A CRITICAL INVESTIGATION OF BREAST CANCER AND ITS RISK FACTORS IN A TERTIARY HOSPITAL IN ABUJA

CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

Cancer is the leading cause of mortality in the industrialized world and the second highest cause of death in the developing world. Breast cancer is by far the most common cancer among women, accounting for 1.38 million new cases identified in 2008 (23 percent of all cancers), and ranks second overall (10.9 percent , of all cancer). It is now the most frequent cancer in both industrialized and developing countries, with an estimated 690,000 new cases in each region (Global Cancer Statistics, 2011).

In high-income countries, great progress has been made in cancer treatment and care, and while cancer incidence continues to climb as a result of an aging lifestyle and population expansion, death has decreased. (Centre for Disease Control-CDC Report 2010) Although breast cancer is the fifth leading cause of cancer death worldwide (458,000 deaths), it remains the leading cause of cancer death in women in both developing and industrialized countries (Global cancer statistics, 2011).

This decline in mortality and increase in survival rates is attributable to advancements in screening, particularly mammography and other early detection tools that are spread around the country, as well as better treatment. There are cancer control programs in Western countries that include active recruitment tactics for breast cancer screening programs such as sending letters, making phone calls, mailing educational materials, and organizing training activities with reminders for women. These are methods that increase the number of women who show up for a community breast cancer screening service. Some combinations of effective actions (such as a letter and phone calls) have significant effects and have been tested primarily among women from lower socioeconomic groups (Bonfill, Marzo, Pladevall, Marti, & Emparanza., 2009). Despite these advances, one-third of breast cancer cases in the United States are diagnosed at a late stage when treatment is less effective. The Centre for Disease Control study discovered reduced acceptance of screening and late presentation of symptoms in low-income and ethnic minority populations, as well as extended delays in diagnosis and treatment. Many patients are ignorant of the signs of cancer, and factors such as health literacy, cultural attitudes about obtaining medical care, fear and embarrassment associated with cancer diagnosis, and challenges navigating the healthcare system all play a role. Physicians often contribute to the delay by failing to notice sentinel symptoms and refer the appropriate patients for further evaluation (CDC Report 2010).

According to studies by the government's director of cancer services, up to 10,000 people die of cancer in the United Kingdom each year because their diagnoses are identified too late due to a variety of characteristics such as ethnicity, social disadvantage, and gender. Social-economic position is a major motivator for women to accept breast cancer screening; impoverished populations appear to have later stage breast cancer presentation, potentially amplifying the effect of inequities in breast screening uptake. Despite the availability of cancer screening facilities and a high proportion of cancer-informed citizens in the UK, there is solid evidence that certain ethnic sub-groups have lower participation rates than the overall population (Weller and Campbell, 2009).

Breast cancer management in low and middle income nations presents a unique mix of issues, including access to screening, stage at presentation, quality of management, and the availability of therapeutic interventions. Routine mammography infrastructure and resources are frequently unavailable. Breast cancer is typically identified late in these countries, and women with breast cancer may receive insufficient treatment or palliative care due to a lack of resources. (2010) (Arafat, Temraz, Mrad, and Shamseddine)

Many hurdles have been discovered for breast cancer patients in low and middle income nations, which may correlate with lower incidence and mortality rates in such countries as compared to high income countries. These barriers include a lack of breast cancer awareness as a result of poor health awareness and education, a lack of screening programs as a result of a lack of government support and insufficient funds, and social barriers to early diagnosis and treatment as a result of a low priority for women's health issues in predominantly male-dominated societies.

Patriarchal developing nations, the social taboo of cancer and misconceptions about cancer treatment and result, a lack of standardized treatment protocol with a diversity of clinical practices, healthcare standards and infrastructure, and ultimately follow-up data and a lack of mortality statistics

1.2 STATEMENT OF THE PROBLEM

Cancer infrastructure in Abuja is limited, and some cancer management alternatives are unavailable. Most breast cancer cases are detected at an advanced stage when there is nothing that can be done. Breast cancer therapy is quite expensive and many women with financial resources have to fly to countries like India, South Africa and USA for specialized treatment (Leigh mc Adam 2010). Women are at a higher risk of developing breast cancer, thus it is critical that they acknowledge and be screened for the disease in order to avoid a late diagnosis that makes treatment difficult, if not impossible.

Several studies have been conducted on the impact of various factors on women's acceptance of breast cancer screening in diverse settings around the world. Most of these studies have mainly focused on women attending hospital or those that had been screened before. In Abuja, studies haven't been undertaken on breast cancer and risk variables in a hospital environment. Inadequate research has been conducted to examine how these characteristics influence the acceptance of breast cancer screening in low-resource areas and among women who do not attend hospital and have never been checked for breast cancer.

Women in rural environments are medically underserved and have a higher risk of acquiring and dying from breast cancer. This study intends to investigate breast cancer and its risk factors.

1.3 OBJECTIVE OF THE STUDY

The primary objective of this study is to investigate breast cancer and its risk factors. Thus, the following objectives;

1. To determine the primary cause of breast cancer.

2. To investigate the risk factors of breast cancer in women.

3. To proffer suggestions that may be helpful to every woman in prevention of cancer.

1.4 RESEARCH QUESTIONS

The following questions guide this study;

1. What is the primary cause of breast cancer?

2. What are the risk factors of breast cancer in women?

3. What are the suggestions that may be helpful to every woman in prevention of cancer?

1.5 SIGNIFICANCE OF THE STUDY

This study will be significant to women as it will expatiate on the concept of breast cancer, its causes and possible treatment. It will also urge women to seek advice and treatment should in case they notice any changes in that part of the body. This study will also create awareness for hospitals to have outreaches to women to encourage them to go for medical checkups regularly.

1.6 SCOPE OF THE STUDY

This study will only cover causes of breast cancer and its risk factors in a tertiary hospital in Abuja. The primary cause of breast cancer will be looked into alongside risk factors after which, suggestions will be provided to women both those with breast cancer and those who do not have breast cancer.

1.7 LIMITATION OF THE STUDY

During the course of this study, the researcher was limited by availability of resources and materials linking breast cancer to tertiary hospitals in Abuja.

1.8 DEFINITION OF TERMS

1. CANCER: Is a class of diseases characterized by out of control cell growth. These cells divide uncontrollably to form lumps or masses of tissues.

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