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Fetene D, Taylor L, Ferrell B, Deribe B, Abdella J, Aynalem A. Factors affecting need and utilization of palliative care services among Ethiopian women in an oncology department: A hospital-based cross-sectional study. Palliat Care Soc Pract 2024; 18:26323524241253625. [PMID: 38800039 PMCID: PMC11127578 DOI: 10.1177/26323524241253625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 04/21/2024] [Indexed: 05/29/2024] Open
Abstract
Background Palliative care, which aims to alleviate physical and emotional distress from cancer, is underutilized in many African healthcare systems. Therefore, there is a lack of data on the need and utilization of palliative care services among women with breast cancer in Ethiopia. Objectives The goal of this study was to identify the level of need and utilization of palliative care services and identify associated factors among women in an oncology department of Hawassa comprehensive and specialized hospitals. Design Hospital-based cross-sectional study. Methods A total of 121 women age ⩾18 years old with breast cancer participated from 1 August to 30 October 2021. A hospital-based consecutive sampling technique was used. Data regarding the need and utilization of palliative care services were collected via questionnaire and interview, entered using EpiData 4.6.0.6, and analyzed by SPSS version 25. Variables with p < 0.25 were considered for multivariate analysis, and those with p < 0.05 indicate an association with palliative care utilization. Result Seventy-two (59.5%) had worse utilization of palliative care services, with higher odds in rural areas (adjusted odds ratio = 11.82). Conclusion The study findings indicated that more than half of the study participants had worse utilization of palliative care services, with rural living being a contributing factor.
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Affiliation(s)
- Deriba Fetene
- Department of Nursing, School of Health Sciences, College of Medicine and Health Sciences, Madda Walabu University, Bale Robe, Oromia 247, Ethiopia
| | - Lesley Taylor
- Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA
| | - Betty Ferrell
- Division of Nursing Research and Education, City of Hope Medical Center, Duarte, CA, USA
| | - Bedilu Deribe
- School of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Jabir Abdella
- School of Nursing, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Amdehiwot Aynalem
- School of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Ssedyabane F, Niyonzima N, Nambi Najjuma J, Birungi A, Atwine R, Tusubira D, Randall TC, Castro CM, Lee H, Ngonzi J. Prevalence of cervical intraepithelial lesions and associated factors among women attending a cervical cancer clinic in Western Uganda; results based on Pap smear cytology. SAGE Open Med 2024; 12:20503121241252265. [PMID: 38764539 PMCID: PMC11100407 DOI: 10.1177/20503121241252265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/15/2024] [Indexed: 05/21/2024] Open
Abstract
Introduction There are high incidence and mortality rates of cervical cancer among females in East Africa. This is exacerbated by limited up-to-date data on premalignant lesions and associated factors in this setting. In this study, we determined the prevalence of cervical intraepithelial lesions and associated factors among women attending the Mbarara Regional Referral Hospital cervical cancer clinic in Southwestern Uganda. Methods In this cross-sectional study, 364 participants were recruited from among women attending the Mbarara Regional Referral Hospital cervical cancer clinic from 1 April to 30 June 2023. On consent, the study nurse collected demographic data and Pap smears, which were microscopically examined and reported by a laboratory scientist and a pathologist following the Bethesda grading system (2014). Statistical analyses were done in STATA version 17, using proportions, Chi-square, bivariate, and multivariate logistic regression analysis to determine associated factors at ⩽0.05 significance level. Results The mean age of participants was 41.9 years. A third of all study participants (37.6%, 132/351) were contraceptive users, mostly hormonal contraceptives (87.1%, 115/132). Almost 88% (307/351) had an unknown Human Papilloma Virus status. The prevalence of cervical intraepithelial lesions among our study participants was 6.6% (23/351), of which 73.9% (17/23) were low-grade squamous intraepithelial lesions. More than half (9/17, 52.9%) of low-grade squamous intraepithelial lesions were active hormonal contraceptive users. Use of hormonal contraceptives (OR: 3.032, p: 0.0253), use of intrauterine devices (OR: 6.284, p: 0.039), and any family history of cervical cancer (OR: 4.144, p: 0.049) were significantly associated with cervical intraepithelial lesions. Conclusion The prevalence of cervical intraepithelial lesions was 6.6%, lower than global estimates. Use of hormonal and intrauterine device contraceptives, as well as family history of cervical cancer, were significantly associated with cervical intraepithelial lesions among our study population. Prospective studies are recommended to further understand associations between different types of intrauterine devices and hormonal contraceptives, and cervical lesions.
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Affiliation(s)
- Frank Ssedyabane
- Department of Medical Laboratory Science, Faculty of Medicine, Mbarara University of Science of Science and Technology, Mbarara, Uganda
| | | | - Josephine Nambi Najjuma
- Department of Nursing, Mbarara University of Science of Science and Technology, Mbarara, Uganda
| | - Abraham Birungi
- Department of Pathology, Mbarara University of Science of Science and Technology, Mbarara Uganda
| | - Raymond Atwine
- Department of Pathology, Mbarara University of Science of Science and Technology, Mbarara Uganda
| | - Deusdedit Tusubira
- Department of Biochemistry, Mbarara University of Science of Science and Technology, Mbarara, Uganda
| | - Thomas C Randall
- Department of Global Health and Social Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Cesar M Castro
- Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Hakho Lee
- Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Joseph Ngonzi
- Department of Obstetrics and Gynecology, Mbarara University of Science of Science and Technology, Mbarara, Uganda
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Asuquo EO, Absolom K, Ebenso B, Allsop MJ. Symptoms, concerns, and experiences of women living with and beyond breast cancer in Africa: A mixed-methods systematic review. Psychooncology 2024; 33:e6342. [PMID: 38747633 DOI: 10.1002/pon.6342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 03/10/2024] [Accepted: 03/30/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVE A mixed-methods systematic review to determine reported symptoms, concerns, and experiences of women living with and beyond breast cancer in Africa. METHODS Literature searches were conducted in Medline, Embase, PsycINFO, Global Health, Web of Science, CINAHL, and the Cochrane Library. Quantitative and qualitative studies that comprised study populations of women with breast cancer from countries in Africa, detailing symptoms, concerns, and experiences of living with and beyond breast cancer were included. Inductive framework analysis was applied to organise existing literature with the Adversity, Restoration, and Compatibility framework and quality was assessed using the Mixed Methods Appraisal Tool. RESULTS In total, 48 studies were included, comprising quantitative (n = 24), qualitative (n = 23) and mixed method (n = 1) studies. Women reported multiple complex and burdensome symptoms at all stages of the breast cancer disease trajectory. Multiple pervasive factors influencing participants' experiences included a lack of cancer knowledge, being removed from decision-making, religion, and the presence and use of traditional medicines. Literature relating to benefit finding, understanding identity for the future, and broader perspectives of well-being was absent. CONCLUSIONS This review contributes insights and mapping of symptoms, concerns, and experiences of women with breast cancer in Africa. There is a great necessity to increase an understanding of the needs and experiences of women with breast cancer in Africa following cancer treatment, stages of remission, and longer-term monitoring and follow-up. This is required to ensure access to prompt and timely clinical and individualized supportive care for women with breast cancer in Africa.
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Affiliation(s)
- Eme O Asuquo
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Kate Absolom
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Bassey Ebenso
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Mathew J Allsop
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, Jemal A. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2024; 74:229-263. [PMID: 38572751 DOI: 10.3322/caac.21834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 04/05/2024] Open
Abstract
This article presents global cancer statistics by world region for the year 2022 based on updated estimates from the International Agency for Research on Cancer (IARC). There were close to 20 million new cases of cancer in the year 2022 (including nonmelanoma skin cancers [NMSCs]) alongside 9.7 million deaths from cancer (including NMSC). The estimates suggest that approximately one in five men or women develop cancer in a lifetime, whereas around one in nine men and one in 12 women die from it. Lung cancer was the most frequently diagnosed cancer in 2022, responsible for almost 2.5 million new cases, or one in eight cancers worldwide (12.4% of all cancers globally), followed by cancers of the female breast (11.6%), colorectum (9.6%), prostate (7.3%), and stomach (4.9%). Lung cancer was also the leading cause of cancer death, with an estimated 1.8 million deaths (18.7%), followed by colorectal (9.3%), liver (7.8%), female breast (6.9%), and stomach (6.8%) cancers. Breast cancer and lung cancer were the most frequent cancers in women and men, respectively (both cases and deaths). Incidence rates (including NMSC) varied from four-fold to five-fold across world regions, from over 500 in Australia/New Zealand (507.9 per 100,000) to under 100 in Western Africa (97.1 per 100,000) among men, and from over 400 in Australia/New Zealand (410.5 per 100,000) to close to 100 in South-Central Asia (103.3 per 100,000) among women. The authors examine the geographic variability across 20 world regions for the 10 leading cancer types, discussing recent trends, the underlying determinants, and the prospects for global cancer prevention and control. With demographics-based predictions indicating that the number of new cases of cancer will reach 35 million by 2050, investments in prevention, including the targeting of key risk factors for cancer (including smoking, overweight and obesity, and infection), could avert millions of future cancer diagnoses and save many lives worldwide, bringing huge economic as well as societal dividends to countries over the forthcoming decades.
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Affiliation(s)
- Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Mathieu Laversanne
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Hyuna Sung
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Jacques Ferlay
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Rebecca L Siegel
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | | | - Ahmedin Jemal
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
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Wu B, Li Y, Shi B, Zhang X, Lai Y, Cui F, Bai X, Xiang W, Geng G, Liu B, Jiao M, Wu Q, Yang H, Zhang C, Liu X, Tian Y, Li H. Temporal trends of breast cancer burden in the Western Pacific Region from 1990 to 2044: Implications from the Global Burden of Disease Study 2019. J Adv Res 2024; 59:189-199. [PMID: 37422280 PMCID: PMC11082062 DOI: 10.1016/j.jare.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 06/07/2023] [Accepted: 07/05/2023] [Indexed: 07/10/2023] Open
Abstract
INTRODUCTION Breast cancer (BC) is a malignant disease that occurs worldwide and poses serious health burden. OBJECTIVES To assess the prevalence of BC burden in the Western Pacific region (WPR) from 1990 to 2019, and to predict trends from 2020 to 2044. To analyze the driving factors and put forward the region-oriented improvement. METHODS Based on the Global Burden of Disease Study 2019, BC cases, deaths, disability-adjusted life years (DALYs) cases, age-standardized incidence rate (ASIR), age-standardized death rate (ASDR), and age-standardized DALYs rate in WPR from 1990 to 2019 was obtained and analysed. Age-period-cohort (APC) model was used to analyze age, period, and cohort effects in BC, and Bayesian APC (BAPC) was used to predict trends over the next 25 years. RESULTS In conclusion, BC incidence and deaths in the WPR have increased rapidly over the past 30 years and are expected to continue to increase between 2020 and 2044. Among behavioral and metabolic factors, high body-mass index was the main risk factor for BC mortality in middle-income countries, whereas alcohol use was the main risk factor in Japan. Age is a key factor in the development of BC, with 40 years being the critical point. Incidence trends coincide with the course of economic development. CONCLUSIONS The BC burden remains an essential public health issue in the WPR and will increase substantially in the future. More efforts should be made in middle-income countries to prompt the health behavior and minimize the burden of BC because these nations accounts for the majority of BC burden in the WPR.
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Affiliation(s)
- Bing Wu
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Ye Li
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China.
| | - Baoguo Shi
- Department of Economics, School of Economics, Minzu University of China, Beijing, China.
| | - Xiyu Zhang
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China; Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Yongqiang Lai
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Xiaodan Bai
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Wenjing Xiang
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Guihong Geng
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Bei Liu
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Mingli Jiao
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Qunhong Wu
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Huiying Yang
- The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Chenxi Zhang
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Xinwei Liu
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yulu Tian
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Hongyu Li
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
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Pizzato M, Santucci C, Parazzini F, Negri E, La Vecchia C. Cancer mortality patterns in selected Northern and Southern African countries. Eur J Cancer Prev 2024; 33:192-199. [PMID: 37997906 DOI: 10.1097/cej.0000000000000852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
BACKGROUND Non-communicable diseases have been rapidly increasing in African countries. We provided updated cancer death patterns in selected African countries over the last two decades. METHODS We extracted official death certifications and population data from the WHO and the United Nations Population Division databases. We computed country- and sex-specific age-standardized mortality rates per 100 000 person-years for all cancers combined and ten major cancer sites for the periods 2005-2007 and 2015-2017. RESULTS Lung cancer ranked first for male cancer mortality in all selected countries in the last available period (with the highest rates in Réunion 24/100 000), except for South Africa where prostate cancer was the leading cause of death (23/100 000). Prostate cancer ranked second in Morocco and Tunisia and third in Mauritius and Réunion. Among Egyptian men, leukemia ranked second (with a stable rate of 4.2/100 000) and bladder cancer third (3.5/100 000). Among women, the leading cancer-related cause of death was breast cancer in all selected countries (with the highest rates in Mauritius 19.6/100 000 in 2015-2017), except for South Africa where uterus cancer ranked first (17/100 000). In the second rank there were colorectal cancer in Tunisia (2/100 000), Réunion (9/100 000) and Mauritius (8/100 000), and leukemia in Egypt (3.2/100 000). Colorectal and pancreas cancer mortality rates increased, while stomach cancer mortality rates declined. CONCLUSION Certified cancer mortality rates are low on a global scale. However, mortality rates from selected screening detectable cancers, as well as from infection-related cancers, are comparatively high, calling for improvements in prevention strategies.
