Assessing delays in accessing and completing radiotherapy for cervical cancer treatment: A multicenter survey of oncology providers in go further-funded countries in Sub-Saharan Africa

Objective: Cervical cancer is a leading cause of cancer death in Sub-Saharan Africa. Go Further provides funds for prevention and screening in Sub-Saharan Africa, but access to treatment for invasive disease remains limited. This survey aims to assess delays in accessing curative-intent chemoradioth...

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Main Authors: Caroline G. Kernell, Megan Kassick, Jessica M. George, Chidinma P. Anakwenze, Edward L. Trimble, Surbhi Grover
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Gynecologic Oncology Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352578925001353
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author Caroline G. Kernell
Megan Kassick
Jessica M. George
Chidinma P. Anakwenze
Edward L. Trimble
Surbhi Grover
author_facet Caroline G. Kernell
Megan Kassick
Jessica M. George
Chidinma P. Anakwenze
Edward L. Trimble
Surbhi Grover
author_sort Caroline G. Kernell
collection DOAJ
description Objective: Cervical cancer is a leading cause of cancer death in Sub-Saharan Africa. Go Further provides funds for prevention and screening in Sub-Saharan Africa, but access to treatment for invasive disease remains limited. This survey aims to assess delays in accessing curative-intent chemoradiotherapy for cervical cancer in countries receiving Go Further funding. Methods: Oncology providers in countries receiving Go Further funding (Botswana, Eswatini, Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Tanzania, Uganda, Zambia, Zimbabwe) and South Africa were invited to participate in a web-based survey beginning September 2023. Results: Fifteen oncology providers responded, with all countries except Malawi represented. Nearly half (46.3 %) reported wait time of ≥two months for chemoradiotherapy consultation. 93.3 %, 71.4 %, 53.7 % and 73.3 % had access to at least one CT, linear accelerator, cobalt, and brachytherapy machine, respectively. Majority (60 %) reported wait time of <one month to initiate chemoradiotherapy after staging. However, 28.6 % reported >95 % of patients complete external radiotherapy within 42 days, and 33 % reported >95 % of these patients receive brachytherapy. Only 26.7 % reported overall treatment time within 56 days for >95 % of patients. Lack of transportation, funding, and patient fear, were other treatment barriers reported. Conclusion: These results highlight the need for additional chemoradiotherapy resources in Go Further-funded countries. In addition to expanding radiotherapy, supplemental avenues to improve access in Sub-Saharan Africa include addressing barriers that increase wait times along the care continuum and implementing social support. This survey serves as a call to Go Further, highlighting the urgent need for resource allocation for cervical cancer treatment.
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spelling doaj-art-ff2cc41d4e1f48ff9987b5ca8fd3538f2025-08-21T04:17:13ZengElsevierGynecologic Oncology Reports2352-57892025-08-016010181010.1016/j.gore.2025.101810Assessing delays in accessing and completing radiotherapy for cervical cancer treatment: A multicenter survey of oncology providers in go further-funded countries in Sub-Saharan AfricaCaroline G. Kernell0Megan Kassick1Jessica M. George2Chidinma P. Anakwenze3Edward L. Trimble4Surbhi Grover5UT Southwestern Medical School, 5323 Harry Hines Blvd, Dallas, TX 75390, United States of AmericaUniversity of Pennsylvania, Department of Radiation Oncology, Perelman Center for Advanced Medicine, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States of America; Botswana-UPenn Partnership, 1836 Princess Marina Hospital, Private Bag BO 320, Gaborone, BotswanaDepartment of Population and Public Health Sciences Keck School of Medicine, University of Southern California, 2001 N Soto St, Los Angeles, CA 90032, United States of AmericaMD Anderson Cancer Center, Department of Radiation Oncology, 1515 Holcombe Blvd, Houston, TX 77030, United States of AmericaNational Institutes of Health, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, United States of AmericaUniversity of Pennsylvania, Department of Radiation Oncology, Perelman Center for Advanced Medicine, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States of America; Botswana-UPenn Partnership, 1836 Princess Marina Hospital, Private Bag BO 320, Gaborone, Botswana; Corresponding author at: 3400 Civic Center Blvd, Philadelphia, PA 19104, United States of America.Objective: Cervical cancer is a leading cause of cancer death in Sub-Saharan Africa. Go Further provides funds for prevention and screening in Sub-Saharan Africa, but access to treatment for invasive disease remains limited. This survey aims to assess delays in accessing curative-intent chemoradiotherapy for cervical cancer in countries receiving Go Further funding. Methods: Oncology providers in countries receiving Go Further funding (Botswana, Eswatini, Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Tanzania, Uganda, Zambia, Zimbabwe) and South Africa were invited to participate in a web-based survey beginning September 2023. Results: Fifteen oncology providers responded, with all countries except Malawi represented. Nearly half (46.3 %) reported wait time of ≥two months for chemoradiotherapy consultation. 93.3 %, 71.4 %, 53.7 % and 73.3 % had access to at least one CT, linear accelerator, cobalt, and brachytherapy machine, respectively. Majority (60 %) reported wait time of <one month to initiate chemoradiotherapy after staging. However, 28.6 % reported >95 % of patients complete external radiotherapy within 42 days, and 33 % reported >95 % of these patients receive brachytherapy. Only 26.7 % reported overall treatment time within 56 days for >95 % of patients. Lack of transportation, funding, and patient fear, were other treatment barriers reported. Conclusion: These results highlight the need for additional chemoradiotherapy resources in Go Further-funded countries. In addition to expanding radiotherapy, supplemental avenues to improve access in Sub-Saharan Africa include addressing barriers that increase wait times along the care continuum and implementing social support. This survey serves as a call to Go Further, highlighting the urgent need for resource allocation for cervical cancer treatment.http://www.sciencedirect.com/science/article/pii/S2352578925001353Radiation oncologyGlobal healthCervical cancerRadiotherapyAccess to healthcareSub-Saharan countries
spellingShingle Caroline G. Kernell
Megan Kassick
Jessica M. George
Chidinma P. Anakwenze
Edward L. Trimble
Surbhi Grover
Assessing delays in accessing and completing radiotherapy for cervical cancer treatment: A multicenter survey of oncology providers in go further-funded countries in Sub-Saharan Africa
Gynecologic Oncology Reports
Radiation oncology
Global health
Cervical cancer
Radiotherapy
Access to healthcare
Sub-Saharan countries
title Assessing delays in accessing and completing radiotherapy for cervical cancer treatment: A multicenter survey of oncology providers in go further-funded countries in Sub-Saharan Africa
title_full Assessing delays in accessing and completing radiotherapy for cervical cancer treatment: A multicenter survey of oncology providers in go further-funded countries in Sub-Saharan Africa
title_fullStr Assessing delays in accessing and completing radiotherapy for cervical cancer treatment: A multicenter survey of oncology providers in go further-funded countries in Sub-Saharan Africa
title_full_unstemmed Assessing delays in accessing and completing radiotherapy for cervical cancer treatment: A multicenter survey of oncology providers in go further-funded countries in Sub-Saharan Africa
title_short Assessing delays in accessing and completing radiotherapy for cervical cancer treatment: A multicenter survey of oncology providers in go further-funded countries in Sub-Saharan Africa
title_sort assessing delays in accessing and completing radiotherapy for cervical cancer treatment a multicenter survey of oncology providers in go further funded countries in sub saharan africa
topic Radiation oncology
Global health
Cervical cancer
Radiotherapy
Access to healthcare
Sub-Saharan countries
url http://www.sciencedirect.com/science/article/pii/S2352578925001353
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