scholarly journals Cervix Cancer in Sub-Saharan Africa: An Assessment of Cervical Cancer Management

2021 ◽  
pp. 173-182
Author(s):  
Lindsay M. Burt ◽  
Mary McCormak ◽  
Fabrice Lecuru ◽  
Daniel M. Kanyike ◽  
Memory Bvochora-Nsingo ◽  
...  

PURPOSE Underdeveloped nations carry the burden of most cervical cancer, yet access to adequate treatment can be challenging. This report assesses the current management of cervical cancer in sub-Saharan Africa to better understand the needs of underdeveloped nations in managing cervical cancer. METHODS A pre- and postsurvey was sent to all centers participating in the Cervical Cancer Research Network's 4th annual symposium. The pre- and postsurvey evaluated human papillomavirus and HIV screening, resources available for workup and/or treatment, treatment logistics, outcomes, and enrollment on clinical trials. Descriptive analyses were performed on survey responses. RESULTS Twenty-nine centers from 12 sub-Saharan countries saw approximately 300 new cases of cervical cancer yearly. Of the countries surveyed, 55% of countries had a human papillomavirus vaccination program and 30% (range, 0%-65%) of women in each region were estimated to have participated in a cervical cancer screening program. In the workup of patients, 43% of centers had the ability to obtain a positron emission tomography and computed tomography scan and 79% had magnetic resonance imaging capabilities. When performing surgery, 88% of those centers had a surgeon with an expertise in performing oncological surgeries. Radiation therapy was available at 96% of the centers surveyed, and chemotherapy was available in 86% of centers. Clinical trials were open at 4% of centers. CONCLUSION There have been significant advancements being made in screening, workup, and management of patients with cervical cancer in sub-Saharan Africa; yet, improvement is still needed. Enrollment in clinical trials remains a struggle. Participants would like to enroll patients on clinical trials with Cervical Cancer Research Network's continuous support.

Vaccines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 496
Author(s):  
Caroline Deignan ◽  
Alison Swartz ◽  
Sara Cooper ◽  
Christopher J. Colvin

Cervical cancer rates in Sub-Saharan Africa (SSA) are amongst the highest worldwide. All three of the Human Papillomavirus (HPV) vaccines (9-valent, quadrivalent and bivalent HPV vaccine) provide primary protection against the most common cancer-causing strains of HPV (types 16 and 18) that are known to cause 70% of cervical cancers. Over the last five years, there has been an increase in Sub-Saharan African countries that have introduced the HPV vaccine. The majority of research has been conducted on supply-side barriers and facilitators to HPV vaccination uptake in SSA, yet little research has been conducted on demand-side or end-user perspectives of, and decisions around, HPV vaccination. In order to complement existing research, and inform current and future HPV vaccination implementation approaches, this qualitative systematic review explored Stakeholders’ understandings of HPV vaccination in SSA. This review searched the following databases: Embase (via Scopus), Scopus, MEDLINE (via PubMed), PubMed, EBSCOhost, Academic Search Premier, Africa-Wide Information, CINAHL, PsycARTICLES, PsycINFO, SocINDEX, Web of Science, and the Cochrane Controlled Register of Trials (CENTRAL) and found a total of 259 articles. Thirty-one studies were found eligible for inclusion and were analyzed thematically using Braun and Clarke’s methods for conducting a thematic analysis. The quality of included studies was assessed using the Critical Appraisal Skills Programme (CASP) checklist. Three major themes emerged from this analysis; knowledge of HPV vaccination and cervical cancer is intertwined with misinformation; fear has shaped contradictory perceptions about HPV vaccination and gender dynamics are relevant in how stakeholders understand HPV vaccination in SSA.