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Affiliation(s)
- Margherita Pizzato
- Department of Clinical Sciences and Community Health, University of Milan, Milan
| | - Claudia Santucci
- Department of Clinical Sciences and Community Health, University of Milan, Milan
| | - Fabio Parazzini
- Department of Clinical Sciences and Community Health, University of Milan, Milan
| | - Eva Negri
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan
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Dlamini Z, Molefi T, Khanyile R, Mkhabele M, Damane B, Kokoua A, Bida M, Saini KS, Chauke-Malinga N, Luvhengo TE, Hull R. From Incidence to Intervention: A Comprehensive Look at Breast Cancer in South Africa. Oncol Ther 2024; 12:1-11. [PMID: 37910378 PMCID: PMC10881925 DOI: 10.1007/s40487-023-00248-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 09/27/2023] [Indexed: 11/03/2023] Open
Abstract
The formidable impact of breast cancer extends globally, with South Africa facing pronounced challenges, including significant disparities in breast cancer screening, treatment and survival along ethnic and socioeconomic lines. Over the last two decades, breast cancer incidence has increased and now accounts for a substantial portion of cancers in women. Ethnic disparities in terms of screening, incidence and survival exacerbate the issue, leading to delayed diagnosis among Black patients and highlighting healthcare inequities. These concerning trends underscore the urgency of enhancing breast cancer screening while mitigating treatment delays, although obstacles within the healthcare system impede progress. The intersection of breast cancer and human immunodeficiency virus (HIV) further complicates matters and particularly affects the Black population. Tackling the aforementioned disparities in breast cancer in South Africa mandates a multifaceted strategy. Robust screening efforts, particularly those targeting marginalised communities, are crucial for early detection. Concurrently, expedited treatment initiation is imperative. Addressing HIV-related complexities requires tailored interventions to ensure effective care. These multifaceted disparities require pan African research and cooperation as well as tailored interventions to enhance breast cancer care within the African region.
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Affiliation(s)
- Zodwa Dlamini
- SAMRC Precision Oncology Research Unit (PORU), DSI/NRF SARChI Chair in Precision Oncology and Cancer Prevention (POCP), Pan African Cancer Research Institute (PACRI), University of Pretoria, Pretoria, 0001, South Africa.
| | - Thulo Molefi
- SAMRC Precision Oncology Research Unit (PORU), DSI/NRF SARChI Chair in Precision Oncology and Cancer Prevention (POCP), Pan African Cancer Research Institute (PACRI), University of Pretoria, Pretoria, 0001, South Africa
- Department of Medical Oncology, Faculty of Health Sciences, Steve Biko Academic Hospital, University of Pretoria, Pretoria, 0001, South Africa
| | - Richard Khanyile
- SAMRC Precision Oncology Research Unit (PORU), DSI/NRF SARChI Chair in Precision Oncology and Cancer Prevention (POCP), Pan African Cancer Research Institute (PACRI), University of Pretoria, Pretoria, 0001, South Africa
- Department of Medical Oncology, Faculty of Health Sciences, Steve Biko Academic Hospital, University of Pretoria, Pretoria, 0001, South Africa
| | - Mahlori Mkhabele
- SAMRC Precision Oncology Research Unit (PORU), DSI/NRF SARChI Chair in Precision Oncology and Cancer Prevention (POCP), Pan African Cancer Research Institute (PACRI), University of Pretoria, Pretoria, 0001, South Africa
| | - Botle Damane
- SAMRC Precision Oncology Research Unit (PORU), DSI/NRF SARChI Chair in Precision Oncology and Cancer Prevention (POCP), Pan African Cancer Research Institute (PACRI), University of Pretoria, Pretoria, 0001, South Africa
- Department of Surgery, Steve Biko Academic Hospital, University of Pretoria, Pretoria, 0001, South Africa
| | - Alexandre Kokoua
- Laboratory of Anatomy, Experimental Surgery and Biomechanics (LANCEB), University of Félix Houphouët-Boigny, 01 BP V 166 Abidjan 01, Abidjan, Ivory Coast
| | - Meshack Bida
- SAMRC Precision Oncology Research Unit (PORU), DSI/NRF SARChI Chair in Precision Oncology and Cancer Prevention (POCP), Pan African Cancer Research Institute (PACRI), University of Pretoria, Pretoria, 0001, South Africa
- Department of Anatomical Pathology, National Health Laboratory Service (NHLS), University of Pretoria, Hatfield, 0028, South Africa
| | - Kamal S Saini
- Fortrea Inc, Durham, NC, USA
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Nkhensani Chauke-Malinga
- SAMRC Precision Oncology Research Unit (PORU), DSI/NRF SARChI Chair in Precision Oncology and Cancer Prevention (POCP), Pan African Cancer Research Institute (PACRI), University of Pretoria, Pretoria, 0001, South Africa
- Department of Plastic, Reconstructive and Aesthetic Surgery, Steve Biko Academic Hospital University of Pretoria, Hatfield, 0028, South Africa
| | - Thifhelimbilu Emmanuel Luvhengo
- Department of Surgery, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Parktown, Johannesburg, 2193, South Africa
| | - Rodney Hull
- SAMRC Precision Oncology Research Unit (PORU), DSI/NRF SARChI Chair in Precision Oncology and Cancer Prevention (POCP), Pan African Cancer Research Institute (PACRI), University of Pretoria, Pretoria, 0001, South Africa
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Kajabwangu R, Bajunirwe F, Izudi J, Bazira J, Farjardo Y, Ssedyabane F, Lugobe HM, Muhumuza J, Kayondo M, Turanzomwe S, Randall TC, Ngonzi J. Magnitude and trends in cervical cancer at Mbarara Regional Referral Hospital in South Western Uganda: Retrospective analysis of data from 2017-2022. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002848. [PMID: 38241290 PMCID: PMC10798516 DOI: 10.1371/journal.pgph.0002848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/29/2023] [Indexed: 01/21/2024]
Abstract
High-income countries have documented a significant decline in the incidence and mortality of cervical cancer over the past decade but such data from low and middle-income countries such as Uganda is limited to ascertain trends. There is also paucity of data on the burden of cervical cancer in comparison to other gynaecologic malignancies and there is a likelihood that the incidence might be on the rise. To describe the current trends and magnitude of cervical cancer in comparison to other gynaecological malignancies histological types, we conducted a retrospective records review of charts of patients admitted with gynaecological malignancies on the gynaecological ward of Mbarara Regional Referral Hospital (MRRH) between January 2017 and December 2022. Of 875 patients with gynaecological malignancies admitted to the MRRH in the 6-year review period, 721 (82.4%) had cervical cancer. Patients with cervical cancer were significantly older than those with other gynaecological malignancies: (50.2±11.5 versus 43.8± 15.0 respectively, p<0.001). Between 2017 and 2022, cervical cancer rates increased by 17% annually compared to other gynaecological cancers (OR:1.17; 95% CI 1.06-1.28, p = 0.0046), with the majority of patients of cervical cancer patients (92.7%, n = 668) having squamous cell carcinoma. Most patients (87.9%, n = 634) had late-stage disease (stage 2 and above) and were referred to the Uganda Cancer Institute for chemoradiation. These results imply that there is a need to scale up screening services and other preventive measures such as vaccination against human papilloma virus.
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Affiliation(s)
- Rogers Kajabwangu
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Francis Bajunirwe
- Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Jonathan Izudi
- Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Joel Bazira
- Department of Medical Microbiology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Yarine Farjardo
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Frank Ssedyabane
- Department of Medical Laboratory Science, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Henry Mark Lugobe
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Joy Muhumuza
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Musa Kayondo
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Stuart Turanzomwe
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Thomas C. Randall
- Department of Obstetrics and Gynecology, Gynecological Oncology Division, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Joseph Ngonzi
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
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Sharma K, Baghirova-Busang L, Abkenari S, Gulubane G, Rana C, Vuylsteke P, Marlink R, Gaolathe T, Masupe T. Breast cancer patient experiences in the Botswana health system: Is it time for patient navigators? J Cancer Policy 2023; 38:100449. [PMID: 37890667 DOI: 10.1016/j.jcpo.2023.100449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND New models of care are required to support women with breast cancer due to rising incidence and mortality in sub-Saharan Africa (SSA). This study gives voice to the experiences of advanced-stage breast cancer patients in the Botswana healthcare system, to guide improved service provision and the potential utility of patient navigator (PN) programs. METHODS focus group discussions (FGD) were conducted with advanced-stage breast cancer patients recruited from the oncology ward of the public Princess Marina Hospital located in Gaborone, Botswana. RESULTS FGDs included 7 female breast cancer patients and their 7 caregivers (2 male and 5 females). Findings fell into the following themes: experiences with cancer diagnosis, experiences with treatment, roles of caregivers, information needs, views on cancer resources, and attitudes towards cancer research. The study identified several barriers across the cascade of care for breast cancer patients in the Botswana health system. These correspond to challenges with timely diagnosis and comprehensive management and highlight community level barriers to achieving the targets of the WHO Global Breast Cancer initiative (GBCI). CONCLUSION The study findings suggest PN programs have the potential to bridge barriers identified in the Botswana healthcare system by improving communication, meeting information needs, providing emotional or practical support, and by addressing logistical barriers to cancer diagnosis and treatment in Botswana.
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Affiliation(s)
- Kirthana Sharma
- Rutgers Global Health Institute, Rutgers University, New Brunswick, NJ, USA; Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
| | - Leyla Baghirova-Busang
- Department of Family Medicine and Public Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Shaheen Abkenari
- Rutgers Global Health Institute, Rutgers University, New Brunswick, NJ, USA
| | - Godwill Gulubane
- Department of Family Medicine and Public Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana; Botswana Ministry of Health, Gaborone, Botswana
| | - Charmi Rana
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Peter Vuylsteke
- Department of Internal Medicine, University of Botswana, Gaborone, Botswana; Botswana Rutgers Partnership for Health, Gaborone, Botswana
| | - Richard Marlink
- Rutgers Global Health Institute, Rutgers University, New Brunswick, NJ, USA; Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Tendani Gaolathe
- Department of Internal Medicine, University of Botswana, Gaborone, Botswana; Botswana Rutgers Partnership for Health, Gaborone, Botswana
| | - Tiny Masupe
- Department of Family Medicine and Public Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana
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10
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Mapanga W, Ayeni OA, Chen WC, Jacobson JS, Neugut AI, Ruff P, Cubasch H, O’Neil DS, Buccimazza I, Čačala S, Stopforth LW, Farrow HA, Nietz S, Phakathi B, Chirwa T, McCormack VA, Joffe M. The South African breast cancer and HIV outcomes study: Profiling the cancer centres and cohort characteristics, diagnostic pathways, and treatment approaches. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002432. [PMID: 37874786 PMCID: PMC10597516 DOI: 10.1371/journal.pgph.0002432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/31/2023] [Indexed: 10/26/2023]
Abstract
The South African Breast Cancer and HIV Outcomes prospective cohort (SABCHO) study was established to investigate survival determinants among HIV-positive and HIV-negative SA women with breast cancer. This paper describes common and unique characteristics of the cancer centres and their participants, examining disparities in pathways to diagnosis, treatment resources and approaches adopted to mitigate resource constraints. The Johannesburg (Jhb), Soweto (Sow), and Durban (Dbn) sites treat mainly urban, relatively better educated and more socioeconomically advantaged patients whereas the Pietermaritzburg (Pmb) and Empangeni (Emp) sites treat predominantly rural, less educated and more impoverished communities The Sow, Jhb, and Emp sites had relatively younger patients (mean ages 54 ±14.5, 55±13.7 and 54±14.3 respectively), whereas patients at the Dbn and Pmb sites, with greater representation of Asian Indian women, were relatively older (mean age 57 ±13.9 and 58 ±14.6 respectively). HIV prevalence among the cohort was high, ranging from 15%-42%, (Cohort obesity (BMI ≥ 30 kg/m2) at 60%, self-reported hypertension (41%) and diabetes (13%). Direct referral of patients from primary care clinics to cancer centre occurred only at the Sow site which uniquely ran an open clinic and where early stage (I and II) proportions were highest at 48.5%. The other sites relied on indirect patient referral from regional hospitals where significant delays in diagnostics occurred and early-stage proportions were a low (15%- 37.3%). The Emp site referred patients for all treatments to the Dbn site located 200km away; the Sow site provided surgery and endocrine treatment services but referred patients to the Jhb site 30 Km away for chemo- and radiation therapy. The Jhb, Dbn and Pmb sites all provided complete oncology treatment services. All treatment centres followed international guidelines for their treatment approaches. Findings may inform policy interventions to address national and regional disparities in breast cancer care.
