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Study in Ghana finds gaps in biopsy uptake and long delays to treatment initiation at district hospitals
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Summary
An ABCD Ghana study presented interim data showing low biopsy uptake, pathology turnaround times that were good but long referral pathways, median 14 days to diagnosis and 76 days to treatment initiation, with recommendations to streamline referral and expand rural diagnostic services.
Dr. Clement t Nair presented findings from a cohort study examining breast cancer diagnostic and referral pathways at district-level hospitals in Ghana. The study—linked to the African Breast Cancer outcome disparities program—enrolled 244 women in the reported cohort and used face-to-face interviews, pathology abstraction and follow-up to measure time-to-diagnosis and time-to-treatment.
Key reported metrics included a median 14 days from initial facility contact to histopathological diagnosis and a median 76 days to treatment initiation. Nair highlighted uptake gaps: biopsy uptake and subsequent treatment initiation were lower than desired at district facilities, despite "excellent" pathology turnaround times reported by the project team. Major barriers included travel distance, referral navigation, and financial constraints; the study used SMS/transport and active recruitment strategies to maintain the cohort.
Nair recommended streamlining referral pathways, expanding diagnostic services outside tertiary centers, and maintaining active recruitment and registry infrastructure to track outcomes in non-capital settings. The presenter credited WHO’s Global Breast Cancer Initiative as an informing framework for targets on early detection and treatment timelines.