Sexual Health ◽  
2015 ◽  
Vol 12 (6) ◽  
pp. 520 ◽  
Author(s):  
Luke B. Connelly ◽  
Ha N. D. Le

Background Human papillomavirus (HPV) vaccines and their widespread adoption have the potential to relieve a large part of the burden of cervical cancer morbidity and mortality, particularly in countries that have low screening rates or, like Japan, lack a cohesive universal screening program. An economic evaluation was conducted to assess the cost-effectiveness of introducing a bivalent HPV vaccination program in Japan from a healthcare perspective. Methods: A Markov model of the natural history of HPV infection that incorporates both vaccination and screening was developed for Japan. The modelled intervention, a bivalent HPV vaccine with a 100% lifetime vaccine efficacy and 80% vaccine coverage, given to a cohort of 12-year-old Japanese girls in conjunction with the current screening program, was compared with screening alone in terms of costs and effectiveness. A discount rate of 5% was applied to both costs and utilities where relevant. Results: Vaccination alongside screening compared with screening alone is associated with an incremental cost-effectiveness ratio (ICER) of US$20 315 per quality-adjusted-life-year gained if 80% coverage is assumed. The ICER at 5% coverage with the vaccine plus screening, compared with screening alone, is US$1158. Conclusion: The cost-effectiveness results suggest that the addition of a HPV vaccination program to Japan’s cervical cancer screening program is highly likely to prove a cost-effective way to reduce the burden of cervical cancer, precancerous lesions and HPV16/18-related diseases.


2013 ◽  
Vol 134 (6) ◽  
pp. 1389-1398 ◽  
Author(s):  
Lynette Denny ◽  
Isaac Adewole ◽  
Rose Anorlu ◽  
Greta Dreyer ◽  
Manivasan Moodley ◽  
...  

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Petmore Zibako ◽  
Mbuzeleni Hlongwa ◽  
Nomsa Tsikai ◽  
Sarah Manyame ◽  
Themba G. Ginindza

Abstract Background Cancer is a non-communicable disease and is the number 2 leading cause of death globally. Among all cancers, cervical cancer is the number 1 killer of women in low-income countries (LICs). Cervical cancer is a well understood preventable cancer. The rates of cervical cancer are very varied and inversely proportional to the effectiveness of disease management policies. Management of cervical cancer includes prevention, screening, diagnosis and treatment. The main objective of this scoping review is to map the evidence on cervical cancer management in sub-Saharan Africa (SSA) to understand the coverage of cervical cancer prevention and treatment services and provide an opportunity to generate knowledge on the risk factors, attitudes and practices extendable globally. Methods and analysis This review will be guided by Arksey and O’Malley’s framework recommended for conducting scoping review studies. The Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews (PRISMA-Scr) checklist will also be completed to ensure that the review adheres to the sound methodological rigour acceptable for scoping review studies. The following electronic databases will be searched for potentially eligible articles: PubMed, Ebsco Host, Scopus and Cochrane Database of Systematic Reviews. Study screening procedures recommended by Higgins and Deeks will be followed. A narrative synthesis will be used, with data synthesised and interpreted using sifting, charting and sorting based on themes and key issues. Discussion Cervical cancer can become a disease of the past with a proper control strategy in place. It is therefore imperative to map available evidence on the management of cervical cancer to inform policy and advocacy action. More knowledge on the status quo will guide policymakers in ensuring cancer management guiding policies are formulated/updated/revised accordingly. Systematic review registration Not registered with PROSPERO (not needed). Protocol and registration This scoping review was not registered.


2019 ◽  
pp. 1-7
Author(s):  
Agnes Binagwaho ◽  
Patricia J. Garcia ◽  
Babacar Gueye ◽  
J. Andrew Dykens ◽  
Nothemba Simelela ◽  
...  

This is a summary of the presentations addressing approaches and achievements to reach the goal of eliminating cervical cancer as a global public health problem that were delivered at the 7th Annual Symposium on Global Cancer Research at the 10th Annual Consortium of Universities for Global Health Meeting in March 2019. Dr Princess Nothemba Simelela, Assistant Director-General for Family, Women, Children and Adolescents, World Health Organization, gave an introduction to the World Health Organization–led Cervical Cancer Elimination Initiative and the emerging conceptual framework and targets that will shape the global 2020 to 2030 strategy. Subsequent presentations shared experiences from national programs in Rwanda (Agnes Binagwaho), Latin America (Patricia J. Garcia), and Senegal (Babacar Gueye and J. Andrew Dykens. Successes in intensified human papillomavirus vaccination and screening with follow-up treatment of early and advanced lesions detected are highlighted as well as the challenges and obstacles in achieving and maintaining high coverage in Africa and Latin America. With strong political leadership, commitment of national stakeholders, and the use of proven and cost-effective approaches to human papillomavirus vaccination, screening, and treatment, the vision of a world free of cervical cancer and saving women’s lives every year by preventing deaths from cervical cancer will be achievable in the next generation in all countries.


