Understanding the bricks to build better surgical oncology unit at Maputo Central Hospital: prevalent surgical cancers and residents knowledge

Abstract

Introduction Cancer is a growing concern in Mozambique. However, the country has limited facilities and few oncologists. Surgical oncologists are an unmet need. The aim of this study was to assess residents' knowledge in prevalent cancer domains and to identify and characterize prevalent cancers treated by surgery at Maputo Central Hospital, the largest hospital in Mozambique. The expectations were that the findings shall inform the development of a comprehensive curriculum in surgical oncology fellowship fit for the Hospital. Methods To identify and characterize prevalent cancers, we performed a retrospective analysis of individual cancer patient registries of Maputo Central Hospital (MCH), Mozambique. Information was recorded into data collection sheets and analyzed with SPSS ® 21. To assess MCH residents oncologic knowledge, we invited Twenty-six junior residents (49% of all residents) of different specialties to take a 30 item multiple choice written test used elsewhere in previous studies. The test focused on the domains of Basis of oncology, Radiotherapy, Pathology, Chemotherapy, Pain management, Surgical oncology and Clinical Pathway. The test was administered anonymously and without prior notice. We analyzed the overall test and topic performance of residents. Results The study covered a period of 3 years and 203 patients. The most prevalent malignant tumors treated by general and thoracic surgery in MCH cancer registry were esophageal (7%), female breast (6.5%) and colorectal cancer (2.8%). Globally these malignancies were diagnosed at an advanced stage of the disease and required a multimodal treatment. The mean percent correct score of residents was 37.3%. The dimension with the highest percent correct score were clinical management (46%) and surgical oncology (28%) showed the lowest correct score. Conclusion In Maputo, Mozambique esophageal, breast and colorectal cancer were the most prevalent malignancies treated, with surgery, by thoracic or general surgery in MCH. The test scores suggest that, among residents, the knowledge in oncology needs to be improved, rendering support to the need of a surgical oncology training tailored to suit the local needs. Specific training should take into account local cancer prevalence, resources, their quality and the support of surgical oncology services with volume and experience.

The Upper Digestive Tract Microbiome and Oesophageal Squamous Cell Carcinoma: Epidemiology, Pathogenesis, and Clinical Implications in Africa

“…In Mozambique, the knowledge in prevalent cancer domains is well characterised, as well as the prevalent cancers treated by surgery at Maputo Central Hospital (MCH), the main hospital in Mozambique, together with residents’ oncological knowledge. Results obtained, besides confirming oesophageal cancer as the most prevalent malignant tumour treated by general and thoracic surgery, with advanced-stage diagnoses requiring multimodal treatment, informed the need to improve residents’ oncology knowledge, supporting the necessity of a surgical oncology training tailored to suit local needs [7, 112]. The improvement of resources, such as tests and procedures to diagnose OSCC are also urgent.…”

“…Africa faces a rising burden of cancer, namely oesophageal cancer along the AOCC. Yet, cancer research is still scarce in the continent to meet this public health challenge and few people are equipped to conduct research in the area despite remarkable progress in building human research capacity over the last decade [7, 112, 113]. In Tanzania, a great part of oncology trainees would like to incorporate research into their careers, but inadequate training in research methodology and absence of longitudinal mentorship is a drawback [114].…”