Background

There is a striking similarity between the prevalence of cervical cancer and maternal mortality. Both are preventable, associated with low socio-economic status, related to inequality in access to quality healthcare, have evidence based preventive interventions and these interventions have successfully been implemented in developed countries while developing countries have not been able to take advantage of these proven interventions to reduce their burden of these conditions. We therefore wish to explore these similarities by asking why did “lady Y” present late similar to why did Mrs X die?

Aims

To provide evidence-based model of the clinical journey of hypothetical “Lady Y” that presented at a late stage of cervical cancer to a tertiary health institution with capacity for cervical cancer treatment in low resource settings.

Objectives:

*To contextually review the reasons for late presentation of cervical cancer patients despite the ease of diagnosis and relatively early signs

* To provide evidence-based model of clinical journey to late presentation of cervical cancer patients in low resource settings.

* To explore application of the knowledge in reducing the burden of cervical cancer in low resource settings within the constraint of available resources.

Methodology

This will be a multi-staged mixed method study of factors responsible for late presentation of cervical cancer patients in Nigeria. A comprehensive list of factors promoting late presentation will be generated through extensive literature review. The listed factors will be categorized based on the delay model of maternal mortality using Delphi approach. Modeling reconstruction of clinical course of hypothetical cervical cancer patient; lady Y that presented late will subsequently be done in compliance with the consensus agreement of categorization of these factors. The journey to late presentation will then be thoroughly reviewed for exit points. The identified exit points will be promoted through every possible avenue such that both the healthcare professionals and general public will become acutely aware of these exist routes to late presentation and start taking advantage of them to reduce the burden of cervical cancer.

Expected Result

We would have at the very least identified exit routes to late presentation of cervical cancer in low resource settings. It is anticipated that the mere identification of these exits should in itself translate a significantly reduction in proportion of cervical cancer patients presenting late. Unfortunately, this in itself might not translate to reduction in the burden of cervical cancer without ensuring that facilities exist to adequately treat identified cases. Therefore the result will form the scientific basis for advocacy for improvement in facility for treatment of cervical cancer including palliative care.

The project is multidimensional with implementation and dissemination research principles as the cross-cutting activity across all the dimensions of the project. We are currently seeking collaboration for this project. To lay foundation for future partnership, we have designed a hybrid multi-centre collaborative retrospective research on outcome of cervical cancer patients managed across Nigeria. Are you a healthcare provider practicing in any part of Nigeria and interested in providing evidence to shape the management of cervical cancer in low resource settings? If yes, we invite you to be part of this growing research partnership that will provide evidence for recommending resource appropriate interventions for cervical cancer prevention and control in low resource settings. Please complete this form to indicate interest in the ongoing research partnership (link to research partnership form). We take every comment, suggestion, criticism and support very seriously. Your input will definitely impact on our final output and ultimately on our ability to impact on the burden of cervical cancer in Nigeria. Please feel free to contact us if you have any idea you want to share with us on why cervical cancer patients are presenting late