered statistically significant. RESULTS Fifty-nine percent received adjuvant chemotherapy. In an adjusted logistic model, no difference was observed in locoregional recurrence between patients receiving NACT compared with those receiving adjuvant chemotherapy (odds ratio = 1.05; 95% CI, 0.44 to 2.47). However, NACT recipients had a higher likelihood of distant recurrence (odds ratio = 1.97; 95% CI, 1.24 to 3.15). In a multivariable analysis, no differences were observed in overall survival between the two chemotherapy groups (hazard ratio = 1.43; 95% CI, 0.91 to 2.26). CONCLUSION NACT yields similar outcomes compared with adjuvant chemotherapy; however, recipients of NACT with advanced disease may have more distant failures. Early detection in a resource-limited setting is therefore crucial to optimal outcomes, significantly limiting recurrence and improving survival.
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Affiliation(s)
- Hannah Ayettey Anie
- National Radiotherapy Oncology and Nuclear Medicine Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | - Joel Yarney
- National Radiotherapy Oncology and Nuclear Medicine Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | - Olutobi Sanuade
- Institute for Global Health, University College London, London, United Kingdom
| | - Shivanshu Awasthi
- H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL
| | | | - Akash D. Parekh
- Department of Radiation Oncology, University of Florida, Gainesville, FL
| | - Charles Aidoo
- National Radiotherapy Oncology and Nuclear Medicine Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | - Mary Ann Dadzie
- National Radiotherapy Oncology and Nuclear Medicine Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | - Verna Vanderpuye
- National Radiotherapy Oncology and Nuclear Medicine Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | - Kosj Yamoah
- H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL
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Adusei E, Ahenkorah J, Adu-Aryee NA, Adutwum-Ofosu KK, Tagoe EA, Koney NKK, Nkansah E, Aryee NA, Blay RM, Hottor BA, Clegg-Lamptey JN, Arko-Boham B. Reduced Serum Circulation of Cell-Free DNA Following Chemotherapy in Breast Cancer Patients. Med Sci (Basel) 2021; 9:medsci9020037. [PMID: 34070520 PMCID: PMC8163010 DOI: 10.3390/medsci9020037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/07/2021] [Accepted: 05/19/2021] [Indexed: 12/21/2022] Open
Abstract
Breast cancer is the most common malignancy in women, with alarming mortalities. Neoadjuvant treatments employ chemotherapy to shrink tumours to a well-defined size for a better surgical outcome. The current means of assessing effectiveness of chemotherapy management are imprecise. We previously showed that breast cancer patients have higher serum circulating cell-free DNA concentrations. cfDNA is degraded cellular DNA fragments released into the bloodstream. We further report on the utility of cfDNA in assessing the response to chemotherapy and its potential as a monitoring biomarker. A total of 32 newly diagnosed and treatment-naive female breast cancer patients and 32 healthy females as controls were included. Anthropometric, demographic and clinicopathological information of participants were recorded. Each participant donated 5 mL of venous blood from which sera were separated. Blood sampling was carried out before the commencement of chemotherapy (timepoint 1) and after the third cycle of chemotherapy (timepoint 2). qPCR was performed on the sera to quantify ALU 115 and 247 levels, and DNA integrity (ALU247/ALU115) was determined. ALU 115 and 247 levels were elevated in cancer patients but were significantly decreased after the third cycle of chemotherapy (T2) compared to T1. DNA integrity increased after the third cycle. Serum cfDNA may provide a relatively inexpensive and minimally invasive procedure to evaluate the response to chemotherapy in breast cancer.
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Affiliation(s)
- Evelyn Adusei
- Department of Anatomy, University of Ghana Medical School, University of Ghana, Accra P.O. Box GP 4236, Ghana; (E.A.); (J.A.); (K.K.A.-O.); (N.K.-K.K.); (E.N.); (R.M.B.); (B.A.H.)
| | - John Ahenkorah
- Department of Anatomy, University of Ghana Medical School, University of Ghana, Accra P.O. Box GP 4236, Ghana; (E.A.); (J.A.); (K.K.A.-O.); (N.K.-K.K.); (E.N.); (R.M.B.); (B.A.H.)
| | - Nii Armah Adu-Aryee
- Department of Surgery, University of Ghana Medical School, University of Ghana, Accra P.O. Box GP 4236, Ghana; (N.A.A.-A.); (J.-N.C.-L.)
- Department of Surgery, Korle-Bu Teaching Hospital, Korle Bu, Accra P.O. Box 77, Ghana
| | - Kevin Kofi Adutwum-Ofosu
- Department of Anatomy, University of Ghana Medical School, University of Ghana, Accra P.O. Box GP 4236, Ghana; (E.A.); (J.A.); (K.K.A.-O.); (N.K.-K.K.); (E.N.); (R.M.B.); (B.A.H.)
| | - Emmanuel Ayitey Tagoe
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Accra P.O. Box KB 143, Ghana;
| | - Nii Koney-Kwaku Koney
- Department of Anatomy, University of Ghana Medical School, University of Ghana, Accra P.O. Box GP 4236, Ghana; (E.A.); (J.A.); (K.K.A.-O.); (N.K.-K.K.); (E.N.); (R.M.B.); (B.A.H.)
| | - Emmanuel Nkansah
- Department of Anatomy, University of Ghana Medical School, University of Ghana, Accra P.O. Box GP 4236, Ghana; (E.A.); (J.A.); (K.K.A.-O.); (N.K.-K.K.); (E.N.); (R.M.B.); (B.A.H.)
| | - Nii Ayite Aryee
- Department of Medical Biochemistry, University of Ghana Medical School, University of Ghana, Accra P.O. Box GP 4236, Ghana;
| | - Richard Michael Blay
- Department of Anatomy, University of Ghana Medical School, University of Ghana, Accra P.O. Box GP 4236, Ghana; (E.A.); (J.A.); (K.K.A.-O.); (N.K.-K.K.); (E.N.); (R.M.B.); (B.A.H.)
| | - Bismarck Afedo Hottor
- Department of Anatomy, University of Ghana Medical School, University of Ghana, Accra P.O. Box GP 4236, Ghana; (E.A.); (J.A.); (K.K.A.-O.); (N.K.-K.K.); (E.N.); (R.M.B.); (B.A.H.)
| | - Joe-Nat Clegg-Lamptey
- Department of Surgery, University of Ghana Medical School, University of Ghana, Accra P.O. Box GP 4236, Ghana; (N.A.A.-A.); (J.-N.C.-L.)
- Department of Surgery, Korle-Bu Teaching Hospital, Korle Bu, Accra P.O. Box 77, Ghana
| | - Benjamin Arko-Boham
- Department of Anatomy, University of Ghana Medical School, University of Ghana, Accra P.O. Box GP 4236, Ghana; (E.A.); (J.A.); (K.K.A.-O.); (N.K.-K.K.); (E.N.); (R.M.B.); (B.A.H.)
