학술논문

Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries
Document Type
Article
Author
Fabian, Ido DidiStacey, Andrew WFoster, AllenKivela¨, Tero TMunier, Francis L.Keren-Froim, NaamaGomel, NirCassoux, NathalieSagoo, Mandeep SReddy, M AshwinHarby, Lamis AlZondervan, MarciaBascaran, CovadongaAbdallah, ElhassanAbdullahi, Shehu UBoubacar, Sahadatou AdamouAdemola-Popoola, Dupe SAdio, AdedayoAghaji, Ada EPortabella, Silvia AlarcónAlfa Bio, Amadou IAli, Amany MAlia, Donjeta BAll-Eriksson, CharlottaAlmeida, Argentino AAlsawidi, Khalifa MAntonino, RomanzoAstbury, Nicholas JAtsiaya, RoseBalaguer, JuliaBalwierz, WalentynaBarranco, HonorioPopovic, Maja BeckBenmiloud, SarraGuebessi, Nissrine BennaniBerete, Rokia CBiddulph, Shelley JBiewald, Eva MBlum, SharonBobrova, NadiaBoehme, MariannaBornfeld, NorbertBouda, Gabrielle CBouguila, HédiBoumedane, AmariaBrichard, Bénédicte Gl, Michael CapraCastela, GuilhermeCatalà-Mora, JaumeChantada, Guillermo LChernodrinska, Violeta SChiwanga, Faraja SCieslik, KrzysztofComsa, CodrutaCorrea Llano, Maria GCsóka, MonikaDa Gama, Isac VDavidson, AlanPotter, Patrick DeDesjardins, LaurenceDragomir, Monica DBruyn, Magritha DuKettani, Asmaa ElElbahi, Amal MElgalaly, DinaElhaddad, Alaa MAli Elhassan, Moawia MElzembely, Mahmoud MEssuman, Vera AEvina, Ted Grimbert AFasina, OluyemiFernández-Teijeiro, AnaGandiwa, MoiraAldana, David GarcíaGeel, Jennifer AGizachew, ZelalemGregersen, Pernille AGuedenon, Koffi MHadjistilianou, TheodoraHassan, SadiqHederova, StanislavaHessissen, LailaHordofa, Diriba FHummlen, MarliesHusakova, KristinaIda, RussoIlic, Vesna RJenkinson, HelenAmani Kabesha, Theophile BKabore, Rolande LKalinaki, AbubakarKapelushnik, NoaKardava, TamarKemilev, Pavlin KroumovKepak, TomasKhotenashvili, ZazaKlett, ArturKosh Komba Palet, Jess ElioKrivaitiene, DaliaKruger, MarianaKyara, AliceLachmann, Eva SLatinović, SlobodankaLecuona, KarinLukamba, Robert MLumbroso, LiviaLysytsia, LesiaMaka, ErikaMakan, MayuriManda, ChatondaBegue, Nieves MartínMatende, Ibrahim OMatua, MarcheloMayet, IsmailMbumba, Freddy BMengesha, Aemero AMidena, EdoardoMndeme, Furahini GMohamedani, Ahmed AMoll, Annette CMoreira, ClaudeMsina, Mchikirwa SMsukwa, GeraldMuma, Kangwa IMurgoi, GabrielaMusa, Kareem OMustak, HamzahMuyen, Okwen MNaidu, GitaNaumenko, LarisaNdoye Roth, Paule Ai¨daNeroev, VladimirNikitovic, MarinaNkanga, Elizabeth DNkumbe, HenryNyaywa, MutaleObono-Obiang, GhislaineOguego, Ngozi COlechowski, AndrzejOscar, Alexander HugoOsei-Bonsu, PeterPainter, Sally LPaintsil, VivianPaiva, LuisaPapyan, RuzannaParrozzani, RaffaeleParulekar, ManojPawinska-Wasikowska, KatarzynaPerić, SanjaPhilbert, RemezoPochop, PavelPolyakov, Vladimir GPompe, Manca TPons, Jonathan JRaobela, LéaRenner, Lorna AReynders, DavidRibadu, DahiruRiheia, Mussagy MRitter-Sovinz, PetraSaakyan, SvetlanaSaid, Azza MARomán Pacheco, Sonsoles SanScanlan, Trish ASchoeman, JudySeregard, StefanSherief, Sadik TCheikh, Sidi SidiSilva, SóniaSorochynska, TetyanaSsali, GraceStathopoulos, ChristinaKranjc, Branka StirnStones, David KSvojgr, KarelSylla, FatoumataTamamyan, GevorgTandili, AlketaTateshi, BekimTheophile, TuyisabeTraoré, FousseyniTyau-Tyau, HarbaUmar, Ali BUrbak, Steen FUshakova, Tatiana LValeina, SandraHoefen Wijsard, Milo vanVeleva-Krasteva, Nevyana VViksnins, MarisWackernagel, WernerWaddell, KeithWade, Patricia DWali Nigeria, Amina HWime, Amelia DCDod, Charlotte WolleyYanga, Jenny MYarovaya, Vera AYarovoy, Andrey AZein, EkhtelbeninaSharabi, ShirleyZhilyaeva, KatsiarynaZiko, Othman AOBowman, Richard
Source
British Journal of Ophthalmology; 2021, Vol. 105 Issue: 10 p1435-1443, 9p
Subject
Language
ISSN
00071161; 14682079
Abstract
BackgroundThe travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe.MethodsA cross-sectional analysis including 518 treatment-nai¨ve patients with retinoblastoma residing in 40 European countries and 1024 treatment-nai¨ve patients with retinoblastoma residing in 43 African countries.ResultsCapture rate was 42.2% of expected patients from Africa and 108.8% from Europe. African patients were older (95% CI −12.4 to −5.4, p<0.001), had fewer cases of familial retinoblastoma (95% CI 2.0 to 5.3, p<0.001) and presented with more advanced disease (95% CI 6.0 to 9.8, p<0.001); 43.4% and 15.4% of Africans had extraocular retinoblastoma and distant metastasis at the time of diagnosis, respectively, compared to 2.9% and 1.0% of the Europeans. To reach a retinoblastoma centre, European patients travelled 421.8 km compared to Africans who travelled 185.7 km (p<0.001). On regression analysis, lower-national income level, African residence and older age (p<0.001), but not travel distance (p=0.19), were risk factors for advanced disease.ConclusionsFewer than half the expected number of patients with retinoblastoma presented to African referral centres in 2017, suggesting poor awareness or other barriers to access. Despite the relatively shorter distance travelled by African patients, they presented with later-stage disease. Health education about retinoblastoma is needed for carers and health workers in Africa in order to increase capture rate and promote early referral.