[Arrival of patients at advanced stage: tempting to identify responsibility]

In many publications on cancer in Africa, the majority of patients were seen in advanced stages (III or IV) during the first consultation. So, it was important to look for factors that explain this situation.

A survey by questionnaire was made in our Medical Oncology Department of University Teaching Hospital of Brazzaville from January to October 2010. The responsibility of advice to go to hospital was codified in Arrival in Advanced Stage (AAS) from the weakest (AAS 1) to the strongest (AAS 8) according to the knowledge in oncology. The impact of organ accessibility and the patient's instruction level were also evaluated.

One hundred and ninety-six patients seen in consultation, hospital day and hospitalization were asked and we had gathered the same information in patients' medical files. Our sample was essentially made by women (67,4%). The age of patients were from 21 to 83 years old with average of 53,8. The direct responsibility of the patient was weak (24,4%) by ignorance or fear of diagnosis. The hospital personal, the nurses and physicians who work in private were for a great part: 40,8%. The number of practitioners by category had limited the results because of the difficulty to join them. The medical doctor, specialist or not, were responsible at 25,5%.

The medical vulgarization, large information, specialization training adapted were the way to choose in the resolution of the problem, which impact on therapeutic result was undeniable.