Surgical oncology at a major referral center in Ghana: Burden, staging, and outcomes

Gyedu, Adam; Gaskill, Cameron; Agbedinu, Kwabena; Salazar, Daniela Rebollo; Kingham, T. Peter

doi:10.1002/jso.25168

Cited by 7 publications

(9 citation statements)

References 34 publications

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“…However, a majority of operated patients underwent surgery with curative intent. This result is in agreement with reports from Ghana where surgery was done in curative intend in 60% of patients [21], but different from reports from Malawi where the vast majority of surgical procedures were of palliative intent [14].…”

Section: Treatment Details and Outcomessupporting

confidence: 81%

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Practice of Oncology in Low- income Setting: A Review of Four Years Activities in Togo

Adani-Ife

2021

Asian Pac J Cancer Care

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Purpose: Until 2016, there was no oncologist in Togo. This study reviewed the first four years of activities in the practice of clinical oncology in the country to provide the cancer profile, the treatment, and outcomes of patients.Methods: We performed a retrospective descriptive study of patients diagnosed with cancer seen in oncology in Togo from March 2016 to March 2020. Data on presentation, staging, treatment, and outcomes were reviewed. Statistics were computed using SPSS.Results: A total of 897 patients were included. There were 625 women (69.7%) and 272 men (30.3%). The mean age at diagnosis was 53.48 years for men and 52.39 for women and more than half of patients were under 60 years. A cancer diagnosis was histologically confirmed in 81.2% of patients. For both sexes, breast cancer was the commonest followed by cervix cancer, colorectal cancer, prostate, and stomach cancer. In men, prostate cancer ranked first followed respectively by gastric cancer and colorectal cancer. The most common cancer in women was breast cancer followed by cervix cancer. Majority of patients (60%) presented at a late stage. 531 patients (59.2%) received at least one cancer therapy modality but more than half of treated patients did not complete their treatment. After fifty-eight months of follow-up, only 132 patients (14.7%) in the all-study population are alive. Conclusion: This study describes the epidemiology and oncologic treatment in Togolese patients. Breast and Prostate are the leading cancer diagnoses in our population. Most patients presented at an advanced stage and the treatment was palliative in a majority of patients. There is an urgent need for early detection of cancer in Togo.

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Section: Treatment Details and Outcomessupporting

confidence: 81%

“…CT and MRI are available in our country, therefore adequate staging was available for 92% of patients who had confirmed diagnosis of cancer. This rate is better than that report from Ghana [21], Malawi [14] and Pakistan [22].…”

Section: Treatment Details and Outcomescontrasting

confidence: 70%

Practice of Oncology in Low- income Setting: A Review of Four Years Activities in Togo

Adani-Ife

2021

Asian Pac J Cancer Care

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“…From the single-country studies, majority were done in Nigeria ( n = 17) ( 24 , 25 , 28 , 29 , 34 , 45 , 54 , 64 , 72 , 75 , 92 , 93 , 103 , 113 , 116 , 124 , 137 ) and South Africa ( n = 20) ( 10 , 26 , 36 , 42 , 55 , 65 , 80 – 83 , 86 , 88 , 89 , 91 , 98 , 105 , 110 , 125 , 129 , 135 ), followed by Uganda ( n = 10) ( 35 , 40 , 48 , 59 , 74 , 78 , 79 , 90 , 94 , 95 ), then Malawi ( n = 9) ( 37 , 52 , 53 , 56 , 66 – 68 , 118 , 133 ) and Ethiopia ( n = 9) ( 33 , 51 , 63 , 97 , 101 , 107 , 112 , 146 , 157 ). We also found studies conducted in Ghana ( n = 6) ( 50 , 71 , 111 ,…”

Section: Resultssupporting

confidence: 53%

“…Two studies were from South Africa, one retrospective record review ( 26 ) and a cross-sectional study of Demographic and Health Survey (DHS) data ( 125 ). Two studies were from Ghana, of which one was a cross-sectional study ( 134 ) and the other a retrospective record review of patient files ( 50 ). There was one study from each of the following countries: a retrospective record review of pathology reports from the Central African Republic ( 32 ), another retrospective record review of non-governmental records in Botswana ( 43 ), one cross-sectional study from Sudan ( 114 ), one cross-sectional study in both South Africa and Uganda ( 120 ), one retrospective record review of registry from Kenya ( 96 ), and a retrospective record review of pathology reports in Zambia ( 44 ).…”

Section: Resultsmentioning

confidence: 99%

Mapping Evidence on the Burden of Breast, Cervical, and Prostate Cancers in Sub-Saharan Africa: A Scoping Review

