Kizub Darya A, Zujewski JoAnne, Gralow Julie R, Ndoh Kingsley, Soko Udie, Dvaladze Allison L
The Everett Clinic, Everett, WA.
Leidos Biomedical Research, Fredrick, MD.
JCO Glob Oncol. 2020 Feb;6:49-55. doi: 10.1200/JGO.19.00219.
Breast and cervical cancer are the most common cancers among women in East and Southern Africa, where mortality remains high because of late diagnosis and limited access to treatment. We explored local approaches to breast and cervical cancer advocacy to identify the most pressing issues and opportunities for increasing the impact of civil society activities in the region.
Focus group discussions were conducted with participants of the 2016 Women's Empowerment Cancer Advocacy Network (WE CAN) Summit in Nairobi, Kenya. Discussions were audio-recorded, transcribed, coded, and analyzed for emergent themes. Results were presented to participants of 2019 WE CAN summit for cross-validation.
Four focus group discussions were conducted with 50 participants. Thirty-six (70%) identified as advocates, 30 (59%) as cancer survivors, 14 (27%) as nongovernmental organization representatives, 13 (25%) as researchers, 4 (8%) as clinicians, and 6 (8%) as policymakers. Although most participants focused on cancer awareness and screening/early detection, some noted that treatment was often unavailable and advocated for a broader strategy to improving access to care. Challenges to designing and implementing such a strategy included knowledge gaps in addressing late diagnosis and access to care, difficulty collaborating with like-minded organizations, approaching policymakers, and addressing treatment financing. Cancer coalitions, although rare, were crucial to building collaborations with ministries of health, policymakers, and international organizations that advanced breast and cervical cancer care.
Participants indicated that they would benefit from additional training about resource-appropriate best practices for improving breast and cervical cancer care and outcomes. Coalition-building and collaborations, including with oncologists and other medical professionals involved in cancer care, were crucial to leveraging limited resources, sharing lessons learned, and developing local solutions to common challenges.
乳腺癌和宫颈癌是东非和南部非洲女性中最常见的癌症，由于诊断延迟和治疗机会有限，该地区的死亡率仍然很高。我们探索了当地在乳腺癌和宫颈癌宣传方面的方法，以确定最紧迫的问题以及增加民间社会活动在该地区影响力的机会。
与2016年在肯尼亚内罗毕举行的妇女赋权癌症宣传网络（WE CAN）峰会的参与者进行了焦点小组讨论。讨论内容进行了录音、转录、编码，并分析了新出现的主题。结果提交给2019年WE CAN峰会的参与者进行交叉验证。
与50名参与者进行了4次焦点小组讨论。其中36人（70%）为宣传者，30人（59%）为癌症幸存者，14人（27%）为非政府组织代表，13人（25%）为研究人员，4人（8%）为临床医生，6人（8%）为政策制定者。尽管大多数参与者关注癌症意识和筛查/早期检测，但一些人指出治疗往往无法获得，并主张采取更广泛的战略来改善医疗服务的可及性。设计和实施这样一项战略的挑战包括在解决晚期诊断和医疗服务可及性方面的知识差距、难以与志同道合的组织合作、接触政策制定者以及解决治疗资金问题。癌症联盟虽然很少见，但对于与卫生部、政策制定者和推进乳腺癌和宫颈癌治疗的国际组织建立合作至关重要。
参与者表示，他们将从关于改善乳腺癌和宫颈癌护理及治疗效果的资源适当最佳实践的额外培训中受益。建立联盟和开展合作，包括与参与癌症护理的肿瘤学家和其他医学专业人员合作，对于利用有限资源、分享经验教训以及制定应对共同挑战的当地解决方案至关重要。
