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dc.contributor.authorMwaka, Amos Deogratiusen
dc.contributor.authorGarimoi, Christopher Orachen
dc.contributor.authorWere, Edward Malobaen
dc.contributor.authorRoland, Martinen
dc.contributor.authorWabinga, Henryen
dc.contributor.authorLyratzopoulos, Georgiosen
dc.date.accessioned2015-12-02T10:08:40Z
dc.date.available2015-12-02T10:08:40Z
dc.date.issued2016-01-21en
dc.identifier.citationMwaka et al. BMJ Open (2016) Vol. 6, Article e007690. doi: 10.1136/bmjopen-2015-007690en
dc.identifier.issn2044-6055
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/252792
dc.description.abstractObjective: To examine patient and primary healthcare factors and stage at diagnosis in women with cervical cancer in Northern Uganda with the intention to identify factors that are associated with advanced stages in order to inform policies to improve survival from cervical cancer in the low- and middle-income countries. Design: Cross sectional hospital-based study Setting: Tertiary, not-for-profit private hospital in post-conflict region. Participants: Consecutive tissue-diagnosed symptomatic cervical cancer patients attending care. Of 166 patients, 149 were enrolled and analysed. Primary outcome: Cervical cancer stage at diagnosis. Results: Most women were diagnosed in stages III (45%) or IV (21%). After controlling for age, marital status, educational attainment and number of biological children, there was evidence for association between greater likelihood of advanced stage at diagnosis and pre-referral diagnosis of cancer by primary healthcare professionals (Adjusted OR (AOR)=13.04:95%CI; 3.59-47.3), financial difficulties precluding prompt help-seeking (AOR=5.5:95%CI; 1.58-20.64). After adjusting for age, marital status, and educational attainment, women with 5-9 biological children (AOR = 0.27:95%CI; 0.08-0.96) were less likely to be diagnosed with advanced stage (defined as stages III/IV) cancer. In this pilot study, there was no statistical evidence for associations between stage at diagnosis and factors such as age at diagnosis and marital status. Conclusions: This study is a first attempt to understand the descriptive epidemiology of cervical cancer in rural Ugandan settings. Understanding individual patient factors, patients’ behavioural characteristics and healthcare factors associated with advanced stage at diagnosis is essential for targeted effective public health interventions to promote prompt health seeking, diagnosis at early stage and improved survival from cervical cancer.
dc.description.sponsorshipThe work was supported by Training Health Researchers into Vocational Excellence (THRiVE) in East Africa, Grant number 087540, funded by Wellcome Trust.
dc.languageEnglishen
dc.language.isoenen
dc.publisherBMJ Group
dc.rightsAttribution 2.0 UK: England & Wales
dc.rights.urihttp://creativecommons.org/licenses/by/2.0/uk/
dc.subjectcervical canceren
dc.subjectadvanced stage cancer at diagnosisen
dc.subjectpredictors of late stageen
dc.subjectpathways to diagnosis and treatmenten
dc.titleSocial, demographic and healthcare factors associated with stage at diagnosis of cervical cancer: cross sectional study in a tertiary hospital in Northern Ugandaen
dc.typeArticle
dc.description.versionThis is the final version of the article. It first appeared from the BMJ Group via http://dx.doi.org/10.1136/bmjopen-2015-007690en
prism.numbere007690en
prism.publicationDate2016en
prism.publicationNameBMJ Openen
prism.volume6en
dc.rioxxterms.funderWellcome Trust
dc.rioxxterms.projectid087540
rioxxterms.versionofrecord10.1136/bmjopen-2015-007690en
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2016-01-21en
dc.contributor.orcidRoland, Martin [0000-0002-8533-3060]
dc.contributor.orcidLyratzopoulos, Georgios [0000-0002-2873-7421]
dc.identifier.eissn2044-6055
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idWellcome Trust (100891/Z/13/Z)
cam.orpheus.successThu Jan 30 12:55:31 GMT 2020 - The item has an open VoR version.*
rioxxterms.freetoread.startdate2300-01-01


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Attribution 2.0 UK: England & Wales
Except where otherwise noted, this item's licence is described as Attribution 2.0 UK: England & Wales