A Narrative Synthesis of Literature on the Barriers to Timely Diagnosis and Treatment of Cancer in Sub-Saharan Africa

Mwamba, Monde; Lombe, Dorothy; Msadabwe, Susan Citonje; Bond, Virginia; Simwinga, Musonda; Ssemata, Andrew Sentoogo; Muhumuza, Richard; Seeley, Janet; Mwaka, Amos Deogratius; Aggarwal, Ajay

doi:10.1016/j.clon.2023.05.011

Clinical Oncology

2023

DOI: 10.1016/j.clon.2023.05.011

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A Narrative Synthesis of Literature on the Barriers to Timely Diagnosis and Treatment of Cancer in Sub-Saharan Africa

Monde Mwamba

Dorothy Lombe

Susan Citonje Msadabwe³

et al.

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2024

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Cited by 6 publications

References 69 publications

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Gastric Cancer at a Nigerian Tertiary Referral Center: Experiences With Establishing an Institutional Cancer Registry

Yibrehu,

Mohammed,

Murthy

et al. 2024

Journal of Surgical Oncology

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BackgroundIn Nigeria, gastric cancer is the 10th most common and 9th most deadly malignancy. The limited availability of robust data makes further characterizing it challenging. The objective of this study was to assess the presentation, and management of gastric cancer in Nigeria using an institutional cancer registry.MethodsWe reviewed a prospective database of patients diagnosed with any gastric cancer at a single tertiary referral center over 15 years (2007–2022). Patients with suspected gastric cancer were surveyed for sociodemographics and then added to the institutional gastric cancer registry. Thereafter, periodic chart review and phone call was used to obtain investigation results, and survival data, respectively. Only patients with complete histopathology were included in analysis.Results138 patients met inclusion criteria (mean age 55.3 years, 68.8% male). Patients typically presented with weight loss (119, 86.2%) and anorexia (92, 66.7%). Blood work (132, 95.7%) and ultrasound (80, 57.9%) were the most common investigations. Most fully staged patients presented with metastatic disease (39, 90.2%). Patients underwent at least one treatment modality (109, 79.0%), and most 54 (49.5%) underwent both chemotherapy and surgery. Patients undergoing surgery usually had resection of their tumor (58, 67.4%). The median time of follow‐up was 45.6 months, and 51.4% (71) of patients were dead at that time point.ConclusionOur gastric cancer database identified that most patients present with advanced disease and are undergoing at least one treatment modality. The next steps include initiatives to strengthen the quality of registry data, identify high‐risk patients, and provide timely treatment.

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Gastric Cancer at a Nigerian Tertiary Referral Center: Experiences With Establishing an Institutional Cancer Registry

Yibrehu,

Mohammed,

Murthy

et al. 2024

Journal of Surgical Oncology

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Meaningful engagement of people living with cancer: Leveraging breast cancer survivors in a stigma reduction intervention in Tanzania

Gutnik,

Msoka,

Dwarampudi

et al. 2024

World j. surg.

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IntroductionCancer‐related stigma is a key driver of advanced breast cancer stage in Sub‐Saharan Africa (SSA). We developed and tested the impact of a breast cancer survivor‐led Stigma reduction intervention (SRI) on stigma and treatment adherence of newly diagnosed patients with breast cancer in Tanzania.MethodsBreast cancer survivors were trained on breast cancer knowledge and motivational interviewing. A total of 4 trained survivors delivered a SRI (standardized flipchart breast education talk, personal testimony, and motivational interviewing) to 30 newly diagnosed patients with breast cancer before treatment. Pre‐ and post‐intervention knowledge surveys and stigma scale surveys were analyzed via Fisher's exact test and Wilcoxon rank‐sum tests. A discussion was held with a group of survivors after the intervention period to elicit feedback on their intervention experience.ResultsAmong the 30 patients, breast cancer knowledge (median overall percent correct) increased from 28% (IQR: 18%–45%) to 85% (IQR: 79%–88%) (p < 0.001) and stigma (median score) decreased from 75 (IQR: 57–81) to 53 (IQR: 44–66) (p < 0.01) following the intervention. All participants were willing to pursue hospital‐based treatment after undergoing the intervention. Eighty‐seven percent (n = 26) initiated treatment at 8‐week follow‐up after the intervention. All survivors endorsed feeling empowered and valued in their role in this intervention.ConclusionsBreast cancer survivors are a powerful group to combat the lack of knowledge and stigma in community and healthcare settings. Expanding the scope and scale of this intervention holds promise for improving treatment‐seeking behavior and ultimately breast cancer outcomes in SSA.

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Defining national research priorities for prostate cancer in Zambia: using the Delphi process for comprehensive cancer policy setting in sub-Saharan Africa

Lombe,

Mwamba,

Simwinga

et al. 2024

bmjonc

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ObjectivesLocally led research on cancer is needed in sub-Saharan Africa to set feasible research priorities that inform national policy. The aim of this project was to develop a research agenda for national cancer control planning, using a nationally driven approach, focused on barriers to diagnosis and high-quality treatment for prostate cancer in Zambia.Methods and analysisThis was a Delphi process. 29 stakeholders were scored barriers on feasibility, the proportion of patients affected, the impact on patient outcomes and if there was a potential to address health systems barriers meaningfully. There were three rounds (R) to the process: (R1 and R2) by electronic survey and (R3) in-person meeting. In R1 statements scoring above 15 from over 70% of participants were prioritised immediately for R3 discussion. Those scoring below 30% were dropped and those in between were re-surveyed in R2.Results22 and 17 of the 29 stakeholders responded to R1 and R2. 14 stakeholders attended R3. National priority research areas for prostate cancer in Zambia were identified as prostate cancer awareness; building affordable high-quality diagnostic capacity; affordability of specialist cancer treatments; supporting better access to medicines; delivery and coordination of services across the pathway and staff training.ConclusionThe suggested seven priority areas allow for the development of the prostate cancer control programme to be conducted in a holistic manner. The expectation is with this guidance international partners can contribute within the frameworks of the local agenda for sustainable development to be realised.

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A Narrative Synthesis of Literature on the Barriers to Timely Diagnosis and Treatment of Cancer in Sub-Saharan Africa

Cited by 6 publications

References 69 publications

Gastric Cancer at a Nigerian Tertiary Referral Center: Experiences With Establishing an Institutional Cancer Registry

Gastric Cancer at a Nigerian Tertiary Referral Center: Experiences With Establishing an Institutional Cancer Registry

Meaningful engagement of people living with cancer: Leveraging breast cancer survivors in a stigma reduction intervention in Tanzania

Defining national research priorities for prostate cancer in Zambia: using the Delphi process for comprehensive cancer policy setting in sub-Saharan Africa

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