- Correspondence: ; Tel.: +233-200120709
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Titiloye NA, Bedu-Addo K, Atta Manu E, Ameh-Mensah C, Opoku F, Duduyemi BM. Breast lesions and cancer: histopathology and molecular classification in a referral hospital in Ghana. ALEXANDRIA JOURNAL OF MEDICINE 2021. [DOI: 10.1080/20905068.2021.1907960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
| | - K. Bedu-Addo
- Department of Physiology, SMD, KNUST, Kumasi, Ghana
| | - E. Atta Manu
- Department of Physiology, SMD, KNUST, Kumasi, Ghana
| | | | - F. Opoku
- Department of Physiology, SMD, KNUST, Kumasi, Ghana
| | - B. M. Duduyemi
- Department of Pathology, SMD, KNUST, Kumasi, Ghana
- University of Sierra Leone Teaching Hospital Complex, Freetown, Sierra Leone
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Osei EA, Appiah S, Gaogli JE, Oti-Boadi E. Knowledge on cervical cancer screening and vaccination among females at Oyibi Community. BMC WOMENS HEALTH 2021; 21:148. [PMID: 33845829 PMCID: PMC8042702 DOI: 10.1186/s12905-021-01296-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/07/2021] [Indexed: 11/13/2022]
Abstract
Background Awareness about cervical cancer screening and vaccination in the developed countries are high as compared to the developing countries. Sixty to eighty percent (60–80%) of the women who develop cervical cancer in sub-Saharan Africa live in the rural areas with inadequate awareness of cervical cancer screening. However, cervical cancer knowledge remained a significant direct predictor of screening behaviors. The study therefore aim to explore the Knowledge on Cervical Cancer Screening and Vaccination among females at Oyibi Community.
Methods A qualitative exploratory design was employed to purposively recruit 35 participants who were made up of 7 members in a group forming 5 Focus Group discussions in all. Data was retrieved using a semi-structured interview guide.
Results The study revealed two main themes with 7 subthemes. The two main themes were cervical cancer screening and vaccination knowledge and cervical cancer vaccination effectiveness and cost. The subthemes were; knowledge on cervical cancer screening types, knowledge about cervical cancer screening and vaccination centers, knowledge about how cancer screening is performed, knowledge about cervical cancer vaccination, cervical cancer screening and vaccination sources of information, knowledge about the effectiveness of cervical cancer vaccination and awareness about cervical cancer screening cost and vaccination cost.
Conclusion Ghanaian women are increasingly becoming aware of cervical cancer, nevertheless low knowledge on screening and vaccination of cervical cancer, and effectiveness was detected with high awareness about the screening and vaccination centers. There is therefore the need for heightened sensitization regarding cervical cancer screening and vaccination in rural communities to help reduce misconceptions and increase patronage rate. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01296-3.
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Affiliation(s)
- Evans Appiah Osei
- Department of Nursing, School of Nursing and Midwifery, Valley View University, P.O. Box DT 595, Oyibi, Ghana.
| | - Stella Appiah
- Department of Nursing, School of Nursing and Midwifery, Valley View University, P.O. Box DT 595, Oyibi, Ghana
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Dawson CP, Aryeetey GC, Agyemang SA, Mensah K, Addo R, Nonvignon J. Costs, burden and quality of life associated with informal caregiving for children with Lymphoma attending a tertiary hospital in Ghana. INTERNATIONAL JOURNAL OF CARE COORDINATION 2021. [DOI: 10.1177/2053434520981357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Introduction Primary family caregivers provide substantial support in the management of lymphoma, potentially affecting their quality of life and increasing household health care costs. Our aim was thus to determine the economic costs and quality of life of primary caregivers of children with lymphoma. Methods This cross-sectional study involved primary informal caregivers of children with lymphoma attending the pediatric cancer unit at Komfo Anokye Teaching Hospital. The study adopted a cost-of-illness approach to estimate the direct costs (medical and non- medical) incurred and indirect cost (productive losses) to caregivers over the one-month period preceding the data collection. Zarit Burden Interview was used to determine caregiver burden and EUROHIS-QoL tool was used to determine the quality of life of primary caregivers. Results The average cost of managing lymphoma in children was estimated to be US$440.32, 97% of which were direct costs. On average, caregiver burden was 26.3 on the scale of 0 to 48. About 94% of caregivers reported high burden, with more males reporting high burden. Overall, average quality of life among caregivers was 2.20 on the 1 to 5 range. Approximately 85% of respondents reported low quality of life, with females reporting lower quality of life than males. Discussion This study shows that lymphoma is associated with substantial cost and increased burden, and affects quality of life of family caregivers. Future studies can explore the impact of social protection interventions (in the form of health insurance) to reduce the household economic burden of managing lymphoma in children.
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Agyei-Baffour P, Asare M, Lanning B, Koranteng A, Millan C, Commeh ME, Montealegre JR, Mamudu HM. Human papillomavirus vaccination practices and perceptions among Ghanaian Healthcare Providers: A qualitative study based on multi-theory model. PLoS One 2020; 15:e0240657. [PMID: 33064718 PMCID: PMC7567370 DOI: 10.1371/journal.pone.0240657] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 09/30/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Healthcare providers' (HCPs) recommendations for the Human Papillomavirus (HPV) vaccine are likely to increase the vaccination uptake. However, little is known about Ghanaian HCPs' general practices regarding HPV vaccination. We used Multi-Theory Model (MTM) constructs (i.e. participatory dialogue, behavioral confidence, environment, social and emotional transformation) to examine Ghanaian HCPs' attitudes towards HPV vaccination and their vaccination recommendation practices. METHODS We conducted three, 60-minute focus group discussions (FGDs) with HCP in the second-largest government hospital in Ghana. Sixteen semi-structured open-ended questions based on MTM constructs were used to guide the FGDs. We explored HCPs' general knowledge about HPV, vaccination recommendation behavior, physical environment, and socio-cultural factors associated with the HPV vaccination. Data from the FGDs were transcribed and thematically coded using NVivo software. RESULTS The sample of (n = 29) HCPs consisting of males (n = 15) and females (n = 14) between the ages of 29 and 42 years participated in the FGDs. Our analyses showed that HCPs (a) rarely offered HPV vaccination recommendations, (b) showed varied understanding about who should be vaccinated regarding age eligibility, gender, and infection status. Perceived barriers to HPV vaccination include (a) low urgency for vaccination education due to competing priorities such as malaria and HIV/AIDS; (b) lack of data on HPV vaccination; (c) lack of awareness about the vaccine safety and efficacy; (c) lack of HPV vaccine accessibility and (d) stigma, misconceptions and religious objections. HCPs expressed that their motivation for counseling their clients about HPV vaccination would be increased by having more knowledge about the vaccine's efficacy and safety, and the involvement of the parents, chiefs, churches, and opinion leaders in the vaccination programs. CONCLUSION The study's findings underscore the need for a comprehensive HPV vaccination education for HCPs in Ghana. Future HPV vaccination education programs should include information about the efficacy of the vaccine and effective vaccination messages to help mitigate HPV vaccine-related stigma.
