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[Impact of an early diagnosis program for childhood cancer in Abidjan?]
Line Couitchéré1, Carole Coze2, Yao Nicaise Atiméré3
1Centre Hospitalier Universitaire de Treichville, Service de Pédiatrie, 01 BP V3 Abidjan 01, Abidjan, Côte d'Ivoire.
Insights
An early diagnosis program for pediatric cancers in Ivory Coast showed no significant impact on diagnosis times or survival rates. Further intensification and broader healthcare worker involvement are needed to improve outcomes for children with cancer.
Area of Science:
- Pediatric Oncology
- Public Health Initiatives
- Cancer Epidemiology
Background:
- Early diagnosis of pediatric cancers is crucial for improving survival rates.
- A program was implemented in Ivory Coast to train physicians on cancer warning signs and raise public awareness.
- This study evaluated the program's impact on diagnosis times, cancer stages, and patient survival.
Purpose of the Study:
- To compare pediatric cancer patient data before and three years after the implementation of an early diagnosis and awareness program.
- To assess the program's effectiveness in reducing diagnosis times and improving survival rates for pediatric cancers in Ivory Coast.
Main Methods:
- Retrospective study of children (0-17 years) admitted between January-December 2014 and May 2018-April 2019.
- Statistical comparison using Mann-Whitney and Fisher's exact tests for time limits, stages, and survival.
- Inclusion of 216 pediatric cancer patients across the two study periods.
Main Results:
- Median consultation times decreased from 75 to 30 days (P=0.003), and median diagnostic times decreased from 120 to 105 days (P=0.033).
- High-risk lymphomas remained prevalent (around 59-60%), and nephroblastoma rates varied (46-56%).
- Overall survival rates were similar, with 31% before and 30.2% after the program (P=0.92).
Conclusions:
- The early diagnosis program demonstrated no significant impact on overall survival or the proportion of high-risk cancers.
- Diagnosis times and cancer profiles are consistent with data from sub-Saharan Africa.
- The program requires intensification, broader healthcare worker engagement, and improved access to care for greater effectiveness.
Introduction:
To promote the early diagnosis of pediatric cancers in Ivory Coast, we have initiated a program to train local physicians in the warning signs and to raise public awareness. The aim of this work was to compare the times, stages and survival of patients before and three years after the initiation of the program.
Methods:
This retrospective study involved children 0-17 years of age admitted from January to December 2014 and from May 2018 to April 2019. The Mann-Whitney non-parametric test and the Fisher's exact test were used to compare time limits, stages and survival.
Results:
One hundred and fifty-nine doctors were trained and 1020 people were sensitized. The median age of the 216 children included was 7 years, sex ratio 1.4. For both periods, the median consultation times were 75 and 30 days (P=0.003) and the median diagnostic times were 120 and 105 days (P=0.033). High-risk lymphomas accounted for 60.5% and 58.5% (P=0.99) respectively and nephroblastoma 46.1% and 56.2% (P=0.51). The overall survival was 31% and 30.2% (P=0.92).
Discussion:
The early diagnosis program had no impact. The diagnosis times and the proportion of cancer classified as high risk are comparable to the data reported in sub-Saharan Africa, which vary respectively from 7 to 15.8 weeks and from 60 to 71%. This program must be intensified, extended to all health workers and include improving access to care.
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