Population-Level Access to Breast Cancer Early Detection and Diagnosis in Nigeria.

Autor:	Omisore AD; Department of Radiology, Obafemi Awolowo University, Ile-Ife, Nigeria., Sutton EJ; Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, NY., Akinola RA; Department of Radiology, Lagos State University Teaching Hospital, Lagos, Nigeria., Towoju AG; Department of Radiology, Obafemi Awolowo University, Ile-Ife, Nigeria., Akhigbe A; Department of Radiology, University of Benin Teaching Hospital, Benin, Nigeria., Ebubedike UR; Department of Radiology, Nnamdi Azikiwe University, Amawbia, Nigeria., Tansley G; Department of Surgery, Division of General Surgery, University of British Columbia, Vancouver, BC, Canada., Olasehinde O; Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria., Goyal A; Department of Surgery, Division of General Surgery, Dalhousie University, Halifax, NS, Canada., Akinde AO; Department of Radiology, Obafemi Awolowo University, Ile-Ife, Nigeria., Alatise OI; Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria., Mango VL; Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, NY., Kingham TP; Department of Surgery, Hepatobiliary Service, Memorial Sloan Kettering Cancer Center, New York, NY., Knapp GC; Department of Surgery, Division of General Surgery, Dalhousie University, Halifax, NS, Canada.
Jazyk:	angličtina
Zdroj:	JCO global oncology [JCO Glob Oncol] 2023 Sep; Vol. 9, pp. e2300093.
DOI:	10.1200/GO.23.00093
Abstrakt:	Purpose: Mammography, breast ultrasound (US), and US-guided breast biopsy are essential services for breast cancer early detection and diagnosis. This study undertook a comprehensive evaluation to determine population-level access to these services for breast cancer early detection and diagnosis in Nigeria using a previously validated geographic information system (GIS) model. Methods: A comprehensive list of public and private facilities offering mammography, breast US, and US-guided breast biopsy was compiled using publicly available facility data and a survey administered nationally to Nigerian radiologists. All facilities were geolocated. A cost-distance model using open-source population density (GeoData Institute) and road network data (OpenStreetMap) was used to estimate population-level travel time to the nearest facility for mammography, breast US, and US-guided biopsy using GIS software (ArcMAP). Results: In total, 1,336 facilities in Nigeria provide breast US, of which 47.8% (639 of 1,336) are public facilities, and 218 provide mammography, of which 45.4% (99 of 218) are public facilities. Of the facilities that provide breast US, only 2.5% (33 of 1,336) also provide US-guided breast biopsy. At the national level, 83.1% have access to either US or mammography and 61.7% have access to US-guided breast biopsy within 120 minutes of a continuous one-way travel. There are differences in access to mammography (64.8% v 80.6% with access at 120 minutes) and US-guided breast biopsy (49.0% v 77.1% with access at 120 minutes) between the northern and southern Nigeria and between geopolitical zones. Conclusion: To our knowledge, this is the first comprehensive evaluation of breast cancer detection and diagnostic services in Nigeria, which demonstrates geospatial inequalities in access to mammography and US-guided biopsy. Targeted investment is needed to improve access to these essential cancer care services in the northern region and the North East geopolitical zone.
Databáze:	MEDLINE
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