Cargando…
Delays in seeking, reaching and access to quality cancer care in sub-Saharan Africa: a systematic review
OBJECTIVES: Late presentation and delays in diagnosis and treatment consistently translate into poor outcomes in sub-Saharan Africa (SSA). The aim of this study was to collate and appraise the factors influencing diagnostic and treatment delays of adult solid tumours in SSA. DESIGN: Systematic revie...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10106057/ https://www.ncbi.nlm.nih.gov/pubmed/37055211 http://dx.doi.org/10.1136/bmjopen-2022-067715 |
_version_ | 1785026341684379648 |
---|---|
author | Lombe, Dorothy Chilambe Mwamba, Monde Msadabwe, Susan Bond, Virginia Simwinga, Musonda Ssemata, Andrew Sentoogo Muhumuza, Richard Seeley, Janet Mwaka, Amos Deogratius Aggarwal, Ajay |
author_facet | Lombe, Dorothy Chilambe Mwamba, Monde Msadabwe, Susan Bond, Virginia Simwinga, Musonda Ssemata, Andrew Sentoogo Muhumuza, Richard Seeley, Janet Mwaka, Amos Deogratius Aggarwal, Ajay |
author_sort | Lombe, Dorothy Chilambe |
collection | PubMed |
description | OBJECTIVES: Late presentation and delays in diagnosis and treatment consistently translate into poor outcomes in sub-Saharan Africa (SSA). The aim of this study was to collate and appraise the factors influencing diagnostic and treatment delays of adult solid tumours in SSA. DESIGN: Systematic review with assessment of bias using Risk of Bias in Non-randomised Studies of Exposures (ROBINS-E) tool. DATA SOURCES: PubMed and Embase, for publications from January 1995 to March 2021. ELIGIBILITY CRITERIA: Inclusion criteria: quantitative or mixed-method research, publications in English, on solid cancers in SSA countries. Exclusion criteria: paediatric populations, haematologic malignancies, and assessments of public perceptions and awareness of cancer (since the focus was on patients with a cancer diagnosis and treatment pathways). DATA EXTRACTION AND SYNTHESIS: Two reviewers extracted and validated the studies. Data included year of publication; country; demographic characteristics; country-level setting; disease subsite; study design; type of delay, reasons for delay and primary outcomes. RESULTS: 57 out of 193 full-text reviews were included. 40% were from Nigeria or Ethiopia. 70% focused on breast or cervical cancer. 43 studies had a high risk of bias at preliminary stages of quality assessment. 14 studies met the criteria for full assessment and all totaled to either high or very high risk of bias across seven domains. Reasons for delays included high costs of diagnostic and treatment services; lack of coordination between primary, secondary and tertiary healthcare sectors; inadequate staffing; and continued reliance on traditional healers and complimentary medicines. CONCLUSIONS: Robust research to inform policy on the barriers to quality cancer care in SSA is absent. The focus of most research is on breast and cervical cancers. Research outputs are from few countries. It is imperative that we investigate the complex interaction of these factors to build resilient and effective cancer control programmes. |
format | Online Article Text |
id | pubmed-10106057 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-101060572023-04-17 Delays in seeking, reaching and access to quality cancer care in sub-Saharan Africa: a systematic review Lombe, Dorothy Chilambe Mwamba, Monde Msadabwe, Susan Bond, Virginia Simwinga, Musonda Ssemata, Andrew Sentoogo Muhumuza, Richard Seeley, Janet Mwaka, Amos Deogratius Aggarwal, Ajay BMJ Open Health Policy OBJECTIVES: Late presentation and delays in diagnosis and treatment consistently translate into poor outcomes in sub-Saharan Africa (SSA). The aim of this study was to collate and appraise the factors influencing diagnostic and treatment delays of adult solid tumours in SSA. DESIGN: Systematic review with assessment of bias using Risk of Bias in Non-randomised Studies of Exposures (ROBINS-E) tool. DATA SOURCES: PubMed and Embase, for publications from January 1995 to