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Affiliation(s)
- Witness Mapanga
- Faculty of Health Sciences, Strengthening Oncology Services Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Health Sciences, DSI-NRF Centre of Excellence in Human Development, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Health Sciences, Department of Medicine, Division of Medical Oncology, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Oluwatosin A. Ayeni
- Faculty of Health Sciences, Strengthening Oncology Services Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Health Sciences, Department of Radiation Oncology, University of the Witwatersrand, Johannesburg, South Africa
| | - Wenlong Carl Chen
- Faculty of Health Sciences, Strengthening Oncology Services Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa
- Faculty of Health Sciences, Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, South Africa
| | - Judith S. Jacobson
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Alfred I. Neugut
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
| | - Paul Ruff
- Faculty of Health Sciences, Strengthening Oncology Services Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Health Sciences, Department of Medicine, Division of Medical Oncology, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- South Africa Medical Research Council Common Epithelial Cancers Research Centre, University of Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
| | - Herbert Cubasch
- Faculty of Health Sciences, Strengthening Oncology Services Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- South Africa Medical Research Council Common Epithelial Cancers Research Centre, University of Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
- Faculty of Health Sciences, Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa
| | - Daniel S. O’Neil
- Yale Cancer Center and Department of Medicine, Yale University, New Haven, CT, United States of America
| | - Ines Buccimazza
- Faculty of Health Sciences, Strengthening Oncology Services Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Department of Specialized Surgery, Inkosi Albert Luthuli Central Hospital, Durban and Ngwelezane Hospital, University of KwaZulu-Natal, Empangeni, KwaZulu-Natal, South Africa
| | - Sharon Čačala
- Faculty of Health Sciences, Strengthening Oncology Services Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Departments of Surgery and Radiation Oncology, Grey’s Hospital, University of KwaZulu-Natal, Pietermaritzburg, KwaZulu-Natal, South Africa
| | - Laura W. Stopforth
- Faculty of Health Sciences, Strengthening Oncology Services Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Departments of Surgery and Radiation Oncology, Grey’s Hospital, University of KwaZulu-Natal, Pietermaritzburg, KwaZulu-Natal, South Africa
| | - Hayley A. Farrow
- Departments of Surgery and Radiation Oncology, Grey’s Hospital, University of KwaZulu-Natal, Pietermaritzburg, KwaZulu-Natal, South Africa
| | - Sarah Nietz
- Faculty of Health Sciences, Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa
- Charlotte Maxeke Surgical Breast Unit, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Boitumelo Phakathi
- Charlotte Maxeke Surgical Breast Unit, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
- Faculty of Health Sciences, Department of Surgery, School of Clinical Medicine, University of Kwa-Zulu Natal, Durban, South Africa
| | - Tobias Chirwa
- Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Valerie A. McCormack
- Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France
| | - Maureen Joffe
- Faculty of Health Sciences, Strengthening Oncology Services Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- South Africa Medical Research Council Common Epithelial Cancers Research Centre, University of Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
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11
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Magwesela FM, Msemakweli DO, Fearon D. Barriers and enablers of breast cancer screening among women in East Africa: a systematic review. BMC Public Health 2023; 23:1915. [PMID: 37794414 PMCID: PMC10548570 DOI: 10.1186/s12889-023-16831-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 09/25/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Breast cancer is among the most common cancers globally with a projected increase in incidence and mortality in low- and middle-income countries. The majority of the patients in East Africa present with advanced disease contributing to poor disease outcomes. Breast cancer screening enables earlier detection of the disease and therefore reduces the poor outcomes associated with the disease. This study aims to identify and synthesize the reported barriers and enablers of breast cancer screening among East African women. METHODS Medline, Embase, SCOPUS, and Cochrane library were searched for articles published on the subject from start to March 2022 using PRISMA guidelines. Also, forward citation, manual search of references and searching of relevant journals were done. A thematic synthesis was carried out on the "results/findings" sections of the identified qualitative papers followed by a multi-source synthesis with quantitative findings. RESULTS Of 4560 records identified, 51 were included in the review (5 qualitative and 46 quantitative), representing 33,523 women. Thematic synthesis identified two major themes - "Should I participate in breast cancer screening?" and "Is breast cancer screening worth it?". Knowledge of breast cancer and breast cancer screening among women was identified as the most influencing factor. CONCLUSION This review provides a rich description of factors influencing uptake of breast cancer screening among East African women. Findings from this review suggest that improving knowledge and awareness among both the public and providers may be the most effective strategy to improve breast cancer screening in Eastern Africa.
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Affiliation(s)
| | | | - David Fearon
- College of Medicine and Veterinary Medicine, University of Edinburgh, Old College, South Bridge, Edinburgh, EH8 9YL, UK
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12
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Kadys A, Gremke N, Schnetter L, Kostev K, Kalder M. Intercontinental comparison of women with breast cancer treated by oncologists in Europe, Asia, and Latin America: a retrospective study of 99,571 patients. J Cancer Res Clin Oncol 2023; 149:7319-7326. [PMID: 36920565 PMCID: PMC10374727 DOI: 10.1007/s00432-023-04681-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/05/2023] [Indexed: 03/16/2023]
Abstract
PURPOSE The aim of the study was to evaluate the baseline data of women with breast cancer (BC) undergoing treatment in an intercontinental comparison. METHODS This study included 99,571 women with BC from Europe (70,834), Asia (18,208), and Latin America (10,529) enrolled between 2017 and 2021, based on data from IQVIA's Oncology Dynamics database. This source is supplied with information by means of a cross-sectional partially retrospective survey collecting anonymized data on inpatients and outpatients treated by a representative panel of oncologists. A multivariable logistic regression model was used to investigate the probability of metastases. RESULTS The data available in Asia (98%) and Latin America (100%) were hospital data, while in Europe, patients were treated both in hospitals and in office-based practices (62%, 38%). The mean age in Asia and Latin America (57 ± 13) was lower than in Europe (61 ± 13; p < 0.001). Lobular BC was diagnosed twice as often in Europe compared to Asia and Latin America (15.2%, 9.8%, 8.0%). The number of patients with metastasized hormone receptor-positive (HR +) BC was significantly higher in Europe and Latin America than in Asia (76%, 68%; p < 0.001). The highest number of women with metastasized BC was reported in Europe (26% compared to 14% and 20%, respectively, in Asia and Latin America). Across the continents, the percentage of women with BC who experienced metastases was 51-61% for bone, 30-39% for lung and 25-32% for liver, followed by 3-6% for skin and 3% for brain. CONCLUSION Women with BC treated in Europe tend to be significantly older and more likely to develop metastases than women in Asia and Latin America, except for lung metastases.
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Affiliation(s)
- Arturas Kadys
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Marburg, Germany
| | - Niklas Gremke
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Marburg, Germany
| | | | - Karel Kostev
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Marburg, Germany.
- Epidemiology, IQVIA, Unterschweinstiege 2-14, Frankfurt am Main, 60549, Frankfurt Am Main, Germany.
| | - Matthias Kalder
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Marburg, Germany
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Adeniji KA, Folaranmi OO, Odetunde OA, Adegboye O, Ibiyeye KM, Ighodalo JE, Olayiwola JO, Suleiman KA, Abubakar-Akanbi SK. Changing pattern of cancer distribution: experience from a tertiary health institution in Nigeria and review of literature. Niger J Clin Pract 2023; 26:902-907. [PMID: 37635573 DOI: 10.4103/njcp.njcp_520_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Background Over the years, epidemiological surveys have established that the five leading cancers in Africa (in descending order of prevalence) are cancers of the breast, cervix, prostate, liver, and colorectum.[1] However, a 10-year retrospective review of cases performed at the University of Ilorin Teaching Hospital (UITH) revealed some changes in the cancer incidence pattern in this region. Aims The aim of the study was to determine the distribution of cancers managed at the UITH, a tertiary health care center in North Central Nigeria, in the past 10 years and create awareness of changing cancer prevalence patterns in this region. Materials and Method This was a retrospective review of cancer epidemiology at UITH over a period of 10 years. Confirmed cancer cases within this period were extracted from the data in the Department of Anatomic Pathology and the Cancer registry. Descriptive and inferential statistics were applied to obtain rates and proportions for both sexes. Results There were 2430 confirmed cases of cancer during the study period from January 2011 to December 2020. Out of these cases, 1310 (54%) were seen in females and 1120 (46%) were seen in males. The most common cancer recorded (in total) was prostate cancer, which accounted for 18% of all cases, constituting approximately one in six of all cancer cases. This was followed closely by breast cancer (16.6%). The most commonly diagnosed cancer in males was prostate cancer (four in ten cancer cases in males), whereas in females, it was breast cancer (approximately three in ten cancer cases in females). Cancers of the lungs and liver were rare in both sexes in this study. In children, the most common malignancies were retinoblastoma (38.3%), non-Hodgkin lymphomas (16.8%), and nephroblastoma (12.8%). Conclusion There is a changing trend in cancer cases with some cancer cases now predominating compared to previous years. This may be because of increased awareness and/or better medical screening and diagnostic techniques.
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Affiliation(s)
- K A Adeniji
- Department of Anatomic Pathology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - O O Folaranmi
- Department of Anatomic Pathology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - O A Odetunde
- Department of Anatomic Pathology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - O Adegboye
- Department of Anatomic Pathology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - K M Ibiyeye
- Department of Anatomic Pathology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - J E Ighodalo
- Department of Anatomic Pathology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - J O Olayiwola
- Department of Anatomic Pathology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - K A Suleiman
- Department of Anatomic Pathology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - S K Abubakar-Akanbi
- Department of Anatomic Pathology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
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14
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Sharma K, Mayer T, Li S, Qureshi S, Farooq F, Vuylsteke P, Ralefala T, Marlink R. Advancing oncology drug therapies for sub-Saharan Africa. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001653. [PMID: 37368872 DOI: 10.1371/journal.pgph.0001653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Cancer incidence is rising across sub-Saharan Africa (SSA), and is often characterized by late-stage presentation, early age of onset and poor survival. While a number of oncology drugs are now improving the length and quality of life for cancer patients in high-income countries, significant disparities in access to a range of oncology therapeutics exist for SSA. A number of challenges to drug access such as drug costs, lack of infrastructure and trained personnel must be urgently addressed to advance oncology therapies for SSA. We present a review of selected oncology drug therapies that are likely to benefit cancer patients with a focus on common malignancies in SSA. We collate available data from seminal clinical trials in high-income countries to highlight the potential for these therapeutics to improve cancer outcomes. In addition, we discuss the need to ensure access to drugs within the WHO Model List of Essential Medicines and highlight therapeutics that require consideration. Available and active oncology clinical trials in the region is tabulated, demonstrating the significant gaps in access to oncology drug trials across much of the region. We issue an urgent call to action to address drug access due to the predicted rise in cancer burden in the region in coming years.
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Affiliation(s)
- Kirthana Sharma
- Rutgers Global Health Institute, New Brunswick, New Jersey, United States of America
- Department of Medicine, Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America
| | - Tina Mayer
- Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, United States of America
| | - Sharon Li
- Rutgers Cancer Institute at University Hospital, New Jersey Medical School, Newark, New Jersey, United States of America
| | - Sadaf Qureshi
- Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, United States of America
| | - Faheem Farooq
- Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, United States of America
| | - Peter Vuylsteke
- Department of Internal Medicine, University of Botswana, Gaborone, Botswana
| | - Tlotlo Ralefala
- Department of Oncology, Princess Marina Hospital, Gaborone, Botswana
| | - Richard Marlink
- Rutgers Global Health Institute, New Brunswick, New Jersey, United States of America
- Department of Medicine, Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America
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15
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Getz KR, Adedokun B, Xu S, Toriola AT. Breastfeeding and Mammographic Breast Density: A Cross-sectional Study. Cancer Prev Res (Phila) 2023; 16:353-361. [PMID: 36930943 PMCID: PMC10239347 DOI: 10.1158/1940-6207.capr-22-0482] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/23/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023]
Abstract
Breastfeeding is inversely associated with breast cancer risk but the associations of breastfeeding with mammographic breast density (MBD) are not clear. We investigated the association between breastfeeding and volumetric measures of MBD [volumetric percent density (VPD), dense volume (DV), and non-dense volume (NDV)] and evaluated whether it differs by race, menopausal status, and body mass index (BMI). The study population was comprised of 964 women (67% non-Hispanic White, 29% non-Hispanic Black) who had screening mammography at Washington University School of Medicine, St. Louis, MO. VPD, DV and NDV were log10 transformed. We performed multivariable linear regression models adjusted for age, BMI, family history of breast cancer, race, and age at menarche among all participants and exclusively in parous women. Mean age was 50.7 years. VPD was 12% lower among women who breastfed 0-6 months, [10β = 0.88, 95% confidence interval (CI; 0.79-0.98)] compared with nulliparous women. Breastfeeding was not associated with VPD among women who breastfed >7 months. Breastfeeding was inversely associated with DV [parous never breastfed: 10β = 0.93; 95% CI (0.83-1.04), breastfed 0-6 months: 10β = 0.91, 95% CI (0.79-1.05), breastfed 7-12 months: 10β = 0.94; 95% CI (0.81-1.10), breastfed >12 months: 10β = 0.87, 95% CI (0.78-0.98), Ptrend = 0.03]. BMI modified the association between breastfeeding and VPD. Women who breastfed for 0-6 months and had a BMI < 25 kg/m2 had lower VPD compared with nulliparous women, but among women with a BMI ≥ 25 kg/m2 there was no association (Pinteraction = 0.04). In this diverse study population, the association of breastfeeding with VPD appears to be modified by BMI, but not by race or menopausal status. Future research exploring the associations of breastfeeding with other mammographic features are needed. PREVENTION RELEVANCE Breastfeeding for up to 6 months may be associated with lower VPD among women with a BMI < 25 kg/m2. The potential role of MBD in mediating the associations of breastfeeding with breast cancer risk in a select group of women deserves further evaluation. See related Spotlight, p. 309.