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Affiliation(s)
- Peter Agyei-Baffour
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Matthew Asare
- Department of Public Health, Baylor University, Waco, Texas, United States of America
- * E-mail:
| | - Beth Lanning
- Department of Public Health, Baylor University, Waco, Texas, United States of America
| | - Adofo Koranteng
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Cassandra Millan
- Department of Public Health, Baylor University, Waco, Texas, United States of America
| | - Mary E. Commeh
- Non-Communicable Disease Control, Ghana Health Services, Accra, Ghana
| | - Jane R. Montealegre
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine Houston, Houston, Texas, United States of America
| | - Hadii M. Mamudu
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, Tennessee, United States of America
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Exploring the social stressors and resources of husbands of women diagnosed with advanced breast cancer in their role as primary caregivers in Kumasi, Ghana. Support Care Cancer 2020; 29:2335-2345. [PMID: 32915296 DOI: 10.1007/s00520-020-05716-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 08/19/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE We aimed to explore the experiences of husbands of women diagnosed with advanced breast cancer, highlighting their stressors and the resources they rely on to cope, in Kumasi, Ghana. METHOD An exploratory descriptive qualitative research design was adopted. Fifteen in-depth interviews with participants were conducted. After a participant's written consent, we audio-recorded the interview sessions and transcribed them verbatim. We managed and analysed the data manually. RESULT The experiences of husbands as primary caregivers of their wives diagnosed with advanced breast cancer have been broadly categorized under two main themes: stressors and resources. The analyses revealed that the burdens associated with the husband's primary caregiving roles threatened the marriage, their relationships with others, work, and finances. Regardless of the stressors, participants drew on a range of resources such as acceptance, marital obligation and commitment to marital vows, social support, and spirituality to cope. CONCLUSION The study is the first of our knowledge to explore the experiences of husbands acting as primary caregivers of their wives who are diagnosed with advanced breast cancer in Ghana. It revealed that they rely on specific resources to cope with the burdens associated with their role. Policies and programs aiming at assisting women diagnosed with advanced breast cancer to manage and cope with the disease should include the partners of the married ones by designing programs that help the husbands to understand the situation and adequately provide the care that promotes the quality of life of the husband, wife, and the family.
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Owusu-Afriyie O, Owiredu WKBA, Oti AA, Acheampong E, Owusu-Danquah K, Larsen-Reindorf R, Fondjo LA, Adu EA, Donkor S, Donkor P. Survival rates of head and neck cancers in Ghana: a retrospective study at the Komfo Anokye Teaching Hospital. BMC Res Notes 2020; 13:392. [PMID: 32847613 PMCID: PMC7448471 DOI: 10.1186/s13104-020-05233-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 08/14/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Data was collected to evaluate the survival rates of head and neck (conjunctiva, oropharyngeal and non-oropharyngeal) squamous cell carcinomas in Ghana. DATA DESCRIPTION We provided data on a retrospective review of 8 years (January 2004 to December 2009) survival rate of head and neck squamous cell carcinomas (HNSCCs) at the Komfo Anokye Teaching Hospital in Ghana. The data consist of patient demographic data and clinicopathological findings which includes tumour site, tumour stage and histological grades of the patients. Clinical outcome measurement was death through to January 2013 on record and confirmed from the hospitals birth and death registry department. More than 85% of death cases were confirmed by gender, age, and folder identification numbers from the birth and death registry.
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Affiliation(s)
- Osei Owusu-Afriyie
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. .,Department of Pathology, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
| | - W K B A Owiredu
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Emmanuel Acheampong
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,School of Medical and Health Science, Edith Cowan University, Joondalup, Australia
| | - Kwabena Owusu-Danquah
- Department of Medical Laboratory Technology, Faculty of Allied Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Rita Larsen-Reindorf
- Directorate of Dental, Eye, Ear, Nose & Throat, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Linda Ahenkorah Fondjo
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Evans Asamoah Adu
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Sampson Donkor
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Peter Donkor
- Department of Maxillofacial Surgery, Dental School, KNUST, Kumasi, Ghana
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Mensah KB, Mensah ABB. Cancer control in Ghana: A narrative review in global context. Heliyon 2020; 6:e04564. [PMID: 32775744 PMCID: PMC7404540 DOI: 10.1016/j.heliyon.2020.e04564] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 09/21/2019] [Accepted: 07/23/2020] [Indexed: 12/12/2022] Open
Abstract
Globally, cancer is likely to be ranked as the leading cause of death among non-communicable diseases in the 21st century. In Ghana, estimates suggest that the disease is expected to increase continuously. The best way to address the increasing burden is through a comprehensive cancer control program. This paper presents an appraisal of the literature, reports and, studies that seek to highlight strategies for cancer control globally and in Ghana. In consideration of literature, a search of relevant databases (PubMed, Google Scholar, Cochrane Database of Systematic Reviews, Google, International organizations web pages, International reports, Ministry of Health of Ghana reports, and textbooks) was performed. A narrative review of the background information on this subject is provided to inform future research on cancer control. This review was conducted as part of a study to involve community pharmacists in cancer detection and prevention in Ghana.
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Affiliation(s)
- Kofi Boamah Mensah
- Department of Pharmacy Practice, Faculty of Pharmacy & Pharmaceutical Science, College of Health Science, Kwame Nkrumah University of Science & Technology, Ghana
- University of KwaZulu-Natal, Discipline of Pharmaceutical Sciences, College of Health Sciences, Westville Campus, University Road, Durban, South Africa
| | - Adwoa Bemah Boamah Mensah
- Department of Nursing, College of Health Science, Kwame Nkrumah University of Science & Technology, Ghana
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Ayanore MA, Adjuik M, Ameko A, Kugbey N, Asampong R, Mensah D, Alhassan RK, Afaya A, Aviisah M, Manu E, Zotor F. Self-reported breast and cervical cancer screening practices among women in Ghana: predictive factors and reproductive health policy implications from the WHO study on global AGEing and adult health. BMC WOMENS HEALTH 2020; 20:158. [PMID: 32723342 PMCID: PMC7388217 DOI: 10.1186/s12905-020-01022-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 07/16/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Breast and cervical cancers constitute the two leading causes of cancer deaths among women in Ghana. This study examined breast and cervical screening practices among adult and older women in Ghana. METHODS Data from a population-based cross-sectional study with a sample of 2749 women were analyzed from the study on global AGEing and adult health conducted in Ghana between 2007 and 2008. Binary and multivariable ordinal logistic regression analyses were performed to assess the association between socio-demographic factors, breast and cervical screening practices. RESULTS We found that 12.0 and 3.4% of adult women had ever had pelvic screening and mammography respectively. Also, 12.0% of adult women had either one of the screenings while only 1.8% had both screening practices. Age, ever schooled, ethnicity, income quantile, father's education, mother's employment and chronic disease status were associated with the uptake of both screening practices. CONCLUSION Nationwide cancer awareness campaigns and education should target women to improve health seeking behaviours regarding cancer screening, diagnosis and treatment. Incorporating cancer screening as a benefit package under the National Health Insurance Scheme can reduce financial barriers for breast and cervical screening.