2017 ◽  
Vol 3 (2_suppl) ◽  
pp. 36s-36s ◽  
Author(s):  
Zelalem Tilahun Tesfaye ◽  
Eyob Alemayehu Gebreyohannes ◽  
Akshaya Srikanth Bhagavathula ◽  
Melaknesh Minda Getaneh ◽  
Henok Getachew Tegegn

Abstract 6 Background: Cervical cancer is causing a burden in sub-Saharan Africa, with human papillomavirus (HPV) identified as the necessary cause of cervical cancer. HPV mainly affects young women, which puts female university students at risk of cervical cancer. Knowledge and awareness of cervical cancer and HPV in sub-Saharan Africa, including Ethiopia, is poor. The aim of this study was to assess the knowledge and awareness of cervical cancer and HPV in University of Gondar medicine and health science female students. Methods: This cross-sectional study was conducted from April 1 to May 30, 2016, at University of Gondar, College of Medicine and Health Sciences, Gondar, Ethiopia. Undergraduate female students from 11 different health-related departments at the College of Medicine and Health Sciences were included in the study. A 14-item, paper-based, self-administered questionnaire was provided to each of the participants to measure her level of knowledge and awareness of cervical cancer and HPV. Results: A total of 267 female students participated in the study, with ages ranging from 18 to 24 years (mean age, 20.58 ± 1.22 years). More than one half of participants (59.6%) stated that they did not know the main cause of cervical cancer, whereas only approximately one fifth (19.5%) identified HPV as the main cause of cervical cancer. As many as 83.9% of participants did not know other causes of cervical cancer. Binary logistic analysis revealed that students from midwifery (adjusted odds ratio [AOR], 14.14; P < .05), anesthesiology (AOR, 9.66; P < .05), and medicine (AOR, 5.84; P < .05) departments were associated with knowledge of the main cause of cervical cancer. Furthermore, fifth-year students (AOR, 16.94; P < .05) and fourth-year students (AOR, 8.32; P < .05) were found to have better knowledge of the main cause of cervical cancer. Only a few students (15%) had been vaccinated for HPV or had had a cervical smear test performed in the past. Conclusion: Cervical cancer mainly affects young women, which puts female university students at risk of cervical cancer. Hence, assessing the knowledge and awareness of these students will be of paramount importance to designing effective measures to increase their knowledge and awareness of the disease. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.


2020 ◽  
Author(s):  
Petmore Zibako ◽  
Mbuzeleni Hlongwa ◽  
Nomsa Tsikai ◽  
Sarah Manyame ◽  
Themba G Ginindza

Abstract BackgroundCancer is a non-communicable disease, and is the number two leading cause of death globally. Among all cancers, cervical cancer is the number one killer of women in Low-Income countries (LICs). Cervical cancer is a well understood preventable cancer. The rates of cervical cancer are very varied and inversely proportional to effectiveness of disease management policies. Management of cervical cancer includes: prevention, screening, diagnosis and treatment. The main objective of this scoping review is to map evidence on cervical cancer management in sub-Saharan Africa (SSA) to understand the coverage of cervical cancer prevention and treatment services and provide an opportunity to generate knowledge on risk factors, attitudes and practices extendable globally.Methods and analysisThis review will be guided by Arksey and O’Malley’s framework recommended for conducting scoping review studies. The Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews (PRISMA-Scr) checklist will also be completed to ensure that the review adheres to sound methodological rigour acceptable for scoping review studies. The following electronic databases will be search for potentially eligible articles: PubMed, Ebsco Host, Scopus and Cochrane Database of Systematic Reviews. Study screening procedures recommended by Higgins and Deeks will be followed.DiscussionCervical cancer can become a disease of the past with a proper control strategy in place. It is therefore imperative to map available evidence on management of cervical cancer to inform policy and advocacy action. More knowledge on the status quo will guide policy makers in ensuring cancer management guiding policies are formulated/updated/ revised accordingly.Scoping review registration: Not registered with PROSPERO (not needed).Protocol and registration: This scoping review was not registered.


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