Esophageal Cancer Awareness Among Patients Attending Out-patient Clinics at Kenyatta National Hospital

Abstract

Report by the National Cancer Institute of Kenya (NCI-K 2023) for 2021 and 2022 indicates that esophageal cancer is now the leading cause of all cancer deaths in both men and women accounting for 15.6% of all cancer deaths. Several studies have predicted a 70% increase by the year 2040 in Eastern Rift Valley corridor with majority being in Low and Middle-Income Countries (LMIC). Due to vague nature of esophageal cancer clinical presentation coupled with low level of awareness, poor symptoms appraisal led to delays in seeking healthcare and consequently prompt diagnosis and treatment. Reports indicate that,70% to 80% of patients attending KNH are diagnosed at stage III and IV of disease progression with 90% succumbing to the disease shortly after diagnosis. The main study objective was to assess the level of awareness of esophageal cancer amongst patient attending outpatients‟ clinics in KNH, with specific interest focusing on assessing the level of awareness of early warning signs, risk factors, patient‟s perception of risk factors and common sources of health promotion information. This is descriptive cross-sectional study where the study population was sampled from patients attending out-patient clinics where a sample size of 344 participants was selected. Data was collected through a structured self-administered questionnaire, coded and entered into an Excel sheet and transferred to SPSS version 28 for analysis. To demonstrate association and comparisons between variables, both regression and chi-square was employed. Descriptive statistics was provided using the mean, percentages, and P-Value to determine the level of significance. Analysis of variance (ANOVA) a statistical formula was used to compare social demographic profile of participants to study objective findings and responses. Ethical approval was sought at the UoN-KNH Ethical review committee for scientific and ethical approvals, similarly license was obtained from NACOSTI and permission to collect data was also sought from heads of department of medicine and surgery in KNH. The finding of this research demonstrated changing patient social demographics with improved literacy level and internet access and young respondents, majority being ages of 30 to 40 years. Knowledge gap of warning signs with only difficulty in swallowing at 24.3% with “very likely response”, smoking and heavy alcohol consumption identified as most significant risks factors with 50.7% and 42% as “very likely” response, on risk perception participants who don‟t smoke cigarette or consume alcohol regarded themselves as no risk population for Esophageal Cancer. Despite increased literacy level and internet access of participants, 62% of respondents reported to have heard about esophageal cancer, however, respondents didn‟t demonstrate fundamental knowledge base of esophageal cancer changing trends and burden as per recently published reports on EC. This finding will be used to inform and develop a literacy program aiming at promoting awareness of symptom recognition, symptom appraisal of EC and health-seeking behavior to the general population and most risk population in developing esophageal cancer for early diagnosis and treatment