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Affiliation(s)
- Martin Amogre Ayanore
- School of Public Health, University of Health and Allied Sciences, University of Health and Allied Sciences, Ho, Ghana.
| | - Martin Adjuik
- School of Public Health, University of Health and Allied Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Asiwome Ameko
- School of Public Health, University of Health and Allied Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Nuworza Kugbey
- School of Public Health, University of Health and Allied Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Robert Asampong
- School of Public Health, University of Health and Allied Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Derrick Mensah
- School of Public Health, University of Health and Allied Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Robert Kaba Alhassan
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Agani Afaya
- School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Mark Aviisah
- School of Public Health, University of Health and Allied Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Emmanuel Manu
- School of Public Health, University of Health and Allied Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Francis Zotor
- School of Public Health, University of Health and Allied Sciences, University of Health and Allied Sciences, Ho, Ghana
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Kusi G, Boamah Mensah AB, Boamah Mensah K, Dzomeku VM, Apiribu F, Duodu PA, Adamu B, Agbadi P, Bonsu KO. The experiences of family caregivers living with breast cancer patients in low-and middle-income countries: a systematic review. Syst Rev 2020; 9:165. [PMID: 32703259 PMCID: PMC7379811 DOI: 10.1186/s13643-020-01408-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 06/10/2020] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION Caregivers of women with breast cancer in low-and-middle-income countries experience significant physical and economic burdens. The review aimed to map the evidence of studies that had reported on the experiences of family caregivers of women diagnosed with breast cancer. METHODS A systematic literature search was conducted in CINAHL, PubMed, PsycINFO, Scopus, and Web of Science databases using a combination of key search terms and medical subject heading terms such as "family caregiver," "breast cancer," "home care," "low-and-middle-income countries," "experience," "effect," and "coping mechanism." A total of 1781 articles were retrieved and screened. Nineteen studies addressing caregiving experiences were included in the final review based on the inclusion and exclusion criteria. RESULTS The systematic review yielded 19 studies that focused on caregivers' motivation, needs of caregivers, intervention for caregivers, and consequences of caregiving. The most significant correlates of the quality of life among caregivers were disease severity, functional status of patients, and family income. The challenges encountered by caregivers were mostly psychosocial. CONCLUSIONS Caregivers play a crucial role in the management of women with breast cancer. However, they are faced with increasing challenges in their caregiving roles. Understanding the nature and extent of the burden experienced by family caregivers in developing countries will facilitate the development of appropriate interventions that can help improve caregivers' quality of life. Gaps in recent studies were identified, and suggestions for future research were also addressed in this review. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019118391.
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Affiliation(s)
- Grace Kusi
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Obstetrics and Gynecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Adwoa Bemah Boamah Mensah
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kofi Boamah Mensah
- Oncology Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Veronica Millicent Dzomeku
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Felix Apiribu
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Precious Adade Duodu
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Bakinam Adamu
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Pascal Agbadi
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kwadwo Osei Bonsu
- Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Adadey SM, Languon S, Ayee R, Quansah DN, Quaye O. Incidence and mortality of cancer in the Volta Region of Ghana. Exp Biol Med (Maywood) 2020; 245:1058-1065. [PMID: 32498552 DOI: 10.1177/1535370220931514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPACT STATEMENT Region-specific cancer reports are essential in knowing the common cancers in specific populations. This study reports all cancer types recorded in the major hospitals in the Volta Region of Ghana, a population that is sparsely captured in the national cancer registries. The study identified the common cancers as well as the death rates in the Volta Region, hence contributing to the national effort to report cancer data. Although not comprising all the elements of a cancer registry, our data will augment the effort of the two national cancer registries in Ghana to provide the national cancer reports.
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Affiliation(s)
- Samuel M Adadey
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell & Molecular Biology, University of Ghana, Accra, Ghana
| | - Sylvester Languon
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell & Molecular Biology, University of Ghana, Accra, Ghana
| | - Richmond Ayee
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell & Molecular Biology, University of Ghana, Accra, Ghana
| | - Darius Nk Quansah
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell & Molecular Biology, University of Ghana, Accra, Ghana
| | - Osbourne Quaye
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell & Molecular Biology, University of Ghana, Accra, Ghana
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Arko-Boham B, Owusu BA, Aryee NA, Blay RM, Owusu EDA, Tagoe EA, Adams AR, Gyasi RK, Adu-Aryee NA, Mahmood S. Prospecting for Breast Cancer Blood Biomarkers: Death-Associated Protein Kinase 1 (DAPK1) as a Potential Candidate. DISEASE MARKERS 2020; 2020:6848703. [PMID: 32566040 PMCID: PMC7267859 DOI: 10.1155/2020/6848703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 05/01/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Breast cancer is the commonest malignancy in women worldwide. It is estimated to affect approximately 1.5 million women annually and responsible for the greatest number of cancer-related mortalities among women. In 2018, breast cancer mortalities stood at 627,000 women representing approximately 15% of all cancer deaths among women. In Ghana, breast cancer is the second leading cause of cancer deaths, with an incidence of 2,900 cases annually; one of eight women with the disease die. This gives impetus to the fight for improved early detection, treatment, and/management. In this light, we investigated the potential of death-associated protein kinase 1 (DAPK1) as a biomarker for breast cancer. As a tumour suppressor, its expression is activated by several carcinogens to influence cellular pathways that result in apoptosis, autophagy, immune response, and proliferation. AIM To investigate DAPK1 as a blood biomarker for breast cancer. METHODS Blood samples of participants diagnosed with breast cancer and healthy controls were collected and processed to obtain serum. Information on age, treatment, diagnosis, and pathology numbers was retrieved from folders. Pathology numbers were used to retrieve breast tissue blocks of patients at the Department of Pathology of the KBTH. Tissue blocks were sectioned and immunohistochemically stained with anti-DAPK1 and counterstained with hematoxylin to determine the DAPK1 expression levels. DAKP1 levels in blood sera were quantified using a commercial anti-DAPK1 ELISA kit. Case and control group means were compared using one-way ANOVA and Chi-square test. Statistical significance was set at p ≤ 0.05. Results and Discussion. DAPK1 levels were higher in sera and breast tissues of breast cancer patients than controls. The augmented DAPK1 expression can be interpreted as a stress response survival mechanism to remediate ongoing deleterious events in the cells orchestrated by carcinogenesis. In the presence of abundant DAPK1, the proliferative power of cells (both cancerous and noncancerous) is increased. This may explain why high DAPK1 expression strongly associates with aggressive breast cancer phenotypes like the ER-negative breast cancers, especially the triple-negative breast cancers (TNBC) which are the most aggressive, fast-growing, and highly metastatic. CONCLUSION DAPK1 is highly expressed in sera and breast tissues of breast cancer patients than nonbreast cancer participants. The elevated expression of DAKP1 in circulation rather than in breast tissues makes it a candidate for use as a blood biomarker and potential use as therapeutic target in drug development.
