Lisa Peters

Comparison of Patients in the Cervical Cancer Screening Unit versus Treatment Center at the Ocean Road Cancer Institute in Dar es Salaam, Tanzania

ABSTRACT: Cervical cancer is a global health issue. 80% of all cases occur in developing countries, accounting for more deaths than during childbirth.(IARC) The burden is highest in East Africa where the mortality rate is 34 deaths per 100,000 people, as compared to only 9 worldwide. In 1996, Tanzania responded to this health crisis by establishing the Ocean Road Cancer Institute (ORCI) in Dar es Salaam. Currently the hospital sees 3000 new patients each year, with 68% being women. Of these women, 47% have cervical cancer. There are about 38 million people in Tanzania, meaning that a very small percentage of the population is coming to ORCI for medical services. This study aims to identify the social and economic characteristics of the women that are presenting at the hospital. ORCI has both a screening unit and a treatment center and therefore by understanding the overall demographics and motivations for seeking treatment within these two patient groups, future research studies and appropriate education and awareness programs can be carried out. The data were obtained by interviewing 150 women for such information as: education, income, occupation, residence information, initial complaints, medical history etc., as well as their understanding of cancer and its corresponding treatment. The preliminary analysis of the data shows that women in the screening unit are often more educated, live in Dar es Salaam, have stable incomes, heard about the screening services via TV or radio, have mild complaints or discomfort and know very little about cancer or HPV. The women in the treatment center appear to be less educated, from all regions of Tanzania, travel great distances at huge expense to reach the hospital, have severe symptoms, heard about the hospital through a doctors referral, are nearly all subsistence farmers, present at late stages of disease, understand very little about cancer and often refuse radiation treatment for traditional medicine. Based on these initial observations, there is a need for education and screening programs in the villages. By doing so, the number of rural women in the treatment center could be decreased or at least allow for a better prognosis. The screening unit currently in place could be used as a model to implement similar services in outlying areas.

Evidence for the Need of Educational Programs for Cervical Screening in Rural Tanzania