Gnangnon Freddy Houéhanou Rodrigue, Lawani Ismaïl, Knight Stephen R, Parenté Alexis, Dossou Francis Moïse, Totah Terrence, Houinato Dismand Stephan, Blanquet Véronique, Preux Pierre-Marie, Harrison Ewen M
Laboratory of Epidemiology of Chronic and Neurological Diseases, University of Abomey-Calavi, Cotonou, Benin.
Department of Visceral Surgery, National Teaching Hospital-Hubert Koutoukou Maga, CNHU-HKM, Cotonou, Benin.
BMC Cancer. 2024 Dec 18;24(1):1529. doi: 10.1186/s12885-024-13267-6.
While breast cancer incidence rates in Sub-Saharan Africa (SSA) are among the lowest worldwide, mortality rates remain among the highest, reflecting particularly poor survival. Only a few studies in SSA have investigated the capabilities of treatment services to adequately provide a continuum of care for breast cancer. Our aim was to assess the availability of diagnostic facilities and adjuvant therapies in hospitals performing breast cancer surgery in SSA.
We performed a secondary analysis of the GlobalSurg3 study data collected in the SSA region. The GlobalSurg 3 study is a multicenter, international, prospective, observational study of hospitals providing surgical services for cancer patients (including breast cancer) around the world. A total of 47 hospitals from 15 SSA countries and 43 cities were included between April 1, 2018, and Jan 31, 2019.
One-third of hospitals covered a population greater than two million (n = 17; 36.2%). Ultrasound was available in all hospitals; however, it was not consistently functional in 11 hospitals (23.4%). Only half of the included hospitals (n = 26, 55.3%) had access to a full-time pathologist, whilst the multidisciplinary team (MDT) approach was absent in 42.4% of hospitals. Radiotherapy equipment was only available in nine hospitals (19.1%). Only half of the hospitals (n = 25, 53.1%) had chemotherapy drugs available on site. In nine hospitals (19.1%), patients had to travel more than 50 km to access chemotherapy drugs.
Outcomes for breast cancer patients in SSA cannot be improved without significant investments in pathology, surgical and oncological treatment pathways to provide timely diagnostic and effective treatment.
虽然撒哈拉以南非洲地区（SSA）的乳腺癌发病率是全球最低的地区之一，但其死亡率却位居全球最高之列，这尤其反映出该地区患者的生存率极低。SSA地区仅有少数研究调查了治疗服务为乳腺癌患者提供连续护理的能力。我们的目的是评估SSA地区开展乳腺癌手术的医院中诊断设施和辅助治疗的可及性。
我们对在SSA地区收集的GlobalSurg3研究数据进行了二次分析。GlobalSurg 3研究是一项多中心、国际性、前瞻性观察性研究，研究对象为全球范围内为癌症患者（包括乳腺癌患者）提供手术服务的医院。在2018年4月1日至2019年1月31日期间，共纳入了来自SSA地区15个国家43个城市的47家医院。
三分之一的医院服务人口超过200万（n = 17；36.2%）。所有医院均配备了超声设备；然而，11家医院（23.4%）的超声设备并非始终能正常使用。纳入研究的医院中只有一半（n = 26，55.3%）有全职病理学家，42.4%的医院未采用多学科团队（MDT）治疗模式。只有9家医院（19.1%）有放疗设备。只有一半的医院（n = 25，53.1%）现场备有化疗药物。在9家医院（19.1%），患者必须前往50多公里外才能获得化疗药物。
如果不在病理、手术和肿瘤治疗途径方面进行大量投资，以提供及时的诊断和有效的治疗，SSA地区乳腺癌患者的治疗结局就无法得到改善。
