The lancet oncology
-
The lancet oncology · Apr 2013
Challenges and opportunities in cancer control in Africa: a perspective from the African Organisation for Research and Training in Cancer.
Sub-Saharan Africa has a disproportionate burden of disease and faces a major public-health challenge from non-communicable diseases. Although infectious diseases continue to afflict Africa, the proportion of the overall disease burden in sub-Saharan Africa attributable to cancer is rising. The region is predicted to have a greater than 85% increase in cancer burden by 2030. ⋯ It should ideally be situated within strong, robust, and sustainable health-care systems that offer quality health care to all people, irrespective of their social or economic standing. However, to achieve this will need new leadership, critical thinking, investment, and understanding. We discuss the present situation in sub-Saharan Africa and propose ideas to advance cancer control in the region, including the areas of cancer awareness, advocacy, research, workforce, care, training, and funding.
-
The lancet oncology · Apr 2013
Status of radiotherapy resources in Africa: an International Atomic Energy Agency analysis.
Radiation therapy is an important component of cancer control programmes. The scarcity of radiation oncology resources in Africa is becoming more severe as cancer incidence increases in the continent. We did a longitudinal assessment of the status of radiation oncology resources in Africa to measure the extent of the problem and the effects of programmes designed to enhance radiation services in the continent. ⋯ These facilities are concentrated in the southern and northern states of the continent. Brachytherapy resources (high-dose rate or low-dose rate) were only available in 20 of the 52 African countries. Although progress has been made in the establishment of radiation oncology services in some countries, a large need still exists for basic radiation services, and much resource mobilisation is needed for services to keep pace with the burgeoning populations of many countries.
-
Roughly half a million people die of cancer in sub-Saharan Africa every year. Despite rapid expansion of palliative care for cancer, coverage remains woefully inadequate. The WHO public health strategy for palliative care aims to increase access to palliative care services through its integration into health-care systems. ⋯ Increased attention to the generation of research evidence is essential to achieve quality and coverage of appropriate palliative care for patients with advanced cancer in sub-Saharan Africa. The use of locally validated, patient-reported outcome measures is an important advance in the measurement and improvement of care and patient wellbeing. Palliative care for patients with cancer in Africa currently receives far less research attention than does palliative care for patients with HIV/AIDS, but in view of projected increasing cancer incidence in the region, generation of local evidence to inform and allow assessment of palliative care for patients with cancer is urgently needed.
-
The lancet oncology · Apr 2013
Improving access to analgesic drugs for patients with cancer in sub-Saharan Africa.
WHO expects the burden of cancer in sub-Saharan Africa to grow rapidly in coming years and for incidence to exceed 1 million per year by 2030. As a result of late presentation to health facilities and little access to diagnostic technology, roughly 80% of cases are in terminal stages at the time of diagnosis, and a large proportion of patients have moderate to severe pain that needs treatment with opioid analgesics. ⋯ However, recent initiatives characterised by cooperation between national governments and local and international non-governmental organisations are improving access to pain relief. Efforts underway in Uganda, Kenya, and Nigeria provide examples of challenges faced and innovative approaches adopted and form the basis of a proposed framework to improve access to pain relief for patients with cancer across the region.