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Factors related to the late presentation of women with vulvar cancer

Thesis (MMed)--Stellenbosch University, 2018.

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Main Author: Shah, S.
Other Authors: Butt, J.
Format: Thesis
Language:en_ZA
Published: Stellenbosch : Stellenbosch University 2018
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access_status_str Open Access
author Shah, S.
author2 Butt, J.
author_browse Butt, J.
Shah, S.
author_facet Butt, J.
Shah, S.
author_sort Shah, S.
collection Thesis
dc_rights_str_mv Stellenbosch University
description Thesis (MMed)--Stellenbosch University, 2018.
format Thesis
id oai:scholar.sun.ac.za:10019.1/105120
institution Stellenbosch University (South Africa)
language en_ZA
last_indexed 2026-06-10T12:41:19.170Z
license_str Other — see source repository
provenance_str_mv Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository
publishDate 2018
publishDateRange 2018
publishDateSort 2018
publisher Stellenbosch : Stellenbosch University
publisherStr Stellenbosch : Stellenbosch University
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source_str SUNScholar — Stellenbosch University Repository
spelling oai:scholar.sun.ac.za:10019.1/105120 Factors related to the late presentation of women with vulvar cancer Shah, S. Butt, J. Botha, Matthys Hendrik Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Obstetrics and Gynaecology. Vulva -- Cancer UCTD Vulva -- Cancer -- Prognosis Health care costs Thesis (MMed)--Stellenbosch University, 2018. Background Vulva cancer is increasing in incidence and becoming more prevalent amongst younger women. Over 50% of patients present with advanced stage disease at Tygerberg Hospital. The prognosis for late stage vulvar cancer is poor and the treatment has a high morbidity. The reasons for delayed presentation of cancer include a lack of knowledge about the disease, financial constraints, psychosocial factors, transport and access to health care. Objective To determine the reasons behind the late presentation of patients with vulva cancer at Tygerberg Hospital and to propose strategies to reduce avoidable factors, both patient-related and within the health care system, leading to the delay in diagnosis. Methods This prospective cohort study included all women presenting to the Tygerberg Oncology unit with a new diagnosis of histologically confirmed vulvar carcinoma between November 2015 and December 2016. An interview was conducted and a questionnaire completed. Data obtained included demographic, social, health seeking behavior, disease and transport related factors. Descriptive statistics were reported and comparisons between early and late stage disease were calculated using Microsoft Excel version 14 and Social Science Statistics Calculators. Results Fifteen of the 30 patients interviewed presented with early vulva cancer (FIGO stage 1 or 2), and 15 patients presented with late stage disease (FIGO stage 3 or 4). The youngest patient was 28 years old and the oldest patient in the study was 72 years. There were no significant differences noted between the early and late stage disease with regards demographic, social or transport factors. There was no correlation between the size of the vulva lesion and delay in presentation. Nineteen patients (63.3%) used alternative modalities before seeking help from a health care worker. Although 21 (70%) women had a gynecological examination at the primary health facility, many were treated with antibiotics or creams before a definitive diagnosis was made. Nineteen patients (63.3%) made 4 or more visits to the primary health care facility before being referred to Tygerberg Hospital for management. Conclusion A delay of diagnosis of vulva cancer can be attributed to patient delay in the lack of recognition and interpretation of seriousness of the symptoms of vulvar cancer. Similar to the available literature, a system delay was also noted on the part of the primary health care practitioner. Educating women about this once rare disease and raising suspicion in health care workers regarding the presentation of vulva cancer might aid in earlier health seeking behavior, a prompter biopsy and prevent delayed diagnosis. AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar 2018-11-29T10:54:27Z 2018-12-07T07:00:25Z 2018-11-29T10:54:27Z 2018-12-07T07:00:25Z 2018-12 Thesis http://hdl.handle.net/10019.1/105120 en_ZA Stellenbosch University 34 pages : illustrations application/pdf Stellenbosch : Stellenbosch University
spellingShingle Vulva -- Cancer
UCTD
Vulva -- Cancer -- Prognosis
Health care costs
Shah, S.
Factors related to the late presentation of women with vulvar cancer
title Factors related to the late presentation of women with vulvar cancer
title_full Factors related to the late presentation of women with vulvar cancer
title_fullStr Factors related to the late presentation of women with vulvar cancer
title_full_unstemmed Factors related to the late presentation of women with vulvar cancer
title_short Factors related to the late presentation of women with vulvar cancer
title_sort factors related to the late presentation of women with vulvar cancer
topic Vulva -- Cancer
UCTD
Vulva -- Cancer -- Prognosis
Health care costs
url http://hdl.handle.net/10019.1/105120
work_keys_str_mv AT shahs factorsrelatedtothelatepresentationofwomenwithvulvarcancer