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Purpose/Objective(s): Cervical cancer is the 7th most common cancer worldwide causing 260,000 deaths annually. Per region, Africa has the highest incidence and mortality due to cervical cancer. There is limited information regarding stage, treatment and outcomes of cervical cancer in Central Africa. Here, we evaluated the epidemiology and treatment patterns of cervical cancer, the second most common cancer among women in Gabon. In addition, we interrogated the impact of brachytherapy on disease recurrence and toxicities. Materials/Methods: We identified 117 patients treated for cervical cancer at a center in Libreville, Gabon from 2011 to 2019. Patient and disease characteristics including FIGO stage, treatment duration, external and/or brachytherapy dose, concurrent chemo-radiation were recorded in SPSS. Statistical analyses were performed using Stata. Results: The majority of patients presented with Stage II disease (n Z 51, 43.6%) while 19.6%, 17.9% and 18% presented with Stages I, III or IV disease respectively. The mean duration of total treatment time for all stages was 59.7 (SD 15.3; p Z .005) though it was higher for advanced stage patients compared to early stage patients. During the study period, twenty-four patients experienced disease progression while ninety-three remained disease-free. The mean duration of treatment was 66 days among those who progressed and 57 days for those who did not (p Z .009). Thirty-eight patients underwent surgery (p<.001). Ninety-one patients (78%) underwent concurrent chemoradiation. Sixty percent of Stage I patients received chemoRT compared with over 80% of Stage II, III or IV patients (p Z .03). Fifteen patients (16%) received 5-6 cycles of chemotherapy. The median dose of external beam radiation therapy was 66 Gy (SD 8), for all stages but fell to 50.4 Gy for Stage I patients. Among the twenty-four patients who progressed, the mean external beam dose was 65 Gy while it was 60 Gy for those who did not progress (twosided p Z .0016). Two patients suffered from Grade III GI toxicity, and one patient suffered Grade III GU toxicity after external beam radiation treatment. However, the patients who received brachytherapy had fewer Grade II toxicities than those who received solely external beam radiotherapy. Conclusion: External beam radiation therapy, often with concurrent chemotherapy, is delivered safely and effectively at this Gabonese center with less than 1% of patients experiencing Grade III GU or GI toxicities. However, external beam doses for Stages II-IV are higher than those recommended in traditional NCCN/ESTRO/ASTRO guidelines which likely reflects forced improvisation due to a lack of HDR brachytherapy. Funds to replace the brachytherapy machine will positively impact the treatment of patients under their care.

Purpose/Objective(s): Although the participation of women in academic oncology has increased in the United States, concerning issues persist regarding disparities between sexes. We wished to quantify the gender distribution of faculty members in academic oncology in the United States, as well as the distribution of the chairpersons. As we speculated similar findings might be present internationally, we also quantified the distribution of the chairs abroad. In prior work, we showed that the female participation in academic oncology in the united states has increased in the past four decades. We also demonstrated a low percentage of female chairs in the United States, Canada, and Spain. In this work, we wish to update our international results and include data from Australia. Materials/Methods: To obtain the gender distribution of faculty members in the United States, data from the Association of American Medical College (AAMC) was used to examine the faculty composition of hematology/oncology, medical oncology, and radiation oncology. We chose the years 1977, 1987, 1997, 2007, and 2017 for comparison. The international data was gathered mostly from web-pages listing postgraduate training programs in oncology and individual institution websites. We also examined local newspapers for completeness of the missing data. Results: In 1977, the female composition of the faculty was 7.7%, 9.8% and 7% for hematology/oncology, medical oncology, and radiation oncology in the United States. The distribution for 1987 was 10.3%, 14.1%, and 17.7% respectively. For 1997 the female composition was 23.2%, 22.1%, and 21.4%. In 2007 the distribution was 34.7%, 34.6% and 24.5%. For 2017, the female distribution changed to 30.5% 41.3% and 28.2%. The female department chair distribution for radiation oncology and medical oncology across the United States in 2017 was 9% and 13.3%. The international chairwoman distribution for radiation oncology and medical oncology in 2017 was 0% and 13.3% for Canada, 25% and 18.2% for Spain and 2% and 6% for Australia. Conclusion: Women have historically increased in representation in the United States oncology workforce; however, they remain underrepresented. Women were also underrepresented at the level of chair in the US, Canada, Spain, and Australia. Further research and efforts need to be focalized on understanding barriers to training and career advancement in the United States and abroad.