Cervix and breast cancers in Oujda city in Eastern Morocco: Determinants and risk factors

摘要

A retrospective study was conducted in 2008 on 681 in Eastern Morocco in order to estimate the incidence of cervical and breast cancer, and to determine the social determinants and risk factors associated with these two types of cancer. Another goal of the study was to give health decision makers evidence of the necessity for early diagnosis and treatment. A questionnaire was used before the clinical gynecological examination and sampling cell for the Pap smear. Any woman with a Pap smear suspect had to do a biopsy at the reference centre. Physicians, obstetricians and midwives in the consultation process did gynecological examination and breast palpation. Patients with a suspicious nodule underwent ultrasound and mammography by radiologists on site. Gynecological samples were carried out systematically to all ever-married women to detect cancer of the cervix. Software Excel and SPSS 17 were used for data processing. Patients with high social status were more susceptible to develop breast cancer whereas women with cervical cancer were poor, belonging to a class with a low marital status of widowed or divorced having been married at an early age. The majority of women were married (81%), poor (80%) and illiterate (66%). Breastfeeding women were less affected by breast cancer than women not breastfeeding. For cervical cancer, the difference was not statistically significant. Women using contraceptives were vulnerable to both breast and cervical cancer. For cervical cancer, over 15% of women with a family history were screened positive. No relationship was found between breast cancer and family history. Taking into account regional particularities, we stress the importance of social determinants and risk factors and show that our results are consistent with those published by other researchers. Breast and cervical cancers constitute a real challenge in Morocco. Their socioeconomic burden can be reduced by early detection and treatment. The delayed diagnosis complicates the task both in terms of survival and cost of treatment. Consequently, Moroccan health authorities are urged to adopt preventive and cost effective strategies.