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Affiliation(s)
- Kayla R. Getz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Babatunde Adedokun
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Shuai Xu
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Adetunji T. Toriola
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
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Mubarik S, Wang F, Nadeem AA, Fawad M, Yu C. Breast cancer epidemiology and sociodemographic differences in BRICS-plus countries from 1990 to 2019: An age period cohort analysis. SSM Popul Health 2023; 22:101418. [PMID: 37215157 PMCID: PMC10193025 DOI: 10.1016/j.ssmph.2023.101418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 04/18/2023] [Accepted: 04/29/2023] [Indexed: 05/24/2023] Open
Abstract
Background Breast cancer (BC) is a major health concern in the BRICS-plus, a group of developing nations consisting of Brazil, Russia, India, China, South Africa, and 30 other Asian countries, with nearly half of the world's population. This study aims to identify potential risk factors contributing to the burden of BC by assessing its epidemiological and socio-demographic changes. Methods Data on BC outcomes were obtained from the 2019 Global Burden of Disease Survey. The age-period-cohort (APC) modeling technique was used to evaluate the nonlinear impacts of age, cohort, and period on BC outcomes and reported risk attributable mortality and disability adjusted life years (DALYs) rate changes between 1990 and 2019. Results In 2019, there were 0.90 million female BC cases and 0.35 million deaths in the BRICS-plus region, with China and India having the largest proportion of incident cases and deaths, followed by Pakistan. Lesotho experienced the highest annualized rates of change (AROC: 2.61%; 95%UI: 1.99-2.99) in the past three decades. Birth cohorts' impact on BC varies greatly between the BRICS-plus nations, with Pakistan suffering the largest risk increase in the most recent cohort. High body mass index (BMI), high fasting plasma glucose (FPG), and a diet high in red meat contributed to the highest death and DALYs rates in most BRICS-plus nations in 2019, and there was a strong negative link between SDI and death and DALYs rate. Conclusions The study found that the burden of BC varies significantly between BRICS-plus regions. Thus, BRICS-plus nations should prioritise BC prevention, raise public awareness, and implement screening efficiency measures to reduce the burden of BC in the future, as well as strengthen public health policies and initiatives for important populations based on their characteristics and adaptability.
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Affiliation(s)
- Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Fang Wang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Adeel Ahmad Nadeem
- State Key Laboratory of Water Resources and Hydropower Engineering Science, Wuhan University, Wuhan, 430072, China
| | - Muhammad Fawad
- School of Public Health and Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, 430071, China
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Saibu OA, Singh G, Olugbodi SA, Oluwafemi AT, Ajayi TM, Hammed SO, Oladipo OO, Odunitan TT, Omoboyowa DA. Identification of HER2 inhibitors from curcumin derivatives using combination of in silico screening and molecular dynamics simulation. J Biomol Struct Dyn 2023; 41:12328-12337. [PMID: 36752338 DOI: 10.1080/07391102.2023.2175260] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/01/2023] [Indexed: 02/09/2023]
Abstract
Breast cancer remains a major world health challenge in women. Some Breast cancers are human epidermal growth factor receptor 2 (HER2) positive. Since this protein promotes the growth of cancer cells, it remains a therapeutic target for novel drugs. This study uses in silico model to predict HER2 inhibitors from curcumin derivatives via QSAR, e-pharmacophore, ADMET as well as structure-based virtual screening using Schrodinger suite. The molecular dynamics simulation of lead compounds, reference ligand and co-crystalized ligand was performed using GROMACS. At the end, eight active curcumin derivatives were predicted as inhibitors of HER2 with high binding affinity and better interaction compared with the reference drug (Neratinib) but lower binding affinity compared with the co-crystalized ligand (TAK-285). After prediction of the bioactivity of the molecules using AutoQSAR, the hit compounds showed appreciable inhibitory pIC50 compared with the reference and co-crystalized ligands against HER2. The pharmacokinetics profile predicted the eight hit compounds as drug-like and drug candidates. The MD simulation predicted the stability of the two top-scored compounds (10763284 and 78321412) in complex with HER2 for the final 80 ns of the trajectory period after initial equilibration with higher H-bond interactions in the protein-reference drug complex compared to the hit compounds-HER2 complexes. This study revealed that curcumin derivatives especially (1E,6E)-1,8-bis(4-hydroxy-3-methoxyphenyl)octa-1,6-diene-3,5-dione and (1E,6E)-4-ethyl-1,7-bis(4-hydroxy-3-methoxyphenyl)hepta-1,6-diene-3,5-dione were identified to demonstrate inhibitory activity against HER2 which is comparable to neratinib. Conclusively, the lead compounds require further in vitro and in vivo experimental validation for the discovery of new HER2 antagonists for breast cancer management.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Oluwatosin A Saibu
- Department of Environmental Toxicology, Universitat Duisburg-Essen, North Rhine-Westphalia, Germany
| | - Gagandeep Singh
- Section of Microbiology, Central Ayurveda Research Institute, Jhansi, Uttar Pradesh, India
- Kusuma School of Biological Sciences, Indian Institute of Technology, Delhi, New Delhi, India
| | - Sunday A Olugbodi
- Department of Environmental Toxicology, Universitat Duisburg-Essen, North Rhine-Westphalia, Germany
| | - Adenrele T Oluwafemi
- Department of Biochemistry, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| | - Temitope M Ajayi
- Department of Biochemistry, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| | - Sodiq O Hammed
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| | - Oladapo O Oladipo
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| | - Tope T Odunitan
- Department of Biochemistry, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
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18
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Molecular characterization of early breast cancer onset to understand disease phenotypes in African patients. Med Oncol 2023; 40:13. [PMID: 36352274 PMCID: PMC9646617 DOI: 10.1007/s12032-022-01877-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/18/2022] [Indexed: 11/11/2022]
Abstract
Female breast cancer (BC) is the leading cause of cancer-related deaths worldwide with higher mortality rates and early onset in developing countries. The molecular basis of early disease onset is still elusive. We recruited 472 female breast cancer from two sub-Saharan African countries (Cameroon and Congo) between 2007 and 2018 and collected clinical data from these patients. To investigate the molecular drivers of early disease onset, we analyzed publicly available breast cancer molecular data from the cancer genome atlas (TCGA) and the gene expression omnibus (GEO) for copy number alteration, mutation and gene expression. Early BC onset (EOBRCA) (diagnosis before 45 years) was higher in African women compared with the TCGA cohort (51.7% vs 15.6%). The tumor grade, mitotic index, HER2 + phenotype, basal-like phenotype and ki67 were higher in EOBRCA for all cohorts. BC risk factors such as parity, breastfeeding early onset of menarche and use of hormonal contraceptives were significantly associated with EOBRCA (p < 0.05). EOBRCA was equally associated with copy number alterations in several oncogenes including CDH6 and FOXM1 and tumor suppressor including TGM3 and DMBT1 as well as higher TP53 mutation rates (OR: 2.93, p < 0.01). There was a significant enrichment of TGFß signaling in EOBRCA with TGM3 deletions, which was associated with high expression of all SMAD transcription factors as well as WNT ligands. The Frizzled receptors FZD1, FZD4 and FZD6 were significantly upregulated in EOBRCA, suggesting activation of non-canonical WNT signaling. Our data, suggest the implication of TGM3 deletion in early breast cancer onset. Further molecular investigations are warranted in African patients.
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Midlenko A, Mussina K, Zhakhina G, Sakko Y, Rashidova G, Saktashev B, Adilbay D, Shatkovskaya O, Gaipov A. Prevalence, incidence, and mortality rates of breast cancer in Kazakhstan: data from the Unified National Electronic Health System, 2014-2019. Front Public Health 2023; 11:1132742. [PMID: 37143985 PMCID: PMC10153091 DOI: 10.3389/fpubh.2023.1132742] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/24/2023] [Indexed: 05/06/2023] Open
Abstract
Background Although there are numerous sources of epidemiologic information on breast cancer in Kazakhstan, none of them have specifically examined the burden of this disease. Therefore, this article aims to provide an overview of the breast cancer prevalence, incidence, mortality, and distribution and changes over time in Kazakhstan based on nationwide large-scale healthcare data from the National Registry in order to encourage more research on the impact of various diseases at the regional and national levels. Methods The study cohort included all adult women older than 25 years who were diagnosed with breast cancer in any clinical setting of the Republic of Kazakhstan during the period of 2014-2019. The data were extracted from the Unified Nationwide Electronic Health System (UNEHS) to get an overview of descriptive statistics, incidence, prevalence, and mortality rate calculations and the Cox proportional hazards regression model. All survival functions and factors associated with mortality were tested for significance. Results The cohort population (n = 55,465) comprised subjects with the age at the diagnosis of breast cancer from 25 to 97 years, with a mean of 55.7 ± 12.0 years. The majority of the study population belonged to the age group 45-59 years, which is 44.8% of the cohort. The all-cause mortality rate of the cohort is 16%. The prevalence rate increased from 30.4 per 10,000 population in 2014 to 50.6 in 2019. The incidence rate varied from 4.5 per 10,000 population in 2015 to 7.3 in 2016. Mortality rates were stable and high in the senile age patients (75-89 years old). Breast cancer mortality was positively associated with women who had been diagnosed with diabetes, HR 1.2 (95% CI, 1.1-2.3), whereas it was negatively associated with arterial hypertension, HR 0.4 (95% CI, 0.4-0.5). Conclusion Overall, Kazakhstan is experiencing an increase in the incidence of breast cancer cases, but the mortality rate has started to decline. The switch to population mammography screening could reduce the breast cancer mortality rate. These findings should be utilized to help Kazakhstan determine what cancer control priorities should be utilized, including the need to implement efficient and affordable screening and prevention programs.
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Affiliation(s)
- Anna Midlenko
- Department of Surgery, School of Medicine, Nazarbayev University, Astana, Kazakhstan
- Anna Midlenko
| | - Kamilla Mussina
- Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan
| | - Gulnur Zhakhina
- Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan
| | - Yesbolat Sakko
- Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan
| | - Gyunel Rashidova
- School of Sciences and Humanities, Nazarbayev University, Astana, Kazakhstan
| | - Bolat Saktashev
- Department of Mammology, Oncological Center of Tomotherapy “UMIT”, Astana, Kazakhstan
| | - Dauren Adilbay
- Department of Otolaryngology Head and Neck Surgery, Louisiana State University Health Sciences, Shreveport, LA, United States
| | - Oxana Shatkovskaya
- Department of Scientific and Strategic Activities, Kazakh Research Institute of Oncology and Radiology, Almaty, Kazakhstan
| | - Abduzhappar Gaipov
- Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan
- Clinical Academic Department of Internal Medicine, CF “University Medical Center”, Astana, Kazakhstan
- *Correspondence: Abduzhappar Gaipov
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Habimana S, Biracyaza E, Mpunga T, Nsabimana E, Kayitesi F, Nzamwita P, Jansen S. Prevalence and associated factors of depression and anxiety among patients with cancer seeking treatment at the Butaro Cancer Center of Excellence in Rwanda. Front Public Health 2023; 11:972360. [PMID: 36875374 PMCID: PMC9978744 DOI: 10.3389/fpubh.2023.972360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 01/25/2023] [Indexed: 02/18/2023] Open
Abstract
Background Depression and anxiety are psychological and physiological disturbances persisting in cancer patients with high prevalence worldwide, particularly in low- and middle-income countries, due to complexities of determinants of health including biological, individual, socio-cultural, and treatment-related characteristics. Although depression and anxiety have an enormous impact on adherence, length of stay at the hospital, quality of life, and treatment outcomes, studies on psychiatric disorders remain limited. Thus, this study determined the prevalence and factors of depression and anxiety among patients with cancer in Rwanda. Methods A cross-sectional study was conducted among 425 patients with cancer from the Butaro Cancer Center of Excellence. We administered socio-demographic questionnaires and psychometric instruments. Bivariate logistic regressions were computed to identify significant factors to be exported into the multivariate logistic models. Then, odds ratios and their 95% confidence intervals were applied, and statistical significance at p < 0.05 were considered to confirm significant associations. Results The prevalence of depression and anxiety was 42.6 and 40.9%, respectively. Patients with cancer initiated to chemotherapy had a greater likelihood of being depressed [AOR = 2.06; 95% CI (1.11-3.79)] than those initiated to chemotherapy and counseling. Breast cancer was significantly associated with a greater risk of depression [AOR = 2.07, 95% CI (1.01-4.22)] than Hodgikins's Lymphoma cancer. Furthermore, patients with depression had greater odds of developing anxiety [AOR = 1.76, 95% CI (1.01-3.05)] than those with no depression. Those suffering from depression were almost two times more likely to experience anxiety [AOR = 1.76; 95% CI (1.01-3.05)] than their counterparts. Conclusion Our results revealed that depressive and anxious symptomatology is a health threat in clinical settings that requires enhancement of clinical monitoring and prioritization of mental health in cancer health facilities. Designing biopsychosocial interventions to address associated factors needs special attention to promote the health and wellbeing of patients with cancer.
