Matovu Nicholas, Mugisha Noleb Mugume, Jatho Alfred, McShane Charlene M
Uganda Cancer Institute, Kampala, Uganda.
Centre for Public Health, Queen's University Belfast, Belfast, UK.
Future Oncol. 2024 Dec;20(39):3169-3177. doi: 10.1080/14796694.2024.2416885. Epub 2024 Oct 25.
The incidence of colorectal cancer (CRC) is increasing in Uganda but there is limited local research to guide policy and programming for CRC prevention and control. A stakeholder engagement workshop took place in Kampala on 19 March 2024 to identify challenges and opportunities for CRC prevention and control in Uganda. A total of 30 stakeholders with expertise in CRC primary and secondary prevention, diagnosis, treatment, palliative care as well as cancer survivors participated in the workshop. Key challenges for primary prevention included low knowledge/awareness of CRC among the general population and health workers, and rising prevalence of CRC related risk factors. Limited CRC screening, diagnostic facilities and specialists were identified as barriers to diagnosis. Treatment related challenges included limited accessibility to surgical services and drugs, late-stage presentation leading to poor treatment response, treatment abandonment and drug related toxicity. Lack of universal health coverage policies, limited community-based cancer awareness programs, and lack of national cancer registries were cited as policy and economics challenges. Opportunities to address these challenges were discussed. Our findings highlight areas for further research and prioritization to address Uganda's growing CRC burden and may be applicable to other low-resource settings.
乌干达结直肠癌(CRC)的发病率正在上升,但当地用于指导CRC预防和控制政策及规划的研究有限。2024年3月19日在坎帕拉举办了一次利益相关者参与研讨会,以确定乌干达CRC预防和控制的挑战与机遇。共有30名在CRC一级和二级预防、诊断、治疗、姑息治疗以及癌症幸存者方面具有专业知识的利益相关者参加了此次研讨会。一级预防的主要挑战包括普通人群和卫生工作者对CRC的知识/认识水平较低,以及CRC相关风险因素的患病率不断上升。CRC筛查、诊断设施和专家有限被确定为诊断的障碍。与治疗相关的挑战包括手术服务和药物的可及性有限、晚期就诊导致治疗反应不佳、治疗中断和药物相关毒性。缺乏全民健康覆盖政策、基于社区的癌症意识项目有限以及缺乏国家癌症登记处被列为政策和经济方面的挑战。会上讨论了应对这些挑战的机遇。我们的研究结果突出了进一步研究和确定优先事项的领域,以应对乌干达日益增加的CRC负担,并且可能适用于其他资源匮乏地区。