March 2021. ELIGIBILITY CRITERIA: Inclusion criteria: quantitative or mixed-method research, publications in English, on solid cancers in SSA countries. Exclusion criteria: paediatric populations, haematologic malignancies, and assessments of public perceptions and awareness of cancer (since the focus was on patients with a cancer diagnosis and treatment pathways). DATA EXTRACTION AND SYNTHESIS: Two reviewers extracted and validated the studies. Data included year of publication; country; demographic characteristics; country-level setting; disease subsite; study design; type of delay, reasons for delay and primary outcomes. RESULTS: 57 out of 193 full-text reviews were included. 40% were from Nigeria or Ethiopia. 70% focused on breast or cervical cancer. 43 studies had a high risk of bias at preliminary stages of quality assessment. 14 studies met the criteria for full assessment and all totaled to either high or very high risk of bias across seven domains. Reasons for delays included high costs of diagnostic and treatment services; lack of coordination between primary, secondary and tertiary healthcare sectors; inadequate staffing; and continued reliance on traditional healers and complimentary medicines. CONCLUSIONS: Robust research to inform policy on the barriers to quality cancer care in SSA is absent. The focus of most research is on breast and cervical cancers. Research outputs are from few countries. It is imperative that we investigate the complex interaction of these factors to build resilient and effective cancer control programmes. BMJ Publishing Group 2023-04-13 /pmc/articles/PMC10106057/ /pubmed/37055211 http://dx.doi.org/10.1136/bmjopen-2022-067715 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Health Policy Lombe, Dorothy Chilambe Mwamba, Monde Msadabwe, Susan Bond, Virginia Simwinga, Musonda Ssemata, Andrew Sentoogo Muhumuza, Richard Seeley, Janet Mwaka, Amos Deogratius Aggarwal, Ajay Delays in seeking, reaching and access to quality cancer care in sub-Saharan Africa: a systematic review |
title | Delays in seeking, reaching and access to quality cancer care in sub-Saharan Africa: a systematic review |
title_full | Delays in seeking, reaching and access to quality cancer care in sub-Saharan Africa: a systematic review |
title_fullStr | Delays in seeking, reaching and access to quality cancer care in sub-Saharan Africa: a systematic review |
title_full_unstemmed | Delays in seeking, reaching and access to quality cancer care in sub-Saharan Africa: a systematic review |
title_short | Delays in seeking, reaching and access to quality cancer care in sub-Saharan Africa: a systematic review |
title_sort | delays in seeking, reaching and access to quality cancer care in sub-saharan africa: a systematic review |
topic | Health Policy |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10106057/ https://www.ncbi.nlm.nih.gov/pubmed/37055211 http://dx.doi.org/10.1136/bmjopen-2022-067715 |
work_keys_str_mv | AT lombedorothychilambe delaysinseekingreachingandaccesstoqualitycancercareinsubsaharanafricaasystematicreview AT mwambamonde delaysinseekingreachingandaccesstoqualitycancercareinsubsaharanafricaasystematicreview AT msadabwesusan delaysinseekingreachingandaccesstoqualitycancercareinsubsaharanafricaasystematicreview AT bondvirginia delaysinseekingreachingandaccesstoqualitycancercareinsubsaharanafricaasystematicreview AT simwingamusonda delaysinseekingreachingandaccesstoqualitycancercareinsubsaharanafricaasystematicreview AT ssemataandrewsentoogo delaysinseekingreachingandaccesstoqualitycancercareinsubsaharanafricaasystematicreview AT muhumuzarichard delaysinseekingreachingandaccesstoqualitycancercareinsubsaharanafricaasystematicreview AT seeleyjanet delaysinseekingreachingandaccesstoqualitycancercareinsubsaharanafricaasystematicreview AT mwakaamosdeogratius delaysinseekingreachingandaccesstoqualitycancercareinsubsaharanafricaasystematicreview AT aggarwalajay delaysinseekingreachingandaccesstoqualitycancercareinsubsaharanafricaasystematicreview |