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Affiliation(s)
- Samuel Habimana
- Department of Social work and Social Ecology, School of Behavioral Health, Loma Linda University, Loma Linda, CA, United States.,Rwanda Resilience and Grounding Organization, Kigali, Rwanda
| | - Emmanuel Biracyaza
- Rwanda Resilience and Grounding Organization, Kigali, Rwanda.,Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
| | | | | | - Florence Kayitesi
- Acquired Immunodeficiency Syndrome Health Care Foundation, Kigali, Rwanda
| | - Pascal Nzamwita
- Acquired Immunodeficiency Syndrome Health Care Foundation, Kigali, Rwanda
| | - Stefan Jansen
- Center for Research and Innovation, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
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21
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Borges PCC, Spencer HB, Barbosa C, Costa V, Furtado A, Leal MC, Lopes C, Ferreira D, Carvalho AL, Dos-Santos-Silva I, Santos LL. XPERT ® breast cancer STRAT4 as an alternative method of identifying breast cancer phenotype in Cape Verde (preliminary results). Ecancermedicalscience 2023; 17:1530. [PMID: 37138965 PMCID: PMC10151082 DOI: 10.3332/ecancer.2023.1530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Indexed: 05/05/2023] Open
Abstract
Introduction Breast cancer (BC) is a public health problem in developing countries, including Cape Verde. Immunohistochemistry (IHC) is the gold standard technique used for BC phenotypic characterisation to support efficient therapeutic decisions. However, IHC is a demanding technique that requires knowledge, trained technicians, expensive antibodies and reagents, controls, and results validation. The low number of cases in Cape Verde increases the risk of expiring the validity of the antibodies, and manual procedures often jeopardise the quality of the results. Thus, IHC is limited in Cape Verde, and an alternative technically easy solution is needed. A point-of-care messenger RNA (mRNA) STRAT4 BC assay to assess estrogen (ER), progesterone (PR), hormone growth factor 2 receptor (HER2), and Ki67, using the GeneXpert platform, has been recently validated on tissues from internationally accredited laboratories, showing excellent concordance with IHC results.To assess whether this technology can be implemented in Cape Verde to guide BC treatment we decided to study the level of agreement between the findings yielded by BC STRAT4 and the results are the same cases obtained by IHC. Methods Formalin-fixed and paraffin-embedded (FFPE) tissue samples from 29 Cabo Verdean BC patients diagnosed in Agostinho Neto University Hospital were analysed by applying IHC and BC STRAT4 assay. The time between sample collection and pre-analytic procedures is unknown. All the samples were pre-processed in Cabo Verde (fixed in formalin and embedded in paraffin). IHC studies were performed in referenced laboratories in Portugal. STRAT4 and IHC result concordance was assessed by calculating the percentage of results agreement and Cohen's Kappa (K) statistics. Results STRAT4 assay failed in 2 out of the 29 analysed samples. Of the 27 successfully analysed samples, STRAT4/IHC results for ER, PR, HER2, and Ki67 were concordant in 25, 24, 25, and 18 cases, respectively. Ki67 was indeterminate in three cases, and PR was indeterminate once.The percentage of agreement between STRAT4 and IHC results for ER, PR, HER2, and Ki67 was 92.59%, 92.31%, 92.59% and 81.82%, respectively. The Cohen's K statistic coefficients for each biomarker were 0.809, 0.845, 0.757 and 0.506, respectively. Conclusions According to our preliminary results, a point-of-care mRNA STRAT4 BC assay may be an alternative in laboratories unable to provide quality and/or cost-efficient IHC services. However, more data and improvement on sample pre-analytic processes are required to implement this BC STRAT4 Assay in Cape Verde.
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Affiliation(s)
- Pamela C C Borges
- Laboratório Biologia Molecular, Hospital Universitário Agostinho Neto, Praia, Plateau 112, Cabo Verde
| | | | - Carla Barbosa
- Hospital Universitário Agostinho Neto, Praia, Plateau 112, Cabo Verde
| | - Victor Costa
- Hospital Universitário Agostinho Neto, Praia, Plateau 112, Cabo Verde
| | - Antónia Furtado
- IMP Diagnostics, Molecular and Anatomic Pathology Lab, 4150-146, Porto, Portugal
| | - Maria Conceição Leal
- Anatomia Patológica, Instituto Português de Oncologia, 4200-072, Porto, Portugal
| | - Carlos Lopes
- Unilabs | Laboratório Anatomia Patológica, 4250-170, Porto, Portugal
| | - Dylan Ferreira
- Experimental Pathology and Therapeutics Group, Research Center of IPO Porto (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Center (Porto.CCC), 4200-072, Porto, Portugal
| | | | | | - Lúcio Lara Santos
- Experimental Pathology and Therapeutics Group, Research Center of IPO Porto (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Center (Porto.CCC), 4200-072, Porto, Portugal
- Surgical Oncology Department, Portuguese Institute of Oncology, 4200-072, Porto, Portugal
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22
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Ramathebane MM, Sooro MA, Kabuya RM, Sayed AR. Knowledge and attitudes relating to cervical and breast cancer among women in Maseru, Lesotho. Afr J Prim Health Care Fam Med 2022; 14:e1-e8. [PMID: 36546486 PMCID: PMC9772699 DOI: 10.4102/phcfm.v14i1.3459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 09/12/2022] [Accepted: 09/08/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Cancer has remained one of the leading causes of death worldwide. In Lesotho, breast and cervical cancers contribute about 43% of all the cancer cases annually. AIM This study is aimed at comparing knowledge, attitudes, and practices between breast and cervical cancers among females in Maseru. SETTINGS This study consists of women residing in five study sites which have clinics that offer cervical and breast cancer-screening services. METHODS A cross-sectional study was conducted in June 2021 in Maseru, the Capital city of Lesotho. The participants were interviewed using a pre-tested questionnaire, through which their knowledge, practices about, and attitudes towards breast and cervical cancers were assessed. RESULTS A total of 228 women aged 15-75 years participated in the study and the majority were aged 30 years and above. Of the women interviewed for cervical cancer, 89.5% had heard of it, 11.8% had heard of its screening, and 7.4% had at least one examination. Similarly, for breast cancer, 77.6% of women who had heard of it, 72.9% had heard of screening, and 40.1% of women did at least one examination. CONCLUSION The majority of women were more knowledgeable about cervical cancer than breast cancer. However, more women had heard about breast cancer screening than cervical cancer screening. Therefore, there is a need for awareness campaigns related to cervical cancers' screening.Contribution: There is an urgent need to intensify awareness about cervical and breast cancer screening and availability of services at the nearby clinics.
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Affiliation(s)
- Maseabata M. Ramathebane
- Department of Pharmacy, Faculty of Health Sciences, National University of Lesotho, Maseru, Lesotho
| | - Mopa A. Sooro
- Department of Pharmacy, Faculty of Health Sciences, National University of Lesotho, Maseru, Lesotho
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23
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Arnold M, Morgan E, Rumgay H, Mafra A, Singh D, Laversanne M, Vignat J, Gralow JR, Cardoso F, Siesling S, Soerjomataram I. Current and future burden of breast cancer: Global statistics for 2020 and 2040. Breast 2022; 66:15-23. [PMID: 36084384 PMCID: PMC9465273 DOI: 10.1016/j.breast.2022.08.010] [Citation(s) in RCA: 524] [Impact Index Per Article: 262.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/26/2022] [Accepted: 08/28/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Breast cancer is the most commonly diagnosed cancer worldwide, and its burden has been rising over the past decades. In this article, we examine and describe the global burden of breast cancer in 2020 and predictions for the year 2040. METHODS Estimates of new female breast cancer cases and deaths in 2020 were abstracted from the GLOBOCAN database. Age-standardized incidence and mortality rates were calculated per 100,000 females by country, world region, and level of human development. Predicted cases and deaths were computed based on global demographic projections for the year 2040. RESULTS Over 2.3 million new cases and 685,000 deaths from breast cancer occurred in 2020. Large geographic variation across countries and world regions exists, with incidence rates ranging from <40 per 100,000 females in some Asian and African countries, to over 80 per 100,000 in Australia/New Zealand, Northern America, and parts of Europe. Smaller geographical variation was observed for mortality; however, transitioning countries continue to carry a disproportionate share of breast cancer deaths relative to transitioned countries. By 2040, the burden from breast cancer is predicted to increase to over 3 million new cases and 1 million deaths every year because of population growth and ageing alone. CONCLUSION Breast cancer is the most common cancer worldwide and continues to have a large impact on the global number of cancer deaths. Global efforts are needed to counteract its growing burden, especially in transitioning countries where incidence is rising rapidly, and mortality rates remain high.
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Affiliation(s)
- Melina Arnold
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Eileen Morgan
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France.
| | - Harriet Rumgay
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Allini Mafra
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Deependra Singh
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Mathieu Laversanne
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Jerome Vignat
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Julie R Gralow
- American Society of Clinical Oncology, Alexandria VA, USA
| | - Fatima Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - Sabine Siesling
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands; Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, Netherlands
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24
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Varallo JE, Ruto D, Patted A. Surgical Burden of Disease in Women. Obstet Gynecol Clin North Am 2022; 49:795-808. [DOI: 10.1016/j.ogc.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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25
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Do T, Whittaker A. Trajectories to a cancer diagnosis: Why and when women seek help for breast symptoms in Vietnam. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6322-e6331. [PMID: 36245318 PMCID: PMC10092510 DOI: 10.1111/hsc.14074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 07/25/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
Women in low- and middle-income countries where the prevalence and mortality of breast cancer are growing rapidly are more likely to be diagnosed at advanced stages, which negatively affects their treatment outcomes and chance of survival. The current literature in those settings tends to focus largely on explaining patient delay in seeking medical attention for breast symptoms. Meanwhile, little is known as to what prompts women to attend screening and diagnostic services after discovering symptomatic breasts. Drawn upon the data from in-depth interviews with 33 breast cancer patients in Central Vietnam conducted in 2019, this paper examines the context of women's decisions about breast screening and how the practice of seeking cancer diagnosis occurred. Our findings reveal an absence of a national screening program and that seeking medical advice was conducted on an ad hoc basis after self-detection of breast symptoms. Women's interpretations of symptomatic breasts as suspicious signs of cancer, the co-occurrence of important life events, or encouragement by people in their social network motivated women to seek medical attention at different public and private health facilities. Their encounters with the health sector often involved multiple visits across time and space in which they experienced various forms of diagnosis delay produced by the health system. Our study carries implications for interventions to encourage women's awareness of early cancer symptoms and prompt medical presentation after self-discovery of symptomatic breasts.
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Affiliation(s)
- Trang Do
- School of Social Sciences, Faculty of ArtsMonash UniversityClaytonVictoriaAustralia
| | - Andrea Whittaker
- Co‐Convener of Health and Biofutures Focus Programme, School of Social Sciences, Faculty of ArtsMonash UniversityClaytonVictoriaAustralia
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26
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Paluch-Shimon S, Cardoso F, Partridge AH, Abulkhair O, Azim HA, Bianchi-Micheli G, Cardoso MJ, Curigliano G, Gelmon KA, Gentilini O, Harbeck N, Kaufman B, Kim SB, Liu Q, Merschdorf J, Poortmans P, Pruneri G, Senkus E, Sirohi B, Spanic T, Sulosaari V, Peccatori F, Pagani O. ESO-ESMO fifth international consensus guidelines for breast cancer in young women (BCY5). Ann Oncol 2022; 33:1097-1118. [PMID: 35934170 DOI: 10.1016/j.annonc.2022.07.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/14/2022] [Accepted: 07/17/2022] [Indexed: 12/31/2022] Open
Abstract
We dedicate this manuscript in memory of a dear friend and colleague Bella Kaufman. The fifth International Consensus Symposium for Breast Cancer in Young Women (BCY5) took place virtually in October 2020, organized by the European School of Oncology (ESO) and the European Society of Medical Oncology (ESMO). Consensus recommendations for the management of breast cancer in young women were updated from BCY4 with incorporation of new evidence to inform the guidelines. Areas of research priorities as well as specificities in different geographic and minority populations were identified. This manuscript summarizes the ESO-ESMO international consensus recommendations, which are also endorsed by the European Society of Breast Specialists (EUSOMA).
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Affiliation(s)
- S Paluch-Shimon
- Hadassah University Hospital & Faculty of Medicine, Hebrew University, Jerusalem, Israel.
| | - F Cardoso
- Breast Unit, Champalimaud Clinical Centre/Champalimaud Foundation, Lisbon, Portugal
| | | | - O Abulkhair
- King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia
| | - H A Azim
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico
| | | | - M J Cardoso
- Breast Unit, Champalimaud Clinical Centre/Champalimaud Foundation, Lisbon, Portugal
| | - G Curigliano
- European Institute of Oncology IRCCS, Milan; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - K A Gelmon
- British Columbia Cancer, Vancouver, Canada
| | | | - N Harbeck
- Breast Center, Department of OB&GYN and CCCMunich, LMU University Hospital, Munich, Germany
| | - B Kaufman
- Sheba Medical Center, Ramat Gan, Israel
| | - S B Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Q Liu
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | | | - P Poortmans
- Iridium Netwerk, Department of Radiation Oncology & University of Antwerp, Faculty of Medicine and Health Sciences, Wilrijk-Antwerp, Belgium
| | - G Pruneri
- National Cancer Institute, IRCCS Foundation, Milan, Italy
| | - E Senkus
- Medical University of Gdansk, Gdansk, Poland
| | - B Sirohi
- Max Institute of Cancer Care, New Delhi and Gurgaon, India
| | - T Spanic
- Europa Donna Slovenia, Ljubljana, Slovenia
| | - V Sulosaari
- European Oncology Nursing Society (EONS) and Turku University of Applied Sciences, Turku, Finland
| | - F Peccatori
- European Institute of Oncology IRCCS, Milan; European Institute of Oncology IRCCS & European School of Oncology, Milan, Italy
| | - O Pagani
- Interdisciplinary Cancer Service Hospital Riviera-Chablais Rennaz, Vaud, Geneva University Hospitals, Lugano University, Swiss Group for Clinical Cancer Research (SAKK), Lugano, Switzerland
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27
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Arzanova E, Mayrovitz HN. The Epidemiology of Breast Cancer. Breast Cancer 2022. [DOI: 10.36255/exon-publications-breast-cancer-epidemiology] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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28
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Wu M, Yuan K, Lyu S, Li Y. Screening potential immune signatures for early-stage basal-like/triple-negative breast cancer. World J Surg Oncol 2022; 20:214. [PMID: 35751103 PMCID: PMC9229513 DOI: 10.1186/s12957-022-02683-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/13/2022] [Indexed: 11/29/2022] Open
Abstract
Background Breast cancer (BC) is a highly heterogeneous disease. Among the BC molecular subtypes, basal-like/triple-negative BC (TNBC) is characterized by a high propensity for relatively early metastases and a lack of available endocrine and targeted therapies. Therefore, this study aimed to discover potential signatures for predicting the immune response in early-stage basal-like/triple-negative BC. Method A total of 86 cases of early-stage TNBC from the TCGA and 459 cases of normal breast tissue from GTEx were enrolled and analyzed to screen out differentially expressed genes (DEGs). Then, the prognostic effect and tumor immune cell infiltration relationship with the basal-like-specific DEGs were also evaluated. Results A total of 1556 DEGs, including 929 upregulated genes and 627 downregulated genes, were screened in early-stage basal-like BC. Two prognosis-associated DEGs, GAL and TTC36, were finally found to be basal-like BC specific. However, only GAL was significantly correlated with tumor immune-infiltrating cells, especially CD8+ T cells. The expressions of GAL and TTC36 were revalidated by using the GEO dataset. Conclusion GAL might be an immune signature for the response to immune checkpoint therapy in early basal-like/triple-negative BC. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-022-02683-2.
