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Study of 79 cases of invasive cervical carcinoma by the Department of Oncology at Antananarivo. Can the delays in diagnosis be improved ? |
Cahiers d'études et de recherches francophones / Santé . Volume 5, Number 3, 195-8, Mai-Juin 1995, Étude originale
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 Résumé
Article gratuit
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Author(s) : Solofoniaina Ratinahirana, Pierre-Victor Razanamparany, Bodo Razafintsalama, Alice Randriamampandry, Julienne Ravaoarison, Léontine Rabarijaona, Joëlson Ranjatoarivelo, Nirina Andriamanalina |
Summary : The frequency of invasive cervical carcinoma in Western countries is currently decreasing. The development of methods of early diagnosis has improved the prognosis of the disease. In Madagascar, like in other African countries, invasive cervical carcinoma is the first genital cancer affecting women. The diagnosis comes late. Actions can be taken to improve the prognosis through early diagnosis of invasive cervical carcinoma. Our purpose was to analyze the main causes leading to these delays in diagnosis and to evaluate possibilities for improvement. This study was retrospective, consecutive and open wide not random, dealing with 79 cases of invasive cervical carcinoma, all confirmed by a histological examination, picked from the Department of Oncology at Antananarivo within a period of 24 months from the 1st of January 1990 through the 1st of January 1992. The Department of Oncology at Antananarivo is the only anti-cancer center available on the island. The position for an oncologist was occupied from 1984 to 1988 by a French doctor under the Technical Cooperation Agreement with France. Since then, no oncologist has been practicing in Madagascar. We evaluated the different reasons that could explain the delays in diagnosis and suggested possible actions to remedy the problem. We selected medical, human and technical, as well as geographical and social criteria for evaluation. Diagnosis was delayed too much (on average, about 8.48 ± 7.12 months), possibly due to the above mentioned criteria. Diagnosis can be improved as follows: 1) to inform the women by teaching them how to recognize the symptoms of cervical carcinoma, and advising them to see a doctor as soon as possible\; 2) to re-train the doctors and para-medical staff on the methods of early diagnosis of cervical carcinoma\; 3) to create histology and cytology laboratories in the main towns throughout the provinces\; 4) to investigate and record the epidemiological trends\; and 5) to train a local specialist in oncology and histology. |
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