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Affiliation(s)
- Benjamin Arko-Boham
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Ghana
- Department of Anatomy, School of Biomedical and Allied Health Sciences, University of Ghana, Ghana
| | - Bright Afriyie Owusu
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Ghana
| | - Nii Ayite Aryee
- Department of Medical Biochemistry, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Ghana
| | - Richard Michael Blay
- Department of Anatomy, School of Biomedical and Allied Health Sciences, University of Ghana, Ghana
| | - Ewurama Dedea Ampadu Owusu
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Ghana
- Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Centre, University of Amsterdam, Netherlands
- Foundation for Innovative and New Diagnostics (FIND), Geneva, Switzerland
| | - Emmanuel Ayitey Tagoe
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
| | - Abdul Rashid Adams
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Ghana
| | - Richard Kwasi Gyasi
- Department of Pathology, School of Biomedical and Allied Health Sciences, University of Ghana, Ghana
| | - Nii Armah Adu-Aryee
- Department of Surgery, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Ghana
- Department of Surgery, Korle-Bu Teaching Hospital, Accra-, Ghana
| | - Seidu Mahmood
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Ghana
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The prevalence and predictive factors of breast cancer screening among older Ghanaian women. Heliyon 2020; 6:e03838. [PMID: 32373741 PMCID: PMC7191248 DOI: 10.1016/j.heliyon.2020.e03838] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/13/2020] [Accepted: 04/21/2020] [Indexed: 12/09/2022] Open
Abstract
Background Breast cancer cases are on the rise in Ghana, with older adult women being more at risk of the disease. However, there is a paucity of current studies on factors that predict breast cancer screening among older adult women using nationally representative data. The present study, therefore, addressed this gap by estimating the prevalence of and identifying the factors that predict breast cancer screening among older adult women in Ghana. Methods We used the cross-sectional survey dataset of the 2014/2015 (wave II) Study on global AGEing and adult health (SAGE). A complex survey design methodology was employed to estimate the prevalence of breast cancer screening and the descriptive statistics of the demographic characteristics of the respondents. We used the firth logistic regression for the bivariate and multivariate analysis. Results The estimated breast cancer prevalence among older Ghanaian adult women was 4.5%. Older Ghanaian adult women who have screened for cervical cancer [AOR: 13.29; CI: 6.12, 28.84], had attained some primary education [AOR: 3.70; CI: 1.94, 7.07], junior secondary [AOR: 4.02; CI: 1.75, 9.21], senior secondary and higher [AOR: 4.57; CI: 2.15, 9.71], and have ever participated in a club meeting [AOR: 1.85; CI: 1.05, 3.24] were more likely to screen for breast cancer. Conclusion The significant predictors of breast cancer screening were cervical cancer screening status, formal education, and participation in club meetings. Given that the prevalence of breast cancer screening among the older adult women in Ghana is low, we recommend that policies and programs dedicated to encouraging women to screen for breast cancer should aim at giving women the opportunity to obtain higher formal education, encouraging women to be actively involved in club meetings and to intensify efforts to encourage women to screen for breast cancer.
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Kusi G, Boamah Mensah AB, Boamah Mensah K, Dzomeku VM, Apiribu F, Duodu PA. Caregiving motivations and experiences among family caregivers of patients living with advanced breast cancer in Ghana. PLoS One 2020; 15:e0229683. [PMID: 32163432 PMCID: PMC7067415 DOI: 10.1371/journal.pone.0229683] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 02/11/2020] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Significant number of women present with advanced-stage breast cancer in Ghana. These women usually depend on family caregivers for their multi-dimensional needs. Yet, there are gaps in research about what motivates family caregivers to assume the caring role and their experiences with caregiving within the Ghanaian context. AIM To explore and describe the caregiving motivations and experiences among family caregivers of patients living with advanced breast cancer. METHODS In-depth, semi-structured qualitative interviews were conducted with 15 family caregivers who were providing unpaid care for women living with advanced breast cancer. Colaizzi's thematic analysis was used to analyze the data. RESULTS Family relationship normally prescribed the caregiving role among family caregivers. Due to the lack of home-based palliative services in Ghana, findings suggest that family caregivers are the main managers of advanced breast cancer-related symptoms in the home. These findings are discussed under three major themes: (i) motivation for assuming the caregiving role; (ii) meeting self-care and psychosocial needs of the patient; and (iii) symptom management and monitoring. CONCLUSION Socio-cultural values influence the role of family caregivers in Ghana. This presents opportunities for health professionals and relevant stakeholders to develop a culturally-appropriate intervention to support informal caregivers in their home-based care for women living with advanced breast cancer in Ghana.
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Affiliation(s)
- Grace Kusi
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Obstetrics and Gynecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Adwoa Bemah Boamah Mensah
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Veronica Millicent Dzomeku
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Felix Apiribu
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Precious Adade Duodu
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Kayamba V, Zyambo K, Mulenga C, Mwakamui S, Tembo MJ, Shibemba A, Heimburger DC, Atadzhanov M, Kelly P. Biomass Smoke Exposure Is Associated With Gastric Cancer and Probably Mediated Via Oxidative Stress and DNA Damage: A Case-Control Study. JCO Glob Oncol 2020; 6:532-541. [PMID: 32228314 PMCID: PMC7113078 DOI: 10.1200/go.20.00002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE We investigated the association between gastric cancer and environmental and dietary exposures. In addition, we explored probable mechanistic pathways for the influence of biomass smoke on gastric carcinogenesis. PATIENTS AND METHODS The study was conducted in Lusaka, Zambia. Questionnaires were used to collect data on risk factors, whereas enzyme-linked immunosorbent assays and high-performance liquid chromatography were used to measure biologic exposures. Study data were analyzed using contingency tables and logistic regression. RESULTS We enrolled 72 patients with gastric adenocarcinoma and 244 controls. Gastric cancer was positively associated with rural residence (odds ratio [OR], 2.9; 95% CI, 1.5 to 5.3), poverty (OR, 4.2; 95% CI, 1.9 to 9.1), and daily consumption of processed meat (OR, 6.4; 95% CI, 1.3 to 32) and negatively associated with consumption of green vegetables (OR, 0.2; 95% CI, 0.1 to 0.5). Gastric cancer was also associated with biomass smoke exposure (OR, 3.5; 95% CI, 1.9 to 6.2; P < .0001), an association that was stronger for intestinal-type cancers (OR, 3.6; 95% CI, 1.5 to 9.1; P = .003). Exposure to biomass smoke in controls was associated with higher urinary levels of 8-isoprostane (P < .0001), 8-hydroxydeoxyguanosine (P = .029), and 1-hydroxypyrene (P = .041). Gastric cancer was not associated with biochemical measures of current exposure to aflatoxins or ochratoxins. CONCLUSION In Zambia, exposure to biomass smoke, daily consumption of processed meat, and poverty are risk factors for gastric cancer, whereas daily consumption of green vegetables is protective against gastric cancer. Exposure to biomass smoke was associated with evidence of oxidative stress and DNA damage, suggesting mechanistic plausibility for the observed association, and the association was restricted to intestinal-type gastric cancer.