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Affiliation(s)
- Min Wu
- Galactophore Department, Galactophore Center, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10, Haidian District, Beijing, 100038, China
| | - Keyu Yuan
- Galactophore Department, Galactophore Center, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10, Haidian District, Beijing, 100038, China
| | - Shuzhen Lyu
- Galactophore Department, Galactophore Center, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10, Haidian District, Beijing, 100038, China
| | - Yanping Li
- Galactophore Department, Galactophore Center, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10, Haidian District, Beijing, 100038, China.
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29
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Burgess R, Lekekela B, McBride RS, Eyles J. South African men's perceptions of breast cancer: impact of gender norms on health care accessibility. Health Promot Int 2022; 37:6639402. [PMID: 35810410 DOI: 10.1093/heapro/daac075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Women in low- and middle-income countries (LMICs) often present to the health care system at advanced stages of breast cancer (BC), leading to poor outcomes. A lack of BC awareness and affordability issues are proposed as contributors to the delayed presentation. In many areas of the world, however, women lack the autonomy to deal with their health needs due to restrictive gender norms. The role of gender norms has been relatively underexplored in the BC literature in LMICs and little is known about what men know about BC and how they are involved in women's access to care. To better understand these factors, we conducted a qualitative descriptive study in South Africa. We interviewed 20 low-income Black men with current woman partners who had not experienced BC. Interviewees had limited knowledge and held specific misconceptions about BC symptoms and treatment. Cancer is not commonly discussed within their community and multiple barriers prevent them from reaching care. Interviewees described themselves as having a facilitative role in their partner's access to health care, facets of which could inadvertently prevent their partners from autonomously seeking care. The findings point to the need to better consider the role of the male partner in BC awareness efforts in LMICs to facilitate prevention, earlier diagnosis and treatment.
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Affiliation(s)
- Raquel Burgess
- Global Health Program, Global Health Office, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Brown Lekekela
- Founder and Project Manager, Green Door Shelter, Johannesburg, Gauteng, South Africa
| | - Ruari-Santiago McBride
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - John Eyles
- School of Geography & Earth Sciences, Faculty of Science, McMaster University, Hamilton, ON, Canada.,Center for Health Policy, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
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Gao H, Li H, Wang J, Xu C, Zhu Y, Tuluhong D, Li X, Wang S, Li J. Polyamine synthesis enzyme AMD1 is closely related to the tumorigenesis and prognosis of human breast cancer. Exp Cell Res 2022; 417:113235. [DOI: 10.1016/j.yexcr.2022.113235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 05/29/2022] [Accepted: 05/29/2022] [Indexed: 11/28/2022]
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Bray F, Parkin DM. Cancer in sub-Saharan Africa in 2020: a review of current estimates of the national burden, data gaps, and future needs. Lancet Oncol 2022; 23:719-728. [PMID: 35550275 DOI: 10.1016/s1470-2045(22)00270-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND With the cancer burden rising in sub-Saharan Africa, countries in the region need surveillance systems to measure the magnitude of the problem and monitor progress in cancer control planning. Based on the national estimates built from data provided by cancer registries in sub-Saharan Africa, we summarise key patterns of the regional burden and argue for investments in locally produced data. METHODS To present national estimates of the cancer incidence and mortality burden in sub-Saharan Africa countries, new cancer cases and deaths were extracted from International Agency for Research on Cancers' GLOBOCAN database for the year 2020. Given weak vital statistics systems, almost all of the information on the cancer burden in sub-Saharan Africa was derived from population-based cancer registries. Of the 48 countries included in GLOBOCAN (national populations must be larger than 150 000 inhabitants in 2020), relatively recent cancer registry data (up to 2019) were directly used to produce national incidence estimates in 25 countries, while the absence of such data for 16 meant that estimates were based on data from neighbouring countries. Tables and figures present the estimated numbers of new cases and deaths, as well as age-standardised (incidence or mortality) rates per 100 000 person-years and the cumulative risk of developing or dying from cancer before the age of 75 years. FINDINGS 801 392 new cancer cases and 520 158 cancer deaths were estimated to have occurred in sub-Saharan Africa in 2020. Cancers of the breast (129 400 female cases) and cervix (110 300 cases) were responsible for three in ten of the cancers diagnosed in both sexes. Breast and cervical cancer were the most common cancers, ranking first in 28 and 19 countries, respectively. In men, prostate cancer led in terms of incidence (77 300 cases), followed by liver cancer (24 700 cases) and colorectal cancer (23 400 cases). Prostate cancer was the leading incident cancer in men in 40 sub-Saharan Africa countries. The risk of a woman in sub-Saharan Africa developing cancer by the age of 75 years was 14·1%, with breast cancer (4·1%) and cervical cancer (3·5%) responsible for half of this risk. For men, the corresponding cumulative incidence was lower (12·2%), with prostate cancer responsible for a third of this risk (4·2%). Cervical cancer was the leading form of cancer death among women in 27 countries, followed by breast cancer (21 countries). Prostate cancer led as the most common type of cancer death in 26 countries, with liver cancer ranking second (11 countries). INTERPRETATION The estimates indicate substantial geographical variations in the major cancers in sub-Saharan Africa. Rational cancer control planning requires capacity to be built for data production, analysis, and interpretation within the countries themselves. Cancer registries provide important information in this respect and should be prioritised for sustainable investment in the region. FUNDING None.
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Affiliation(s)
- Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France.
| | - D Maxwell Parkin
- Nuffield Department of Population Health, University of Oxford, Oxford, UK; The African Cancer Registry Network, INCTR African Registry Programme, Oxford, UK
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Sharma R, Aashima, Nanda M, Fronterre C, Sewagudde P, Ssentongo AE, Yenney K, Arhin ND, Oh J, Amponsah-Manu F, Ssentongo P. Mapping Cancer in Africa: A Comprehensive and Comparable Characterization of 34 Cancer Types Using Estimates From GLOBOCAN 2020. Front Public Health 2022; 10:839835. [PMID: 35548083 PMCID: PMC9082420 DOI: 10.3389/fpubh.2022.839835] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 03/10/2022] [Indexed: 01/22/2023] Open
Abstract
Objective Cancer incidence and mortality rates in Africa are increasing, yet their geographic distribution and determinants are incompletely characterized. The present study aims to establish the spatial epidemiology of cancer burden in Africa and delineate the association between cancer burden and the country-level socioeconomic status. The study also examines the forecasts of the cancer burden for 2040 and evaluates infrastructure availability across all African countries. Methods The estimates of age, sex, and country-specific incidence and mortality of 34 neoplasms in 54 African countries, were procured from GLOBOCAN 2020. Mortality-to-incidence ratio (MIR) was employed as a proxy indicator of 5-year survival rates, and the socioeconomic development of each country was measured using its human development index (HDI). We regressed age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and MIR on HDI using linear regression model to determine the relationship between cancer burden and HDI. Maps were generated for each cancer group for each country in Africa. The data about the cancer infrastructure of African countries were extracted from the WHO Cancer Country Profiles. Results In Africa, an estimated 1.1 million new cases [95% uncertainty intervals (UIs) 1.0 - 1.3 million] and 711,429 [611,604 - 827,547] deaths occurred due to neoplasms in 2020. The ASIR was estimated to be 132.1/100,000, varying from 78.4/100,000 (Niger) to 212.5/100,000 (La Réunion) in 2020. The ASMR was 88.8/100,000 in Africa, ranging from 56.6/100,000 in the Republic of the Congo to 139.4/100,000 in Zimbabwe. The MIR of all cancer combined was 0.64 in Africa, varying from 0.49 in Mauritius to 0.78 in The Gambia. HDI had a significant negative correlation with MIR of all cancer groups combined and main cancer groups (prostate, breast, cervical and colorectal). HDI explained 75% of the variation in overall 5-year cancer survival (MIR). By 2040, the burden of all neoplasms combined is forecasted to increase to 2.1 million new cases and 1.4 million deaths in Africa. Conclusion High cancer mortality rates in Africa demand a holistic approach toward cancer control and management, including, but not limited to, boosting cancer awareness, adopting primary and secondary prevention, mitigating risk factors, improving cancer infrastructure and timely treatment.
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Affiliation(s)
- Rajesh Sharma
- University School of Management and Entrepreneurship, Delhi Technological University, New Delhi, India
| | - Aashima
- University School of Management and Entrepreneurship, Delhi Technological University, New Delhi, India
| | - Mehak Nanda
- University School of Management and Entrepreneurship, Delhi Technological University, New Delhi, India
| | - Claudio Fronterre
- Centre for Health Informatics, Computing, and Statistics, Lancaster University, Lancaster, United Kingdom
| | | | - Anna E. Ssentongo
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
- Division of Trauma Surgery, Department of Surgery, Penn State College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, United States
| | - Kelsey Yenney
- Washington State University Elson S. Floyd College of Medicine, Seattle, WA, United States
| | - Nina D. Arhin
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - John Oh
- Division of Trauma Surgery, Department of Surgery, Penn State College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, United States
| | | | - Paddy Ssentongo
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
- Center for Neural Engineering, The Pennsylvania State University, State College, PA, United States
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Sharma R, Aashima, Nanda M, Fronterre C, Sewagudde P, Ssentongo AE, Yenney K, Arhin ND, Oh J, Amponsah-Manu F, Ssentongo P. Mapping Cancer in Africa: A Comprehensive and Comparable Characterization of 34 Cancer Types Using Estimates From GLOBOCAN 2020. Front Public Health 2022; 10:839835. [PMID: 35548083 PMCID: PMC9082420 DOI: 10.3389/fpubh.2022.839835 10.3389/fpubh.2022.839835/full#:~:text=we%20examined%20the%20burden%20of,29)%20to%20711%2c000%20in%202020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objective Cancer incidence and mortality rates in Africa are increasing, yet their geographic distribution and determinants are incompletely characterized. The present study aims to establish the spatial epidemiology of cancer burden in Africa and delineate the association between cancer burden and the country-level socioeconomic status. The study also examines the forecasts of the cancer burden for 2040 and evaluates infrastructure availability across all African countries. Methods The estimates of age, sex, and country-specific incidence and mortality of 34 neoplasms in 54 African countries, were procured from GLOBOCAN 2020. Mortality-to-incidence ratio (MIR) was employed as a proxy indicator of 5-year survival rates, and the socioeconomic development of each country was measured using its human development index (HDI). We regressed age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and MIR on HDI using linear regression model to determine the relationship between cancer burden and HDI. Maps were generated for each cancer group for each country in Africa. The data about the cancer infrastructure of African countries were extracted from the WHO Cancer Country Profiles. Results In Africa, an estimated 1.1 million new cases [95% uncertainty intervals (UIs) 1.0 - 1.3 million] and 711,429 [611,604 - 827,547] deaths occurred due to neoplasms in 2020. The ASIR was estimated to be 132.1/100,000, varying from 78.4/100,000 (Niger) to 212.5/100,000 (La Réunion) in 2020. The ASMR was 88.8/100,000 in Africa, ranging from 56.6/100,000 in the Republic of the Congo to 139.4/100,000 in Zimbabwe. The MIR of all cancer combined was 0.64 in Africa, varying from 0.49 in Mauritius to 0.78 in The Gambia. HDI had a significant negative correlation with MIR of all cancer groups combined and main cancer groups (prostate, breast, cervical and colorectal). HDI explained 75% of the variation in overall 5-year cancer survival (MIR). By 2040, the burden of all neoplasms combined is forecasted to increase to 2.1 million new cases and 1.4 million deaths in Africa. Conclusion High cancer mortality rates in Africa demand a holistic approach toward cancer control and management, including, but not limited to, boosting cancer awareness, adopting primary and secondary prevention, mitigating risk factors, improving cancer infrastructure and timely treatment.
