Ruzindana Kenneth, Anorlu Rose I
Department of Obstetrics and Gynecology, College of Medicine, and Health Sciences, University of Rwanda, Kigali, Rwanda.
Kigali University Teaching Hospital, Kigali, Rwanda.
Int J Gynaecol Obstet. 2025 Sep;171 Suppl 1:210-220. doi: 10.1002/ijgo.70278.
Gynecologic cancers pose a substantial global health challenge, disproportionately affecting women in low- and middle-income countries (LMICs). Although high-income countries (HICs) have witnessed advancements in prevention, early detection, and treatment, LMICs continue to experience elevated incidence and mortality rates, coupled with diminished survival outcomes. In 2022, these cancers accounted for approximately 1.4 million new cases and over 600 000 deaths worldwide, concentrated primarily in LMICs. This disparity stems from a confluence of systemic factors, including limited access to health care, absent or inadequate cervical cancer screening programs, underdeveloped healthcare infrastructure, and socioeconomic barriers such as poverty and lack of health insurance. Furthermore, shortages of trained specialists, advanced diagnostic tools, and effective treatment modalities hinder care delivery in resource-constrained settings. This paper delves into the root causes of these disparities, exploring the systemic and structural obstacles impeding equitable gynecologic oncology care in LMICs. Evidence-based recommendations will focus on expanding access to preventative measures like HPV vaccination and cervical cancer screening, enhancing timely diagnosis and treatment, and bolstering healthcare systems to address workforce and infrastructure deficits. Achieving equitable outcomes requires concerted global efforts to bridge resource gaps, prioritize health system reforms, and cultivate partnerships between HICs and LMICs for expertise and resource sharing. Ultimately, addressing these disparities is essential to ensure that all women, irrespective of geographic location or socioeconomic status, can access quality care, thereby mitigating the global burden of gynecologic cancers and improving survival.
妇科癌症对全球健康构成了重大挑战,对低收入和中等收入国家(LMICs)的女性影响尤为严重。尽管高收入国家(HICs)在预防、早期检测和治疗方面取得了进展,但LMICs的发病率和死亡率仍居高不下,生存结果也较差。2022年,这些癌症在全球约占140万新发病例和60多万人死亡,主要集中在LMICs。这种差异源于一系列系统性因素,包括获得医疗保健的机会有限、宫颈癌筛查项目缺失或不足、医疗基础设施不发达以及贫困和缺乏医疗保险等社会经济障碍。此外,训练有素的专家、先进的诊断工具和有效的治疗方式短缺,阻碍了资源有限地区的医疗服务提供。本文深入探讨了这些差异的根本原因,探讨了阻碍LMICs公平妇科肿瘤护理的系统性和结构性障碍。基于证据的建议将侧重于扩大获得HPV疫苗接种和宫颈癌筛查等预防措施的机会,加强及时诊断和治疗,并加强医疗系统以解决劳动力和基础设施短缺问题。实现公平结果需要全球共同努力,弥合资源差距,优先进行卫生系统改革,并促进HICs和LMICs之间的伙伴关系以实现专业知识和资源共享。最终,解决这些差异对于确保所有女性,无论地理位置或社会经济地位如何,都能获得优质护理至关重要,从而减轻全球妇科癌症负担并提高生存率。