Songwe Mupeta, Lombe Dorothy, Msadabwe Susan, Munalula Mukatimui, Kamfwa Paul, Fundafunda Swali, Walubita Emily, Chisele Samson, Mudenda Victor, Mwanahamuntu Mulindi, Parham Groesbeck, Pfaendler Krista S
Department of Pathology, Adult Hospital, University Teaching Hospitals, Zambia.
Palmerston North Hospital Regional Cancer Treatment and Screening Services MidCentral, Radiation Oncology, Palmerston North, New Zealand; University of Otago.
J Cancer Policy. 2025 Sep;45:100608. doi: 10.1016/j.jcpo.2025.100608. Epub 2025 Jun 13.
Zambia has the third highest incidence of cervical cancer in the world. Patients with gynecological malignancy self-navigate by transmitting referral letters from practitioner to practitioner across different health levels and geographic localities. Specialized oncology services for women with gynecological malignancies are shared between two tertiary hospitals in the capital city: the Cancer Diseases Hospital and the Women and Newborn Hospital.
In 2020, a two-day gynecological malignancies multidisciplinary tumor board workshop targeted clinical oncologists, surgical oncologists, radiologists, pathologists, medical social workers, and nursing and palliative care practitioners. It aimed at harmonizing the functions, goals, and benefits of a multidisciplinary approach to patient navigation and cancer care.
Eleven participants from the six specialties attended the workshop. More than 70 % of the workshop participants have consistently attended the weekly virtual gynecological malignancies multidisciplinary tumor board meetings. Attendance of these meetings has expanded from practitioners within the capital Lusaka to other practitioners from all the nation's ten provinces. A virtual referral platform and patient dashboard were created. These platforms have improved the navigation of patients through the system via enhanced communication among practitioners.
Patient navigation through a multidisciplinary approach in a low-middle-income country is feasible. Further quantitative work is required to establish how this intervention has improved patient care and clinical research efforts for women with gynecological malignancies in Zambia.
Health service leaders in low-middle-income countries need to re-examine the workforce and financing to determine how navigation support can be implemented across the cancer care continuum.
赞比亚宫颈癌发病率位居世界第三。妇科恶性肿瘤患者需自行辗转，在不同医疗层级和地理位置的医疗机构之间传递转诊信。首都两家三级医院——癌症疾病医院和妇女与新生儿医院，共同为患有妇科恶性肿瘤的女性提供专业肿瘤服务。
2020年，举办了一场为期两天的妇科恶性肿瘤多学科肿瘤委员会研讨会，参会人员包括临床肿瘤学家、外科肿瘤学家、放射科医生、病理学家、医学社会工作者以及护理和姑息治疗从业者。其目的是协调多学科方法在患者转诊及癌症护理方面的功能、目标和益处。
六个专业的11名参与者参加了此次研讨会。超过70%的研讨会参与者一直参加每周的妇科恶性肿瘤多学科虚拟肿瘤委员会会议。这些会议的参会人员已从首都卢萨卡的从业者扩大到全国十个省份的其他从业者。创建了一个虚拟转诊平台和患者信息平台。通过加强从业者之间的沟通，这些平台改善了患者在整个系统中的转诊流程。
在中低收入国家，通过多学科方法进行患者转诊是可行的。需要进一步开展定量研究，以确定这一干预措施如何改善了赞比亚妇科恶性肿瘤女性患者的护理及临床研究工作。
中低收入国家的卫生服务领导者需要重新审视劳动力和资金问题，以确定如何在癌症护理的全过程中实施转诊支持。
