College of Public Health, University of Nebraska Medical School, Omaha, NE, USA.
City University of New York Medical School, 160 Convent Avenue, New York, NY, 10031, USA.
BMC Cancer. 2020 Sep 30;20(1):939. doi: 10.1186/s12885-020-07439-3.
Cervical cancer is the most common cancer among women in Sub-Saharan countries, including Tanzania. While early detection and diagnosis are available in some parts of this large country, radiotherapy has been only available at the Ocean Road Cancer Institute (ORCI), in the capital city of Dar es Salaam and is just starting in a few regions.
The objective of this study was to compare the observed incidence of cervical cancer for the two remote regions of Mwanza in western Tanzania and Mbeya in southern Tanzania, based on their patients treated at the ORCI from 2011 to 2014.
The number patients referred and treated at ORCI were (120 from Mwanza, and 171 from Mbeya, representing 24.6 and 32.8% of the patients histopathologically confirmed in the two sites, respectively. The results showed significant underestimation of cervical cancer in the two regions. The vast majority of patients who were histopathologically-confirmed in their local regions (73.92% from Mwanza and 65.1% from Mbeya), but did not receive the needed radiotherapy treatment at the ORCI. The estimated incidence for the two regions based on the number of patients treated at the ORCI were underestimated by 53.9% for Mwanza and 68.9% for Mbeya.
Local establishment of radiotherapy treatment facilities in remote regions in Tanzania and similar other low-income countries is essential for providing effective treatment and improving survival of diagnosed cervical cancer patients. Linkage between the records of local remote hospitals and the main cancer treatment center in the capital city can also help support the emerging the population-based cancer registry at ORCI.
在撒哈拉以南非洲国家,包括坦桑尼亚,宫颈癌是女性中最常见的癌症。虽然该国部分地区提供早期检测和诊断服务,但放射治疗仅在首都达累斯萨拉姆的海洋路癌症研究所(ORCI)提供,并且刚刚在几个地区开始。
本研究的目的是根据 2011 年至 2014 年在 ORCI 接受治疗的患者,比较坦桑尼亚西部姆万扎和南部姆贝亚两个偏远地区的宫颈癌观察发病率。
转诊并在 ORCI 接受治疗的患者人数分别为(120 例来自姆万扎,171 例来自姆贝亚,分别代表两个地点病理确诊患者的 24.6%和 32.8%。结果显示,这两个地区的宫颈癌存在明显低估。绝大多数在当地地区经病理确诊的患者(73.92%来自姆万扎,65.1%来自姆贝亚),但未能在 ORCI 接受所需的放射治疗。根据在 ORCI 接受治疗的患者人数,这两个地区的估计发病率分别低估了 53.9%(姆万扎)和 68.9%(姆贝亚)。
在坦桑尼亚和类似的低收入国家的偏远地区建立放射治疗设施对于提供有效治疗和提高确诊宫颈癌患者的生存率至关重要。将当地偏远医院的记录与首都主要癌症治疗中心联系起来,也有助于支持 ORCI 新兴的基于人群的癌症登记处。