Department of Biochemistry, University of Ibadan, Ibadan, Nigeria.
Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Int J Equity Health. 2023 Sep 11;22(1):189. doi: 10.1186/s12939-023-01962-y.
Cancer is a significant public health challenge globally, with nearly 2000 lives lost daily in Africa alone. Without adequate measures, mortality rates are likely to increase. The major challenge for cancer care in Africa is equity and prioritization, as cancer is not receiving adequate attention from policy-makers and strategic stakeholders in the healthcare space. This neglect is affecting the three primary tiers of cancer care: prevention, diagnosis, and treatment/management. To promote cancer care equity, addressing issues of equity and prioritization is crucial to ensure that everyone has an equal chance at cancer prevention, early detection, and appropriate care and follow-up treatment.
Using available literature, we provide an overview of the current state of cancer care in Africa and recommendations to close the gap.
We highlight several factors that contribute to cancer care inequity in Africa, including inadequate funding for cancer research, poor cancer education or awareness, inadequate screening or diagnostic facilities, lack of a well-organized and effective cancer registry system and access to care, shortage of specialized medical staff, high costs for screening, vaccination, and treatment, lack of technical capacity, poor vaccination response, and/or late presentation of patients for cancer screening. We also provide recommendations to address some of these obstacles to achieving cancer care equity. Our recommendations are divided into national-level initiatives and capacity-based initiatives, including cancer health promotion and awareness by healthcare professionals during every hospital visit, encouraging screening and vaccine uptake, ensuring operational regional and national cancer registries, improving healthcare budgeting for staff, equipment, and facilities, building expertise through specialty training, funding for cancer research, providing insurance coverage for cancer care, and implementing mobile health technology for telemedicine diagnosis.
Addressing challenges to cancer equity holistically would improve the likelihood of longer survival for cancer patients, lower the risk factors for groups that are already at risk, and ensure equitable access to cancer care on the continent. This study identifies the existing stance that African nations have on equity in cancer care, outlines the current constraints, and provides suggestions that could make the biggest difference in attaining equity in cancer care.
癌症是全球面临的重大公共卫生挑战,仅在非洲,每天就有近 2000 人因此失去生命。如果没有采取充分的措施,死亡率可能会上升。非洲癌症护理面临的主要挑战是公平性和优先级,因为癌症在医疗保健领域并没有得到决策者和战略利益相关者的足够重视。这种忽视影响了癌症护理的三个主要层次:预防、诊断和治疗/管理。为了促进癌症护理公平性,解决公平性和优先级问题至关重要,这可以确保每个人都有平等的机会进行癌症预防、早期发现以及获得适当的护理和后续治疗。
利用现有文献,我们概述了非洲癌症护理的现状,并提出了缩小差距的建议。
我们强调了导致非洲癌症护理不公平的几个因素,包括癌症研究资金不足、癌症教育或意识低下、筛查或诊断设施不足、缺乏组织良好且有效的癌症登记系统以及获得护理的机会、专业医疗人员短缺、筛查、疫苗接种和治疗费用高、技术能力不足、疫苗接种反应不佳以及/或患者癌症筛查就诊时间较晚。我们还提出了一些建议,以解决实现癌症护理公平性的这些障碍。我们的建议分为国家级倡议和基于能力的倡议,包括医疗保健专业人员在每次就诊时进行癌症健康促进和宣传、鼓励筛查和疫苗接种、确保运营区域和国家癌症登记处、改善工作人员、设备和设施的医疗保健预算、通过专业培训建立专业知识、为癌症研究提供资金、为癌症护理提供保险覆盖范围以及实施移动医疗技术进行远程医疗诊断。
全面应对癌症公平性挑战将提高癌症患者的生存机会,降低已经处于高危状态的人群的风险因素,并确保非洲大陆公平获得癌症护理。本研究确定了非洲国家在癌症护理公平性方面的现有立场,概述了当前的限制,并提供了可能在实现癌症护理公平性方面产生最大影响的建议。