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Affiliation(s)
- Violet Kayamba
- Department of Internal Medicine, Tropical Gastroenterology and Nutrition Group, Lusaka, Zambia
- Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia
| | - Kanekwa Zyambo
- Department of Internal Medicine, Tropical Gastroenterology and Nutrition Group, Lusaka, Zambia
| | - Chola Mulenga
- Department of Internal Medicine, Tropical Gastroenterology and Nutrition Group, Lusaka, Zambia
| | - Simutanyi Mwakamui
- Department of Internal Medicine, Tropical Gastroenterology and Nutrition Group, Lusaka, Zambia
| | | | - Aaron Shibemba
- Department of Pathology, University Teaching Hospital, Lusaka, Zambia
| | | | - Masharip Atadzhanov
- Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia
| | - Paul Kelly
- Department of Internal Medicine, Tropical Gastroenterology and Nutrition Group, Lusaka, Zambia
- Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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Ajani M, Omenai S, Okolo C. Histopathological characteristics of carcinoma of the uterine cervix in a tertiary hospital in southern Nigeria. SAHEL MEDICAL JOURNAL 2020. [DOI: 10.4103/smj.smj_60_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Annan FM, Oppong Asante K, Kugbey N. Perceived seriousness mediates the influence of cervical cancer knowledge on screening practices among female university students in Ghana. BMC WOMENS HEALTH 2019; 19:140. [PMID: 31744545 PMCID: PMC6862849 DOI: 10.1186/s12905-019-0842-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 11/07/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Cervical cancer knowledge and awareness, as well as an individual's perceptions about cervical cancer have been shown to significantly influence the screening practices of female students. Despite these studies, the mechanisms linking cervical cancer knowledge to screening practices among female students remain unexplored in the literature. Thus, this study examined the direct and indirect influences of cervical cancer knowledge on screening practices through perceptions about cervical cancer as informed by the health belief model. METHODS A cross-sectional survey design with a purposive sample of 200 female students were used in the study. Standardized questionnaires were used to measure cervical cancer knowledge, perceived susceptibility, perceived seriousness, perceived benefits, perceived barriers and cervical cancer screening behaviours. The Pearson product-moment correlation co-efficient and mediation analyses were used to analyse the data. RESULTS Our findings showed that cervical cancer knowledge, perceived susceptibility, perceived seriousness and perceived benefits were significant and positively correlated with increased screening behaviours. However, only perceived seriousness significantly mediated the relationship between cervical cancer knowledge and screening behaviour. Cervical cancer knowledge remained a significant direct predictor of screening behaviour in all the models. CONCLUSION These findings underscore the need for increased awareness with emphasis on the seriousness of cervical cancer among female university students as it plays a key role in influencing their screening behaviours.
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Affiliation(s)
| | - Kwaku Oppong Asante
- Department of Psychology, University of Ghana, Legon, Accra, Ghana. .,Department of Psychology, University of the Free State, Bloemfontein, South Africa.
| | - Nuworza Kugbey
- Department of Family and Community Health, University of Health and Allied Sciences, Hohoe Campus, Hohoe, Volta Region, Ghana
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Nyame YA, Gore JL. What Goes Up Must Come Down: Identifying Truth from Global Prostate Cancer Epidemiology. Eur Urol 2019; 77:53-54. [PMID: 31627967 DOI: 10.1016/j.eururo.2019.09.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 09/10/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Yaw A Nyame
- Department of Urology, University of Washington, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - John L Gore
- Department of Urology, University of Washington, Seattle Cancer Care Alliance, Seattle, WA, USA.
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Williams MS, Kenu E, Adanu A, Yalley RA, Lawoe NK, Dotse AS, Adu RF, Fontaine K. Awareness and Beliefs About Cervical Cancer, the HPV Vaccine, and Cervical Cancer Screening Among Ghanaian Women with Diverse Education Levels. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:897-903. [PMID: 29974412 DOI: 10.1007/s13187-018-1392-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Cervical cancer is the leading cause of cancer death among women in Ghana. Cost-effective tools for the primary and secondary prevention of cervical cancer, such as the Pap test, the HPV DNA test, and the HPV vaccine, are available in hospitals and clinics throughout Ghana. However, participation in cervical cancer prevention behaviors is low among Ghanaian women. Our objective was to determine if there were significant differences in cervical cancer awareness and stigmatizing beliefs about women with cervical cancer between Ghanaian women of different education levels. We surveyed 288 Ghanaian women who were at least 18 years old. Data on the participants' demographic characteristics, awareness of cervical cancer, cervical cancer screening, and the HPV vaccine, beliefs about cervical cancer screening, and stigmatizing beliefs about women with cervical cancer was collected. Chi-square tests for independence and Fisher's exact test of independence were preformed to determine if education level was associated with those factors. Participation in cervical cancer screening and uptake of the HPV vaccine was significantly lower among women with less than a senior high school education. Awareness about cervical cancer, cervical cancer screening, and the HPV vaccine was lower among women with less education. Women with lower levels of education were more likely to agree with the negative statements about cervical cancer screening and stigmatizing beliefs about women with cervical cancer. Cervical cancer education interventions that are tailored for Ghanaian women with different educational levels are needed to increase awareness of and participation in cervical cancer prevention strategies.
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Affiliation(s)
| | | | | | | | | | | | | | - Kevin Fontaine
- University of Alabama at Birmingham, Birmingham, AL, USA
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Kugbey N, Meyer-Weitz A, Oppong Asante K. Mental adjustment to cancer and quality of life among women living with breast cancer in Ghana. Int J Psychiatry Med 2019; 54:217-230. [PMID: 30296866 DOI: 10.1177/0091217418805087] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE This study examined whether cancer-specific coping strategies have any significant influence on the quality of life of 205 women living with breast cancer in Ghana. METHODS Using a cross-sectional survey design, participants were administered questionnaires which measured their cancer-specific coping strategies and health-related quality of life. RESULTS Correlation analysis showed that helplessness-hopelessness negatively correlated with physical wellbeing, emotional wellbeing, functional wellbeing, and breast cancer additional concerns. Anxious preoccupation negatively correlated with all the domains of quality of life, whereas fighting spirit was positively correlated with emotional and functional wellbeing. Cognitive avoidance was positively correlated with functional wellbeing, while fatalism was positively related with all the domains of quality of life. Regression analysis revealed that anxious preoccupation predicted significant decreases in all the domains of quality of life, while helplessness-hopelessness predicted significant decreases in emotional and functional wellbeing domains. However, cognitive avoidance predicted significant increase in the functional domain of quality of life. CONCLUSION These findings underscore the need for psychosocial support for breast cancer patients to adopt effective coping strategies to deal with their challenges in managing their illness.
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Affiliation(s)
- Nuworza Kugbey
- 1 Discipline of Psychology, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa.,2 Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Anna Meyer-Weitz
- 1 Discipline of Psychology, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Kwaku Oppong Asante
- 1 Discipline of Psychology, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa.,3 Department of Psychology, School of Social Sciences, University of Ghana, Accra, Ghana
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Arko-Boham B, Aryee NA, Blay RM, Owusu EDA, Tagoe EA, Doris Shackie ES, Debrah AB, Adu-Aryee NA. Circulating cell-free DNA integrity as a diagnostic and prognostic marker for breast and prostate cancers. Cancer Genet 2019; 235-236:65-71. [PMID: 31105051 DOI: 10.1016/j.cancergen.2019.04.062] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 04/15/2019] [Accepted: 04/21/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cancer incidence and its related mortality is rising and is currently the second leading cause of death globally. In Africa, breast and prostate cancer in females and males, respectively, are the worst globally. However, biomarkers for their early detection and prognosis are not well developed. This study sought to investigate circulating cell-free DNA (ccfDNA) integrity and its potential utility as diagnostic and/or prognostic biomarker. Circulating cell-free DNA (ccfDNA) is degraded DNA fragments released into the blood plasma. In healthy individuals, the source of ccfDNA is solely apoptosis, producing evenly sized shorter DNA fragments. In cancer patients, however, necrosis produces uneven longer cell-free DNA fragments in addition to the shorter fragments originating from apoptosis. DNA integrity, expressed as the ratio of longer fragments to total DNA, may be clinically useful for the detection of breast and prostate cancer progression. METHODS Sixty-four (64) females, consisting of 32 breast cancer patients and 32 controls, and 61 males (31 prostate cancer patients and 30 controls) were included in the study. Each participant donated 5 ml peripheral blood from which sera were separated. Real-time qPCR was performed on the sera to quantify ALU 115 and 247 levels, and DNA integrity (ALU247/ALU115) determined. RESULTS & CONCLUSION ALU species 115 and 247 levels in serum were elevated in breast and prostate cancer patients compared to their counterpart healthy controls. DNA integrity was higher in prostate cancer patients than in the control, but in breast cancer patients was lower compared to their controls. In prostate but not in breast cancers, DNA integrity increased with disease severity and higher staging.
