期刊
BMJ OPEN
卷 11, 期 7, 页码 -出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/bmjopen-2020-040352
关键词
public health; preventive medicine; epidemiology; health policy; organisation of health services; health economics
资金
- African Research Group for Oncology (ARGO) consortium
- National Cancer Institute's (NCI) Center for Global Health
- National Cancer Institute [R01 CA246620, P30 CA008748]
Cancer burden is expected to double in sub-Saharan Africa by 2030, making access to healthcare services for cancer management a priority. A study conducted in a rural community in South West Nigeria revealed low rates of cancer screening activities, lack of medical insurance, and a positive correlation between higher personal income and increased cancer screening. Despite these challenges, most individuals had contact with primary healthcare doctors and access to media, suggesting potential for expanding community-based screening interventions and awareness.
Background/aims Cancer burden is predicted to double by 2030 in sub-Saharan Africa; access to healthcare services for cancer management is a priority in the region. In Nigeria, National Cancer Control Plan aims to ensure >50% cancer screening of eligible populations by 2022 for all Nigerians. We describe healthcare utilisation, cancer screening activities and potential barriers to accessing cancer care within an understudied rural community-based adult population in South West Nigeria. Methods In April 2018, we conducted a cross-sectional study of community-based adults (>18 years) similar to 130 km east of Ibadan, 250 km from Lagos in Osun State, South West Nigeria. Participants completed a face-to-face survey in local dialect. We used a questionnaire to assess demographics, health status, income, medical expenditures, doctor visits and cancer screening history. Results We enrolled 346 individuals: with median age of 52 years and 75% women. Of the entire cohort, 4% had medical insurance. 46% reported a major medical cost in the last year. Cancer screening activities were infrequent in eligible participants: 1.5% reported having had cervical cancer screening, 3.3% mammogram and 5% colonoscopy screening. Cancer screening assessment was less frequent in those with less income and lower education levels. Using a multivariable logistic regression model including personal income, insurance status and education, higher personal income was associated with more cancer screening activity (OR 2.7, 95% CI 1.3 to 5.7, p<0.01). Despite this, most individuals had contact with a primary healthcare doctor (52% in the last year), and over 70% access to radio and TV suggesting the opportunity to expand community-based screening interventions and awareness exists. Conclusions Despite national increases in cancer cases, we highlight a deficiency in cancer screening and universal healthcare coverage within a community-based adult Nigerian population. Subject to availability of governmental resources, increasing financial risk protection, awareness and targeted resource allocation may help expand access in Nigeria.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据