Musekiwa

Moyo²,

Mohammed³

et al. 2022

Front. Public Health

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BackgroundCancer remains a major public health problem, especially in Sub-Saharan Africa (SSA) where the provision of health care is poor. This scoping review mapped evidence in the literature regarding the burden of cervical, breast and prostate cancers in SSA.MethodsWe conducted this scoping review using the Arksey and O'Malley framework, with five steps: identifying the research question; searching for relevant studies; selecting studies; charting the data; and collating, summarizing, and reporting the data. We performed all the steps independently and resolved disagreements through discussion. We used Endnote software to manage references and the Rayyan software to screen studies.ResultsWe found 138 studies that met our inclusion criteria from 2,751 studies identified through the electronic databases. The majority were retrospective studies of mostly registries and patient files (n = 77, 55.8%), followed by cross-sectional studies (n = 51, 36.9%). We included studies published from 1990 to 2021, with a sharp increase from 2010 to 2021. The quality of studies was overall satisfactory. Most studies were done in South Africa (n = 20) and Nigeria (n = 17). The majority were on cervical cancer (n = 93, 67.4%), followed by breast cancer (67, 48.6%) and the least were on prostate cancer (48, 34.8%). Concerning the burden of cancer, most reported prevalence and incidence. We also found a few studies investigating mortality, disability-adjusted life years (DALYs), and years of life lost (YLL).ConclusionsWe found many retrospective record review cross-sectional studies, mainly in South Africa and Nigeria, reporting the prevalence and incidence of cervical, breast and prostate cancer in SSA. There were a few systematic and scoping reviews. There is a scarcity of cervical, breast and prostate cancer burden studies in several SSA countries. The findings in this study can inform policy on improving the public health systems and therefore reduce cancer incidence and mortality in SSA.

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“… 37 For out-of-stock drugs and consumables approved by national health insurance scheme and certain services not approved by the national health insurance scheme, patients are required to pay out-of-pocket regardless of their condition. 38 The vision behind Ghana’s national health insurance scheme is to cover all expenses with the goal of achieving UHC. 9 Our study showed that the national health insurance scheme contributed to decreasing out-of-pocket payments.…”

Section: Discussionmentioning

confidence: 99%

National health insurance and surgical care for injured people, Ghana

Gyedu

Goodman²,

Katz

et al. 2020

Bull. World Health Organ.

Self Cite

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Objective To determine the association between having government health insurance and the timeliness and outcome of care, and catastrophic health expenditure in injured patients requiring surgery at a tertiary hospital in Ghana. Methods We reviewed the medical records of injured patients who required surgery at Komfo Anokye Teaching Hospital in 2015–2016 and extracted data on sociodemographic and injury characteristics, outcomes and out-of-pocket payments. We defined catastrophic health expenditure as ≥ 10% of the ratio of patients’ out-of-pocket payments to household annual income. We used multivariable regression analyses to assess the association between having insurance through the national health insurance scheme compared with no insurance and time to surgery, in-hospital mortality and experience of catastrophic health expenditure, adjusted for potentially confounding variables. Findings Of 1396 patients included in our study, 834 (60%) were insured through the national health insurance scheme. Time to surgery and mortality were not statistically different between insured and uninsured patients. Insured patients made smaller median out-of-pocket payments (309 United States dollars, US$) than uninsured patients (US$ 503; P < 0.001). Overall, 45% (443/993) of patients faced catastrophic health expenditure. A smaller proportion of insured patients (33%, 184/558) experienced catastrophic health expenditure than uninsured patients (60%, 259/435; P < 0.001). Insurance through the national health insurance scheme reduced the likelihood of catastrophic health expenditure (adjusted odds ratio: 0.27; 95% confidence interval: 0.20 to 0.35). Conclusion The national health insurance scheme needs strengthening to provide better financial risk protection and improve quality of care for patients presenting with injuries that require surgery.

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Surgical oncology at a major referral center in Ghana: Burden, staging, and outcomes

Abstract: Improved capacity for both therapeutic and palliative cancer care is needed to achieve better outcomes by more appropriate allocation of surgery with respect to the goal of treatment.

Cited by 7 publications

References 34 publications

Practice of Oncology in Low- income Setting: A Review of Four Years Activities in Togo

Practice of Oncology in Low- income Setting: A Review of Four Years Activities in Togo

Mapping Evidence on the Burden of Breast, Cervical, and Prostate Cancers in Sub-Saharan Africa: A Scoping Review

National health insurance and surgical care for injured people, Ghana

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