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Affiliation(s)
- Benjamin Arko-Boham
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P.O. Box KB 143, Korle-Bu, Accra, Ghana; Department of Anatomy, School of Biomedical and Allied Health Sciences, University of Ghana, P.O. Box KB 143, Korle-Bu, Accra, Ghana.
| | - Nii Ayite Aryee
- Department of Medical Biochemistry, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P.O. Box KB 143, Korle-Bu, Accra, Ghana
| | - Richard Michael Blay
- Department of Anatomy, School of Biomedical and Allied Health Sciences, University of Ghana, P.O. Box KB 143, Korle-Bu, Accra, Ghana
| | - Ewurama Dedea Ampadu Owusu
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P.O. Box KB 143, Korle-Bu, Accra, Ghana; Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Centre, University of Amsterdam, Postbus 226601100 DD Amsterdam, the Netherlands; Foundation for Innovative and New Diagnostics (FIND), 9 Chemin des Mines, 1202, Geneva, Switzerland
| | - Emmanuel Ayitey Tagoe
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P.O. Box KB 143, Korle-Bu, Accra, Ghana; West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, P.O. Box LG 25, Legon, Accra, Ghana
| | - Eshirow-Sam Doris Shackie
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P.O. Box KB 143, Korle-Bu, Accra, Ghana
| | - Ama Boatemaa Debrah
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P.O. Box KB 143, Korle-Bu, Accra, Ghana
| | - Nii Armah Adu-Aryee
- Department of Surgery, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, P.O. Box KB 143, Korle-Bu, Accra, Ghana; Department of Surgery, Korle-Bu Teaching Hospital, P.O. Box, 77 Accra, Ghana
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Amoako YA, Hammond ENB, Assasie-Gyimah A, Laryea DO, Ankrah A, Amoah G. Prostate-specific antigen and risk of bone metastases in west Africans with prostate cancer. World J Nucl Med 2019; 18:143-148. [PMID: 31040745 PMCID: PMC6476246 DOI: 10.4103/wjnm.wjnm_38_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
We aimed to assess the relationship between bone scintigraphy findings and prostate-specific antigen (PSA) and Gleason score in a group of treatment naïve West Africans with prostate cancer. The age, PSA, and Gleason scores of 363 patients with prostate cancer were collected. Patients were risk stratified using the D'Amico criteria. Logistic regression was performed to assess the relationship between bone scan results and PSA and Gleason score. Receiver operating characteristics (ROC) analysis was used to determine the diagnostic reliability of the bone scan findings. Ninety of the 96 patients with metastases had high risk, and only 6 had low-to-intermediate risk disease (P = 0.0001). PSA (odds ratio [OR] 2.4 [95% confidence interval [CI] 1.5-3.8], P = 0.001) and GS (OR 2.2 [95% CI 1.5-3.1], P = 0.001) were independently predictive of the presence of metastases. ROC analysis revealed that PSA predicted the presence of metastases with an area under the curve of 0.72, and using a cut-off value of ≥20 predicted metastases with a sensitivity of 86.5% and specificity of 41.2%. A Gleason score of ≥7 had an 89.6% sensitivity and 34.8% specificity for bone metastases. Using a Gleason cutoff of ≥8, the sensitivity and specificity for predicting bone metastases were 54.2% and 71.5%, respectively. The area under the Gleason score ROC curve was 0.68. PSA and Gleason score are independent predictors of the presence of bone metastases in West Africans with prostate cancer.
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Affiliation(s)
- Yaw Ampem Amoako
- Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana, West Africa
| | - Emmanuel Nii Boye Hammond
- Department of Nuclear Medicine Service, Korle Bu Teaching Hospital, Accra, Ghana, West Africa
- Department of Ghana Atomic Energy Commission, Accra, Ghana, West Africa
| | - Awo Assasie-Gyimah
- Department of Nuclear Medicine Service, Korle Bu Teaching Hospital, Accra, Ghana, West Africa
| | - Dennis Odai Laryea
- Department of Non Communicable Disease Control Programme, Ghana Health Service Headquarters, Accra, Ghana, West Africa
| | - Alfred Ankrah
- Department of Nuclear Medicine Service, Korle Bu Teaching Hospital, Accra, Ghana, West Africa
- Department of Nuclear Medicine, University of Pretoria, Pretoria, South Africa
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Netherland
| | - George Amoah
- Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana, West Africa
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Amoako YA, Awuah B, Larsen-Reindorf R, Awittor FK, Kyem G, Ofori-Boadu K, Osei-Bonsu E, Laryea DO. Malignant tumours in urban Ghana: evidence from the city of Kumasi. BMC Cancer 2019; 19:267. [PMID: 30909876 PMCID: PMC6434839 DOI: 10.1186/s12885-019-5480-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 03/14/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Data from population-based cancer registries (PBCRs) are a useful resource for estimating the incidence of cancers. PBCR data is useful in the planning and implementation of cancer prevention and control strategies. Ghana's plan for control of non-communicable diseases recognises the need for good quality data to facilitate the attainment of set goals. METHODS We reviewed data from the Kumasi Cancer Registry for the year 2015. Data collected included clinical and demographic information, laboratory reports and source of case information. Data was entered into the Canreg-5 software. Data was initially analysed using Canreg-5 to estimate the incidence and age standardised rates (ASR) for various tumours. Data was also exported to Microsoft Excel for further analysis using Epi Info version 7.1.4. Microsoft Excel was used to generate charts and graphs. Aggregated data for the years 2013 and 2014 were also analysed for trends in cancer incidence and ASR. RESULTS A total of 736 cancer cases were recorded among the residents of Kumasi for the year 2015. Females accounted for 62.4% of all cases. The overall incidence of cancer in Kumasi for 2015 was 46.1 per 100,000. The mean age of all cases was 51.3 years (with a range of 1 to 99 years). The incidence among female residents was estimated at 54.1 per 100,000 compared with 37.1 per 100,000 in males. Among females, breast and cervical cancers recorded the highest incidences of 16.1 per 100,000 and 13.7 per 100,000 respectively. Among males, prostate cancer had the highest incidence of 10.5 per 100,000. Breast, cervical and liver cancers were the commonest in both sexes accounting for 19.7, 14.7 and 11.4% of cases respectively. CONCLUSION There has been significant improvement in data quality and coverage since the inception of our PBCR in 2012. PBCRs are feasible; therefore there is the need for more such registries to improve data on cancers in Ghana. Consistent with other evidence, we found breast cancer as the commonest female cancer in Ghana.