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Affiliation(s)
- Rajesh Sharma
- University School of Management and Entrepreneurship, Delhi Technological University, New Delhi, India
| | - Aashima
- University School of Management and Entrepreneurship, Delhi Technological University, New Delhi, India
| | - Mehak Nanda
- University School of Management and Entrepreneurship, Delhi Technological University, New Delhi, India
| | - Claudio Fronterre
- Centre for Health Informatics, Computing, and Statistics, Lancaster University, Lancaster, United Kingdom
| | | | - Anna E. Ssentongo
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States,Division of Trauma Surgery, Department of Surgery, Penn State College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, United States
| | - Kelsey Yenney
- Washington State University Elson S. Floyd College of Medicine, Seattle, WA, United States
| | - Nina D. Arhin
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - John Oh
- Division of Trauma Surgery, Department of Surgery, Penn State College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, United States
| | | | - Paddy Ssentongo
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States,Center for Neural Engineering, The Pennsylvania State University, State College, PA, United States,*Correspondence: Paddy Ssentongo
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Sharma R, Aashima, Nanda M, Fronterre C, Sewagudde P, Ssentongo AE, Yenney K, Arhin ND, Oh J, Amponsah-Manu F, Ssentongo P. Mapping Cancer in Africa: A Comprehensive and Comparable Characterization of 34 Cancer Types Using Estimates From GLOBOCAN 2020. Front Public Health 2022; 10:839835. [PMID: 35548083 PMCID: PMC9082420 DOI: 10.3389/fpubh.2022.839835 10.3389/fpubh.2022.839835/full] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Cancer incidence and mortality rates in Africa are increasing, yet their geographic distribution and determinants are incompletely characterized. The present study aims to establish the spatial epidemiology of cancer burden in Africa and delineate the association between cancer burden and the country-level socioeconomic status. The study also examines the forecasts of the cancer burden for 2040 and evaluates infrastructure availability across all African countries. METHODS The estimates of age, sex, and country-specific incidence and mortality of 34 neoplasms in 54 African countries, were procured from GLOBOCAN 2020. Mortality-to-incidence ratio (MIR) was employed as a proxy indicator of 5-year survival rates, and the socioeconomic development of each country was measured using its human development index (HDI). We regressed age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and MIR on HDI using linear regression model to determine the relationship between cancer burden and HDI. Maps were generated for each cancer group for each country in Africa. The data about the cancer infrastructure of African countries were extracted from the WHO Cancer Country Profiles. RESULTS In Africa, an estimated 1.1 million new cases [95% uncertainty intervals (UIs) 1.0 - 1.3 million] and 711,429 [611,604 - 827,547] deaths occurred due to neoplasms in 2020. The ASIR was estimated to be 132.1/100,000, varying from 78.4/100,000 (Niger) to 212.5/100,000 (La Réunion) in 2020. The ASMR was 88.8/100,000 in Africa, ranging from 56.6/100,000 in the Republic of the Congo to 139.4/100,000 in Zimbabwe. The MIR of all cancer combined was 0.64 in Africa, varying from 0.49 in Mauritius to 0.78 in The Gambia. HDI had a significant negative correlation with MIR of all cancer groups combined and main cancer groups (prostate, breast, cervical and colorectal). HDI explained 75% of the variation in overall 5-year cancer survival (MIR). By 2040, the burden of all neoplasms combined is forecasted to increase to 2.1 million new cases and 1.4 million deaths in Africa. CONCLUSION High cancer mortality rates in Africa demand a holistic approach toward cancer control and management, including, but not limited to, boosting cancer awareness, adopting primary and secondary prevention, mitigating risk factors, improving cancer infrastructure and timely treatment.
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Affiliation(s)
- Rajesh Sharma
- University School of Management and Entrepreneurship, Delhi Technological University, New Delhi, India
| | - Aashima
- University School of Management and Entrepreneurship, Delhi Technological University, New Delhi, India
| | - Mehak Nanda
- University School of Management and Entrepreneurship, Delhi Technological University, New Delhi, India
| | - Claudio Fronterre
- Centre for Health Informatics, Computing, and Statistics, Lancaster University, Lancaster, United Kingdom
| | | | - Anna E. Ssentongo
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States,Division of Trauma Surgery, Department of Surgery, Penn State College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, United States
| | - Kelsey Yenney
- Washington State University Elson S. Floyd College of Medicine, Seattle, WA, United States
| | - Nina D. Arhin
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - John Oh
- Division of Trauma Surgery, Department of Surgery, Penn State College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, United States
| | | | - Paddy Ssentongo
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States,Center for Neural Engineering, The Pennsylvania State University, State College, PA, United States,*Correspondence: Paddy Ssentongo
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Sharma R, Aashima, Nanda M, Fronterre C, Sewagudde P, Ssentongo AE, Yenney K, Arhin ND, Oh J, Amponsah-Manu F, Ssentongo P. Mapping Cancer in Africa: A Comprehensive and Comparable Characterization of 34 Cancer Types Using Estimates From GLOBOCAN 2020. Front Public Health 2022; 10:839835. [PMID: 35548083 PMCID: PMC9082420 DOI: 10.3389/fpubh.2022.839835+10.3389/fpubh.2022.839835/full#:~:text=we%20examined%20the%20burden%20of,29)%20to%20711%2c000%20in%202020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
OBJECTIVE Cancer incidence and mortality rates in Africa are increasing, yet their geographic distribution and determinants are incompletely characterized. The present study aims to establish the spatial epidemiology of cancer burden in Africa and delineate the association between cancer burden and the country-level socioeconomic status. The study also examines the forecasts of the cancer burden for 2040 and evaluates infrastructure availability across all African countries. METHODS The estimates of age, sex, and country-specific incidence and mortality of 34 neoplasms in 54 African countries, were procured from GLOBOCAN 2020. Mortality-to-incidence ratio (MIR) was employed as a proxy indicator of 5-year survival rates, and the socioeconomic development of each country was measured using its human development index (HDI). We regressed age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and MIR on HDI using linear regression model to determine the relationship between cancer burden and HDI. Maps were generated for each cancer group for each country in Africa. The data about the cancer infrastructure of African countries were extracted from the WHO Cancer Country Profiles. RESULTS In Africa, an estimated 1.1 million new cases [95% uncertainty intervals (UIs) 1.0 - 1.3 million] and 711,429 [611,604 - 827,547] deaths occurred due to neoplasms in 2020. The ASIR was estimated to be 132.1/100,000, varying from 78.4/100,000 (Niger) to 212.5/100,000 (La Réunion) in 2020. The ASMR was 88.8/100,000 in Africa, ranging from 56.6/100,000 in the Republic of the Congo to 139.4/100,000 in Zimbabwe. The MIR of all cancer combined was 0.64 in Africa, varying from 0.49 in Mauritius to 0.78 in The Gambia. HDI had a significant negative correlation with MIR of all cancer groups combined and main cancer groups (prostate, breast, cervical and colorectal). HDI explained 75% of the variation in overall 5-year cancer survival (MIR). By 2040, the burden of all neoplasms combined is forecasted to increase to 2.1 million new cases and 1.4 million deaths in Africa. CONCLUSION High cancer mortality rates in Africa demand a holistic approach toward cancer control and management, including, but not limited to, boosting cancer awareness, adopting primary and secondary prevention, mitigating risk factors, improving cancer infrastructure and timely treatment.
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Affiliation(s)
- Rajesh Sharma
- University School of Management and Entrepreneurship, Delhi Technological University, New Delhi, India
| | - Aashima
- University School of Management and Entrepreneurship, Delhi Technological University, New Delhi, India
| | - Mehak Nanda
- University School of Management and Entrepreneurship, Delhi Technological University, New Delhi, India
| | - Claudio Fronterre
- Centre for Health Informatics, Computing, and Statistics, Lancaster University, Lancaster, United Kingdom
| | | | - Anna E. Ssentongo
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States,Division of Trauma Surgery, Department of Surgery, Penn State College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, United States
| | - Kelsey Yenney
- Washington State University Elson S. Floyd College of Medicine, Seattle, WA, United States
| | - Nina D. Arhin
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - John Oh
- Division of Trauma Surgery, Department of Surgery, Penn State College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, United States
| | | | - Paddy Ssentongo
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States,Center for Neural Engineering, The Pennsylvania State University, State College, PA, United States,*Correspondence: Paddy Ssentongo
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Glenn BE, Espira LM, Larson MC, Larson PS. Ambient air pollution and non-communicable respiratory illness in sub-Saharan Africa: a systematic review of the literature. Environ Health 2022; 21:40. [PMID: 35422005 PMCID: PMC9009030 DOI: 10.1186/s12940-022-00852-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 04/04/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Aerosol pollutants are known to raise the risk of development of non-communicable respiratory diseases (NCRDs) such as asthma, chronic bronchitis, chronic obstructive pulmonary disease, and allergic rhinitis. Sub-Saharan Africa's rapid pace of urbanization, economic expansion, and population growth raise concerns of increasing incidence of NCRDs. This research characterizes the state of research on pollution and NCRDs in the 46 countries of Sub-Saharan Africa (SSA). This research systematically reviewed the literature on studies of asthma; chronic bronchitis; allergic rhinitis; and air pollutants such as particulate matter, ozone, NOx, and sulfuric oxide. METHODS We searched three major databases (PubMed, Web of Science, and Scopus) using the key words "asthma", "chronic bronchitis", "allergic rhinitis", and "COPD" with "carbon monoxide (CO)", "sulfuric oxide (SO)", "ozone (O3)", "nitrogen dioxide (NO2)", and "particulate matter (PM)", restricting the search to the 46 countries that comprise SSA. Only papers published in scholarly journals with a defined health outcome in individuals and which tested associations with explicitly measured or modelled air exposures were considered for inclusion. All candidate papers were entered into a database for review. RESULTS We found a total of 362 unique research papers in the initial search of the three databases. Among these, 14 met the inclusion criteria. These papers comprised studies from just five countries. Nine papers were from South Africa; two from Malawi; and one each from Ghana, Namibia, and Nigeria. Most studies were cross-sectional. Exposures to ambient air pollutants were measured using spectrometry and chromatography. Some studies created composite measures of air pollution using a range of data layers. NCRD outcomes were measured by self-reported health status and measures of lung function (spirometry). Populations of interest were primarily schoolchildren, though a few studies focused on secondary school students and adults. CONCLUSIONS The paucity of research on NCRDs and ambient air pollutant exposures is pronounced within the African continent. While capacity to measure air quality in SSA is high, studies targeting NCRDs should work to draw attention to questions of outdoor air pollution and health. As the climate changes and SSA economies expand and countries urbanize, these questions will become increasingly important.
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Affiliation(s)
- Bailey E. Glenn
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA USA
| | - Leon M. Espira
- Center for Global Health Equity, University of Michigan, Ann Arbor, USA
| | | | - Peter S. Larson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA USA
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI USA
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI USA
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Sun H, Dai J, Chen M, Chen Q, Xie Q, Zhang W, Li G, Yan M. miR-139-5p Was Identified as Biomarker of Different Molecular Subtypes of Breast Carcinoma. Front Oncol 2022; 12:857714. [PMID: 35433464 PMCID: PMC9009410 DOI: 10.3389/fonc.2022.857714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/24/2022] [Indexed: 12/12/2022] Open
Abstract
Located on chromosome 11q13.4, miR-139-5p has been confirmed by several studies as a possible attractive biomarker for cancer, including breast cancer, but its mechanism of correlation in different molecular subtypes of breast cancer has not been reported. In this study, comprehensive bioinformatics analysis was used to evaluate the expression of miR-139-5p in different molecular subtypes of breast cancer (luminal A, luminal B, HER2-enriched, and basal-like). The target genes of miR-139-5p were predicted by using an online database TargetScan and miRDB, and three key genes, FBN2, MEX3A, and TPD52, were screened in combination with differentially expressed genes in different molecular subtypes of breast cancer. The expression of the three genes was verified separately, and the genes were analyzed for pathway and functional enrichment. Bone marrow mesenchymal stem cells (BMSC) are another kind of highly plastic cell population existing in bone marrow besides hematopoietic stem cells. BMSC can affect the proliferation and migration of cancer cells, promote the metastasis and development of cancer, and regulate the tumor microenvironment by secreting exosome mirnas, thus affecting the malignant biological behavior of tumor cells. Finally, human bone marrow mesenchymal stem cells exosomes were obtained by ultracentrifugation, and the morphology of exosomes was observed by transmission electron microscopy. The expression of miR-139-5p in normal breast cells MCF-10A, human breast cancer cell line MDA-MB-231 cells, and BMSCs-derived exosomes were compared; the exosomes and MDA-MB-231 cells were co-cultured to observe their effects on the proliferation of the MDA-MB-231 cells. Human bone marrow mesenchymal stem cell-derived exosomes inhibited the growth of breast cancer cells and promoted the expression of FBN2, MEX3A, and TPD52 by transporting miR-139-5p.
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Affiliation(s)
- Haohang Sun
- General Surgery I (Thyroid, Breast, Vascular, Hernia Surgery), General Hospital of Zhenhai District People’s Hospital Medical Group, Ningbo, China
| | - Ji Dai
- Department of General Surgery, Zhenhai District People’s Hospital, Ningbo, China
| | - Mengze Chen
- General Surgery I (Thyroid, Breast, Vascular, Hernia Surgery), General Hospital of Zhenhai District People’s Hospital Medical Group, Ningbo, China
| | - Qi Chen
- General Surgery I (Thyroid, Breast, Vascular, Hernia Surgery), General Hospital of Zhenhai District People’s Hospital Medical Group, Ningbo, China
| | - Qiong Xie
- General Surgery I (Thyroid, Breast, Vascular, Hernia Surgery), General Hospital of Zhenhai District People’s Hospital Medical Group, Ningbo, China
| | - Weijun Zhang
- General Surgery I (Thyroid, Breast, Vascular, Hernia Surgery), General Hospital of Zhenhai District People’s Hospital Medical Group, Ningbo, China
| | - Guoqing Li
- General Surgery I (Thyroid, Breast, Vascular, Hernia Surgery), General Hospital of Zhenhai District People’s Hospital Medical Group, Ningbo, China
| | - Meidi Yan
- General Surgery I (Thyroid, Breast, Vascular, Hernia Surgery), General Hospital of Zhenhai District People’s Hospital Medical Group, Ningbo, China
- *Correspondence: Meidi Yan,
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Stark RT, Pye DR, Chen W, Newton OJ, Deadman BJ, Miller PW, Panayides JL, Riley DL, Hellgardt K, Hii KK(M. Assessing a sustainable manufacturing route to lapatinib. REACT CHEM ENG 2022. [DOI: 10.1039/d2re00267a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A synthetic route to an anti-cancer drug, lapatinib, was devised to support the development of a sustainable manufacturing process in South Africa.
