Ngalla Calvin, Didymus Jaff, Manjuh Florence, Nwufor Marius, Nkfusai Joseph, Elit Laure, Fokom Domgue Joel
Women's Health Program, Cameroon Baptist Convention Health Services, Cameroon.
University of Buea, Cameroon.
Gynecol Oncol Rep. 2024 Aug 13;55:101485. doi: 10.1016/j.gore.2024.101485. eCollection 2024 Oct.
Cameroon is a low-and-middle income country (LMIC) with one of the highest incidence and mortality from cervical cancer in Africa. In this Central African country where the prevalence of human immunodeficiency virus (HIV) is high and the screening coverage is low, cervical cancer is the most deadly and the second most common cancer among women. Notwithstanding the growing burden of cervical cancer in Cameroon, most patients - often of lower socioeconomic status - continue to encounter multi-level barriers to timely and adequate care. These include the lack of physical and financial access to healthcare facilities, limited quality pathology, imaging and treatment services, ignorance of disease by the population, shortage of a well-trained oncology workfroce, which result in significant delays in gaining access to screening, diagnosis, treatment and care. This paper presents 3 cases of patients with advanced cervical cancer who had surgery (hysterectomy) as primary treatment, without appropriate post-surgical investigation to further specify disease stage, persistence of residual disease, and need for adjuvant chemoradiation. Pathology services and diagnostic imaging procedures remain scarce and underused in LMIC countries like Cameroon. Healthcare professionals involved in patient care lack adequate knowledge, skills and collaborative strategy to properly navigate these patients. To address these challenges, the health system should be reinforced with adequate infrastructures, sustainable funding should be secured to enhance universal health coverage and promote cancer prevention and control programs, multidisciplinary teams and coordination of care among providers should be improved, and relevant health indicators should be put in place to better monitor the quality of care delivered to patients who are mostly vulnerable and uninformed.
喀麦隆是一个中低收入国家（LMIC），其宫颈癌发病率和死亡率在非洲位居前列。在这个人类免疫缺陷病毒（HIV）流行率高且筛查覆盖率低的中非国家，宫颈癌是女性中最致命且第二常见的癌症。尽管喀麦隆宫颈癌负担日益加重，但大多数患者（通常社会经济地位较低）在获得及时、充分治疗方面仍面临多层次障碍。这些障碍包括难以实际获得和负担得起医疗保健设施、高质量病理学、影像学和治疗服务有限、民众对疾病缺乏了解、训练有素的肿瘤学工作人员短缺，这些导致在获得筛查、诊断、治疗和护理方面出现显著延误。本文介绍了3例晚期宫颈癌患者，她们接受了手术（子宫切除术）作为主要治疗方法，但术后未进行适当的检查以进一步明确疾病分期、残留疾病的持续情况以及辅助放化疗的必要性。在喀麦隆这样的中低收入国家，病理学服务和诊断成像程序仍然稀缺且未得到充分利用。参与患者护理的医疗保健专业人员缺乏足够的知识、技能和协作策略来妥善处理这些患者。为应对这些挑战，应加强卫生系统，配备充足的基础设施，确保可持续资金以加强全民健康覆盖并促进癌症预防和控制计划，改善多学科团队以及医疗服务提供者之间的护理协调，并制定相关健康指标以更好地监测为最脆弱和信息不足的患者提供的护理质量。
