An audit of Cancer in the Surgical Wards of a tertiary healthcare facility in a resource-limited setting

Abstract

Background: In Africa, cancer is an emerging public health concern. In Sub-Saharan Africa, data on cancer epidemiology and survival which are necessary for the planning of treatment and control of cancers are scarce.

Methods: A retrospective study of all patients who were admitted to the surgical wards in a Nigerian tertiary facility between January 2012 and December 2016 was done.  The retrieved data included demographic features, presenting symptoms, mode of presentation, duration of illness, diagnosis, stage of disease, treatment modalities, treatment intention, compliance with treatment, survival, and current status.

Result: The 279 patients studied comprised 81 (29.0%) males and 198 (71.0%) females. Cancer of the female breast was the leading malignancy occurring in 59% (165/279) patients; this was followed by colon cancer in19% (54/279) and prostate cancer in 10% (29/279). The commonest cancer among the females was breast cancer while prostate cancer was the commonest among the males. The stage of the disease was classified as early in 14.7% (41/279), locally advanced in 61.6% (172/279) and metastatic in 23.7% (66/279). Treatment goal was palliative for 57% (159/279) of the patients, curative in 26%while 13.6% (38/279) of the patients received no anti-cancer treatment. Ninety-six patients (34.5%) refused treatment or defaulted from treatment after the commencement of therapy. Although 53 (19%) patients died within the first month of admission, the overall mean duration of survival was 12.71 ± 13.0 months (range of 1- 84 months).

Conclusion: Late presentation of patients, high treatment default rate, inappropriate management plan and overall poor survival were identified as daunting issues in cancer management in a resource-limited setting.