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Affiliation(s)
- Yaw Ampem Amoako
- Department of Medicine, Komfo Anokye Teaching Hospital, P O Box 1934, Kumasi, Ghana.
| | - Baffour Awuah
- Kumasi Cancer Registry, Kumasi, Ghana.,Directorate of Oncology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Rita Larsen-Reindorf
- Directorate of Ear, Nose and Throat, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | | | - Gloria Kyem
- Department of Medicine, Komfo Anokye Teaching Hospital, P O Box 1934, Kumasi, Ghana
| | | | | | - Dennis Odai Laryea
- Kumasi Cancer Registry, Kumasi, Ghana.,Non-Communicable Disease Control Programme, Ghana Health Service, Accra, Ghana
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Bonsu AB, Ncama BP. Integration of breast cancer prevention and early detection into cancer palliative care model. PLoS One 2019; 14:e0212806. [PMID: 30893313 PMCID: PMC6426220 DOI: 10.1371/journal.pone.0212806] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 02/08/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Breast cancer is common among Ghanaian women. Late stage presentation has been credited to knowledge deficit and lack of breast cancer prevention and early detection services for women. OBJECTIVE This study aimed to develop a model to facilitate the integration of breast cancer prevention and early detection into cancer palliative care. METHOD This study used synthesized concepts emerging from a single case study research. The case was a tertiary health care facility, embedded with sub-units of analysis. Mixed-method approach was used to collect data from 102 participants. The study examined the experiences and views of the participants on breast cancer and screening pathways in Ghana. Thematic analysis and descriptive statistics ware used to analyze the qualitative and quantitative data respectively. This was followed with a cross-case analysis across the sub-units of analysis. A theory development approach was further used towards the development of a model, following three steps: concept analysis, statement synthesis and theory synthesis. RESULTS Six key concepts synthesized from the data were used to develop the model: initiate and sustain breast cancer prevention and early detection program, collaboration of health professionals, patients, families and micro-communities, conducive environment of the health care facility and needed resources, actions, services, and lastly diffusing innovation into the community through agents. CONCLUSION A model has been developed based on the experiences shared by women diagnosed with advanced breast cancer, their first degree relatives, micro-communities as well as clinicians working in a palliative care setting. This model will aid clinicians to provide breast cancer education, teach breast self-examination and offer clinical breast examination to families and micro-communities of advanced breast cancer patients receiving supportive care in a resource-limited setting.
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Affiliation(s)
- Adwoa Bemah Bonsu
- Discipline of Nursing, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Busisiwe Purity Ncama
- Discipline of Nursing, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
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Kayamba V, Kelly P. DELAYED REFERRAL FOR DIAGNOSTIC ENDOSCOPY IS A CONTRIBUTING FACTOR TO LATE GASTRIC CANCER DIAGNOSIS IN ZAMBIA. THE HEALTH PRESS 2019; 3:14-19. [PMID: 33969265 PMCID: PMC8104419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
There is evidence that 15 % of gastric cancer patients in Zambia survive more than one-year after diagnosis. The major contributing factor to these poor outcomes is late case detection. We set out to investigate the time course of gastric cancer diagnosis in Zambia. The study was conducted at the University Teaching Hospital, in Lusaka. Consenting patients presenting to the endoscopy unit were enrolled and their endoscopic findings recorded. An interviewer-administered questionnaire was used to collect information on basic characteristics, presenting symptoms and duration. We enrolled 388 patients, 92 (24%) of whom had gastric cancer. About two-thirds of the gastric cancers were located in the distal part of the stomach. The median time to endoscopic gastric cancer diagnosis was 12 weeks, IQR 4-32 weeks after the first health care consultation. This was despite gastric cancer patients seeking healthcare attention within a median of 2 weeks, IQR 0-4 weeks of noticing the symptoms. Patients presenting with persistent vomiting or evidence of blood loss had significantly shorter delays than those with abdominal pain (p<0.05 and p<0.001 respectively). Delayed referral for diagnostic endoscopy is a contributing factor to late gastric cancer diagnosis in Zambia. The delay is highest in patients presenting with abdominal pain.
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Affiliation(s)
- V Kayamba
- Tropical Gastroenterology & Nutrition group, Department of Internal Medicine, PO Box 50398, Nationalist Road, Lusaka, Zambia
- University of Zambia School of Medicine, Department of Internal Medicine, PO Box 50110, Nationalist Road, Lusaka, Zambia
| | - P Kelly
- Tropical Gastroenterology & Nutrition group, Department of Internal Medicine, PO Box 50398, Nationalist Road, Lusaka, Zambia
- University of Zambia School of Medicine, Department of Internal Medicine, PO Box 50110, Nationalist Road, Lusaka, Zambia
- Blizard Institute, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, London E1 2AT, UK
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Bonsu AB, Ncama BP. Recognizing and appraising symptoms of breast cancer as a reason for delayed presentation in Ghanaian women: A qualitative study. PLoS One 2019; 14:e0208773. [PMID: 30625156 PMCID: PMC6326484 DOI: 10.1371/journal.pone.0208773] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 11/21/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The burden of late presentation is well established in women presenting with advanced breast cancer in Africa. This paper aims to explore the reasons for delayed presentation in Ghanaian women with breast cancer. METHOD Eleven (11) women diagnosed with advanced breast cancer were purposively sampled within three years of diagnosis at the palliative care clinic of the Komfo Anokye Teaching Hospital, Ghana. Participation was voluntary. Data was collected through in-depth interviews using a self-devised semi-structured interview guide. The interviews were conducted in "Twi" (local language), audio-tape recorded and covered the women's journey from symptom discovery to their intention to seek help. All audio-taped interviews were transcribed based on the meaning of the respondents' comments. The data was managed using Nvivo version 11 qualitative software. Data was analyzed concurrently with data collection applying the principles of thematic analysis. KEY FINDINGS All the women delayed presentation due to overlapping reasons. Symptom appraisal among the women occurred in two main stages: individual understanding of breast symptom and interactive understanding of the breast symptom. These stages were based on cognitive, psycho-cultural and social factors. The five main themes generated from the data were: symptom experience, knowledge of breast cancer, role of social life and network, coping with a breast symptom and lastly intent to seeking health care. A conceptual model was developed to illustrate the relationships among the key factors and concepts emanated from this study. CONCLUSION Recognition and appraisal of breast cancer symptom in the eleven (11) Ghanaian women interviewed in this study was poor. For instance, a painless breast lump was considered not serious until a sensory symptom appears. This led women to experience appraisal and time point intervals. To minimize the incidence of late presentation of breast cancer cases in Ghana, adequate educational intervention should be provided for Ghanaian women and their social network, and other stakeholders.
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Affiliation(s)
- Adwoa Bemah Bonsu
- Discipline of Nursing, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Busisiwe Purity Ncama
- Discipline of Nursing, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Bonsu AB, Ncama BP, Bonsu KO. Breast cancer knowledge, beliefs, attitudes and screening efforts by micro-community of advanced breast cancer patients in Ghana. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2019. [DOI: 10.1016/j.ijans.2019.100155] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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