Jaye Stapleton

Patient-mediated factors predicting early- and late-stage presentation of breast cancer in Egypt

ABSTRACT: While chronic diseases are often seen as a problem of high-resource countries, they are in fact an increasing part of the disease burden in limited-resource countries. In 2005, the number of global deaths due to cancer was greater than that of malaria, tuberculosis, and AIDS combined, with 70% of these deaths reported in limited-resource countries. The leading cause of cancer death in women worldwide is breast cancer and the highest fatality rates are found in limited-resource countries. This is largely due to the number of late stage presentations upon initial diagnosis which can be attributed to various social factors that may vary from country to country. An additional public health problem in these areas that is intensified by increased incidence of late stage presentation is the lack of palliative care programs. In fact, despite the growing number of HIV/AIDS and cancer patients, the World Health Organization (WHO) sites that morphine consumption in Africa is lowest in the world v. There are many barriers to effective palliative care programs ranging from national regulations to individual stigma regarding opiod use. Therefore, understanding physicians attitudes and beliefs surrounding palliative care may provide unique insight into both the institutional and the cultural barriers to effective programs in a particular region. Because countries are highly varied in the resources that are available to them, it is important to understand these issues within the context of an individual countrys healthcare infrastructure.

Given the information above, this study aims 1) To investigate social causal factors of late stage presentation of breast cancer in Casablanca, Morocco
2) To investigate physician attitudes and beliefs toward palliative care in Casablanca, Morocco

To achieve these goals, women clinically diagnosed with breast cancer will be interviewed to collect information on medical history as well as knowledge and attitudes regarding breast health. Additionally, physicians of the Central Hospital and University Ibn Rochd who interact with cancer patients in their normal practice (oncologists, radiologists, surgeons, anesthesiologists) will be interviewed regarding attitudes and beliefs toward palliative care needs, with an emphasis on pain management practices.

The results of this study will allow for a better understanding of barriers to effective care for cancer patients, specifically those in Casablanca, Morocco. Additionally, this study will contribute to the growing body of research detailing social determinants of health outcomes and health practices in limited-resource environments.

Patient-mediated factors predicting early- and late-stage presentation of breast cancer in Egypt