Anakwenze Chidinma P, Allanson Emma, Ewongwo Agnes, Lumley Christian, Bazzett-Matabele Lisa, Msadabwe Susan C, Kamfwa Paul, Shouman Tarek, Lombe Dorothy, Rubagumya Fidel, Polo Alfredo, Ntekim Atara, Vanderpuye Verna, Ghebre Rahel, Kochbati Lofti, Awol Munir, Gnangnon Freddy Houéhanou Rodrigue, Snyman Leon, Fokom Domgue Joël, Incrocci Luca, Ndlovu Ntokozo, Razakanaivo Malala, Abdel-Wahab May, Trimble Edward, Schmeler Kathleen, Simonds Hannah, Grover Surbhi
Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.
Division of Obstetrics & Gynecology, King Edward Memorial Hospital for Women, Subiaco, Australia, and Institute for Health Research, University of Notre Dame, Fremantle, Australia.
Int J Radiat Oncol Biol Phys. 2024 Mar 1;118(3):595-604. doi: 10.1016/j.ijrobp.2023.10.036. Epub 2023 Nov 18.
To meet the demand for cervical cancer care in Africa, access to surgical and radiation therapy services needs to be understood. We thus mapped the availability of gynecologic and radiation therapy equipment and staffing for treating cervical cancer.
We collected data on gynecologic and radiation oncology staffing, equipment, and infrastructure capacities across Africa. Data was obtained from February to July 2021 through collaboration with international partners using Research Electronic Data Capture. Cancer incidence was taken from the International Agency for Research on Cancer's GLOBOCAN 2020 database. Treatment capacity, including the numbers of radiation oncologists, radiation therapists, physicists, gynecologic oncologists, and hospitals performing gynecologic surgeries, was calculated per 1000 cervical cancer cases. Adequate capacity was defined as 2 radiation oncologists and 2 gynecologic oncologists per 1000 cervical cancer cases.
Forty-three of 54 African countries (79.6%) responded, and data were not reported for 11 countries (20.4%). Respondents from 31 countries (57.4%) reported access to specialist gynecologic oncology services, but staffing was adequate in only 11 countries (20.4%). Six countries (11%) reported that generalist obstetrician-gynecologists perform radical hysterectomies. Radiation oncologist access was available in 39 countries (72.2%), but staffing was adequate in only 16 countries (29.6%). Six countries (11%) had adequate staffing for both gynecologic and radiation oncology; 7 countries (13%) had no radiation or gynecologic oncologists. Access to external beam radiation therapy was available in 31 countries (57.4%), and access to brachytherapy was available in 25 countries (46.3%). The number of countries with training programs in gynecologic oncology, radiation oncology, medical physics, and radiation therapy were 14 (26%), 16 (30%), 11 (20%), and 17 (31%), respectively.
We identified areas needing comprehensive cervical cancer care infrastructure, human resources, and training programs. There are major gaps in access to radiation oncologists and trained gynecologic oncologists in Africa.
为满足非洲宫颈癌护理的需求，需要了解手术和放射治疗服务的可及性。因此，我们绘制了用于治疗宫颈癌的妇科和放射治疗设备及人员配备情况。
我们收集了非洲各地妇科和放射肿瘤学人员配备、设备及基础设施能力的数据。数据于2021年2月至7月通过与国际伙伴合作，使用研究电子数据采集系统获得。癌症发病率取自国际癌症研究机构的2020年全球癌症数据库。计算每1000例宫颈癌病例的治疗能力，包括放射肿瘤学家、放射治疗师、物理学家、妇科肿瘤学家的数量以及进行妇科手术的医院数量。充足的能力定义为每1000例宫颈癌病例有2名放射肿瘤学家和2名妇科肿瘤学家。
54个非洲国家中有43个（79.6%）作出回应，11个国家（20.4%）未报告数据。31个国家（57.4%）的受访者表示可获得专科妇科肿瘤学服务，但只有11个国家（20.4%）人员配备充足。6个国家（11%）报告称普通妇产科医生进行根治性子宫切除术。39个国家（72.2%）可获得放射肿瘤学家服务，但只有16个国家（29.6%）人员配备充足。6个国家（11%）妇科和放射肿瘤学人员配备均充足；7个国家（13%）没有放射或妇科肿瘤学家。31个国家（57.4%）可获得外照射放疗，25个国家（46.3%）可获得近距离放疗。有妇科肿瘤学、放射肿瘤学、医学物理和放射治疗培训项目的国家数量分别为14个（26%）、16个（30%）、11个（20%）和17个（31%）。
我们确定了需要全面宫颈癌护理基础设施、人力资源和培训项目的领域。非洲在获得放射肿瘤学家和训练有素的妇科肿瘤学家方面存在重大差距。
