To assess health-seeking pathway of patients with oral cancer presenting at our oral and maxillofacial surgical unit in a Nigerian teaching hospital; explore the psychosocial effect of the disease; and assess relationship between psychosocial perspectives and health-seeking behaviour.
Method: A prospective, cross-sectional study with serial recruitment of consenting patients on presentation at facility and histological diagnosis. Standardised questionnaire was administered and data analysed using STATA.
Result:
Sixty patients participated: 31 males (51.7%), 29 females (48.3%)’ age range 2 – 94 years (mean + SD: 39.7 + 18.5 years). Majority (53.0%) had at least secondary school education; 21.6% had no formal education. Three-quarters (76.7%) were in low socio-economic class. The median duration for jaw swelling was 2 years (range: 0.05-18 years; IQR: 2-5 years). Mandible was the most common location of jaw swelling (65.5%). The most common accompanying features were: pain/toothache (53.9%) and nasal discharge/ulcer (15.4%). Overall, 11.7% of respondents believed that their condition could be due to ‘juju’ (charm/diabolical acts). Twenty percent had accessed care from herbalists/spiritualists: two-thirds of these before ever seeking orthodox health care. Only 11.7% of respondents consulted dental hospital as first source of health care, while 26.7% had ever consulted dental services before presenting at our centre. The most common psychosocial challenges for the patients were: issues about their appearance (68.3% were “very much” bothered about it); trouble going out to public (36.7%); trouble in making social contacts with family and friends (23.3%). No significant relationship was, however, found between psychosocial situations/perspectives and health-seeking behaviour.
Conclusion:
Patients with oral cancer in Nigerian setting have high psychosocial burden, and poor health-seeking behaviour. Oral surgeons must integrate steps to reduce psychosocial burden into treatment plans. Communication interventions are needed to improve health-seeking behaviour.