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Affiliation(s)
- Roderick T. Stark
- Department of Chemistry, Imperial College London, Molecular Sciences Research Hub, 82, Wood Lane, London W12 0BZ, UK
| | - Dominic R. Pye
- Department of Chemistry, Imperial College London, Molecular Sciences Research Hub, 82, Wood Lane, London W12 0BZ, UK
| | - Wenyi Chen
- Department of Chemistry, Imperial College London, Molecular Sciences Research Hub, 82, Wood Lane, London W12 0BZ, UK
| | - Oliver J. Newton
- Department of Chemistry, Imperial College London, Molecular Sciences Research Hub, 82, Wood Lane, London W12 0BZ, UK
| | - Benjamin J. Deadman
- Centre for Rapid Online Analysis of Reactions (ROAR), Molecular Sciences Research Hub, 82, Wood Lane, London W12 0BZ, UK
| | - Philip W. Miller
- Department of Chemistry, Imperial College London, Molecular Sciences Research Hub, 82, Wood Lane, London W12 0BZ, UK
| | - Jenny-Lee Panayides
- Pharmaceutical Technologies, Future Production: Chemicals, Council for Scientific & Industrial Research (CSIR), Meiring Naude Rd, Brummeria, Pretoria, 0184, South Africa
| | - Darren L. Riley
- Department of Chemistry, Faculty of Natural and Agricultural Sciences, University of Pretoria, Lynnwood Rd, Hatfield, Pretoria, 0002, South Africa
| | - Klaus Hellgardt
- Department of Chemical Engineering, Imperial College London, Exhibition Road, South Kensington, London SW7 2AZ, UK
| | - King Kuok (Mimi) Hii
- Department of Chemistry, Imperial College London, Molecular Sciences Research Hub, 82, Wood Lane, London W12 0BZ, UK
- Centre for Rapid Online Analysis of Reactions (ROAR), Molecular Sciences Research Hub, 82, Wood Lane, London W12 0BZ, UK
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Kabukye JK, Kakungulu E, Keizer ND, Cornet R. Digital health in oncology in Africa: A scoping review and cross-sectional survey. Int J Med Inform 2021; 158:104659. [PMID: 34929545 DOI: 10.1016/j.ijmedinf.2021.104659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/09/2021] [Accepted: 12/05/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Low- and middle-income countries, especially in Africa, face a growing cancer burden. Adoption of digital health solutions has the potential to improve cancer care delivery and research in these countries. However, the extent of implementation and the impact of digital health interventions across the cancer continuum in Africa have not been studied. AIMS To describe the current landscape of digital health interventions in oncology in Africa. METHODS We conducted a scoping literature review and supplemented this with a survey. Following the PRISMA for Scoping Reviews guidelines, we searched literature in PubMed and Embase for keywords and synonyms for cancer, digital health, and African countries, and abstracted data using a structured form. For the survey, participants were delegates of the 2019 conference of the African Organization for Research and Training in Cancer. RESULTS The literature review identified 57 articles describing 40 digital health interventions or solutions from 17 African countries, while the survey included 111 respondents from 18 African countries, and these reported 25 different digital health systems. Six articles (10.5%) reported randomized controlled trials. The other 51 articles (89.5%) were descriptive or quasi-experimental studies. The interventions mostly targeted cancer prevention (28 articles, 49.1%) or diagnosis and treatment (23 articles, 40.4%). Four articles (7.0%) targeted survivorship and end of life, and the rest were cross-cutting. Cervical cancer was the most targeted cancer (25 articles, 43.9%). Regarding WHO classification of digital interventions, most were for providers (35 articles, 61.4%) or clients (13, 22.8%), while the others were for data services or cut across these categories. The interventions were mostly isolated pilots using basic technologies such as SMS and telephone calls for notifying patients of their appointments or results, or for cancer awareness; image capture apps for cervical cancer screening, and tele-conferencing for tele-pathology and mentorship. Generally positive results were reported, but evaluation focused on structure and process measures such as ease of use, infrastructure requirements, and acceptability of intervention; or general benefits e.g. supporting training and mentorship of providers, communication among providers and clients, and improving data collection and management. No studies evaluated individualized clinical outcomes, and there were no interventions in literature for health system managers although the systems identified in the survey had such functionality, e.g. inventory management. The survey also indicated that none of the digital health systems had all the functionalities for a comprehensive EHR, and major barriers for digital health were initial and ongoing costs, resistance from clinical staff, and lack of fit between the EHR and the clinical workflows. CONCLUSION Digital health interventions in oncology in Africa are at early maturity stages but promising. Barriers such as funding, fit between digital health tools and clinical workflows, and inertia towards technology, shall need to be addressed to allow for advancement of digital health solutions to support all parts of the cancer continuum. Future research should investigate the impact of digital health solutions on long-term cancer outcomes such as cancer mortality, morbidity and quality of life.
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Affiliation(s)
- Johnblack K Kabukye
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC, Location AMC, Meibergdreef 15, Amsterdam, the Netherlands; Uganda Cancer Institute, Upper Mulago Hill Road, P.O. Box 3935, Kampala, Uganda.
| | - Edward Kakungulu
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC, Location AMC, Meibergdreef 15, Amsterdam, the Netherlands
| | - Nicolette de Keizer
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC, Location AMC, Meibergdreef 15, Amsterdam, the Netherlands
| | - Ronald Cornet
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC, Location AMC, Meibergdreef 15, Amsterdam, the Netherlands
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Moustafa M, Mali ME, Lopez-Verdugo F, Sanyang O, Nellermoe J, Price RR, Manortey S, Biritwum-Nyarko A, Ofei I, Sorensen J, Goldsmith A, Brownson KE, Kumah A, Sutherland E. Surveying and mapping breast cancer services in Ghana: a cross-sectional pilot study in the Eastern Region. BMJ Open 2021; 11:e051122. [PMID: 34824116 PMCID: PMC8627397 DOI: 10.1136/bmjopen-2021-051122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 10/20/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Define the services available for the care of breast cancer at hospitals in the Eastern Region of Ghana, identify areas of the region with limited access to care through geospatial mapping, and test a novel survey instrument in anticipation of a nationwide scale up of the study. DESIGN A cross-sectional, facility-based survey study. SETTING This study was conducted at 33 of the 34 hospitals in the Eastern Region of Ghana from March 2020 to May 2020. PARTICIPANTS The 33 hospitals surveyed represented 97% of all hospitals in the region. This included private, government, quasi-government and faith-based organisation owned hospitals. RESULTS Sixteen hospitals (82%) surveyed provided basic screening services, 11 (33%) provided pathological diagnosis and 3 (9%) provided those services in addition to basic surgical care.53%, 64% and 78% of the population lived within 10 km, 25 km and 45 km of screening, diagnostic and treatment services respectively. Limited chemotherapy was available at two hospitals (6%), endocrine therapy at one hospital (3%) and radiotherapy was not available. Twenty-nine hospitals (88%) employed a general practitioner and 13 (39%) employed a surgeon. Oncology specialists, pathology personnel and a plastic surgeon were only available in one hospital (3%) in the Eastern Region. CONCLUSIONS Although 16 hospitals (82%) provided screening, only half the population lived within reasonable distance of these services. Few hospitals offered diagnosis and surgical services, but 64% and 78% of the population lived within a reasonable distance of these hospitals. Geospatial analysis suggested two priorities to cost-effectively expand breast cancer services: (1) increase the number of health facilities providing screening services and (2) centralise basic imaging, pathological and surgical services at targeted hospitals.
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Affiliation(s)
- Moustafa Moustafa
- Center for Global Surgery, University of Utah Health, Salt Lake City, Utah, USA
| | - Meghan Eileen Mali
- Center for Global Surgery, University of Utah Health, Salt Lake City, Utah, USA
- General Surgery, University of Utah Hospital, Salt Lake City, Utah, USA
| | - Fidel Lopez-Verdugo
- Center for Global Surgery, University of Utah Health, Salt Lake City, Utah, USA
| | - Ousman Sanyang
- Center for Global Surgery, University of Utah Health, Salt Lake City, Utah, USA
- Department of Surgery, Edward Francis Small Teaching Hospital, Banjul, The Gambia
| | - Jonathan Nellermoe
- Center for Global Surgery, University of Utah Health, Salt Lake City, Utah, USA
| | - Raymond R Price
- Center for Global Surgery, University of Utah Health, Salt Lake City, Utah, USA
- General Surgery, Intermountain Medical Center, Murray, Utah, USA
| | | | | | - Irina Ofei
- Eastern Regional Health Directorate, Ghana Health Service, Koforidua, Eastern Region, Ghana
| | - Justin Sorensen
- J. Willard Marriott Library, University of Utah, Salt Lake City, Utah, USA
| | - Alison Goldsmith
- Center for Global Surgery, University of Utah Health, Salt Lake City, Utah, USA
- Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah, USA
| | - Kirstyn E Brownson
- Center for Global Surgery, University of Utah Health, Salt Lake City, Utah, USA
- Department of Surgery, Huntsman Cancer Institute Cancer Hospital, Salt Lake City, Utah, USA
| | - Augustine Kumah
- Quality and Public Health, Nyaho Medical Centre, Accra, Greater Accra, Ghana
| | - Edward Sutherland
- Center for Global Surgery, University of Utah Health, Salt Lake City, Utah, USA
- Ensign Global College, Kpong, Eastern Region, Ghana
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Rahman WT, Helvie MA. Breast cancer screening in average and high-risk women. Best Pract Res Clin Obstet Gynaecol 2021; 83:3-14. [PMID: 34903436 DOI: 10.1016/j.bpobgyn.2021.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/03/2021] [Accepted: 11/04/2021] [Indexed: 12/28/2022]
Abstract
Breast cancer is the most common cancer among females worldwide with rising incidence. In the United States, screening mammography and advances in therapy have lowered mortality by 41% since 1990. Screening mammography is supported by randomized control trials (RCT), observational studies, and computer model data. Digital breast tomosynthesis is a new technology that addresses limitations in mammography resulting from overlapping breast tissue, improving its sensitivity and specificity. Patients at high risk for breast cancer include those with a ≥20% lifetime risk, high-risk germline mutation, or history of thoracic radiation treatment between 10-30 years of age. Such patients are recommended to undergo annual screening mammography and adjunctive annual screening breast MRI. Patients unable to undergo MRI may undergo whole breast ultrasound or contrast-enhanced mammography. Pregnant and lactating patients at average risk for breast cancer are recommended to undergo age-appropriate screening mammography.
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Affiliation(s)
- W Tania Rahman
- Department of Radiology, Division of Breast Imaging, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA.
| | - Mark A Helvie
- Department of Radiology, Division of Breast Imaging, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA
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Amouzou KS, Ketevi AA, Sambiani DM, Caroli A. Female breast cancer in sub-Saharan Africa: A PRISMA-S-compliant systematic review of surgery. J Surg Oncol 2021; 125:336-351. [PMID: 34738640 DOI: 10.1002/jso.26720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/25/2021] [Accepted: 09/25/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND In sub-Saharan countries (SSAs), the advanced stage at diagnosis and the limited surgical interventions of female breast cancer (FBC) lead to poor outcomes. This study assessed current modalities of FBC surgeries. METHODS Six literature databases (Medline, Embase, African Journal Online, Google Scholar, Web of Science, Cochrane Library) were searched, plus a manual search, in 2011-2021. We included primary data studies with any setting and presurgeries or postsurgeries treatments, we excluded non-English language studies, editorials, and grey literature. RESULTS The search yielded 21 observational studies (16 retrospective, 3 prospective, and 2 case reports). Of the total 6900 patients, 4121 (60%) patients underwent FBC surgical excision only, and 751/2779 (27%) conservative surgery (BCS) or therapy (BCT). All studies reported similar use of mastectomy (>60%), the FBC surgical excision/reconstruction studies displayed more neoadjuvant chemotherapy (536/2779, 19% vs. 215/4121, 5%), and radiotherapy or adjuvant radiotherapy (1461/2779, 52% vs. 411/3921, 4%). Patients' age, histological classification, staging, and follow-up data were often missing. CONCLUSIONS The FBC complexity requires structured management by general and plastic surgeons, radiotherapy specialists, and obstetrician-gynecologists through shared guidelines, protocols, and specific programs of public health. In SSAs, FBC surgical strategies should point at decreasing radical mastectomy and increasing BCS/BCT.
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Affiliation(s)
- Komla Séna Amouzou
- Department of Surgery, University of Lomé, Sylvanus Olympio Teaching Hospital, Lomé, Togo
| | - Ameyo Ayoko Ketevi
- Department of Gynaecology, University of Lomé, Sylvanus Olympio Teaching Hospital, Lomé, Togo
| | | | - Angela Caroli
- Radiotherapy Unit, Centro di Riferimento Oncologico, IRCCS-National Cancer Institute, Aviano, Pordenone, Italy
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Lei S, Zheng R, Zhang S, Wang S, Chen R, Sun K, Zeng H, Zhou J, Wei W. Global patterns of breast cancer incidence and mortality: A population-based cancer registry data analysis from 2000 to 2020. Cancer Commun (Lond) 2021; 41:1183-1194. [PMID: 34399040 PMCID: PMC8626596 DOI: 10.1002/cac2.12207] [Citation(s) in RCA: 329] [Impact Index Per Article: 109.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 07/22/2021] [Accepted: 08/03/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Breast cancer is the most commonly diagnosed cancer and leading cause of cancer death among women worldwide but has patterns and trends which vary in different countries. This study aimed to evaluate the global patterns of breast cancer incidence and mortality and analyze its temporal trends for breast cancer prevention and control. METHODS Breast cancer incidence and mortality data in 2020 were obtained from the GLOBOCAN online database. Continued data from the Cancer Incidence in Five Continents Time Trends, the International Agency for Research on cancer mortality and China National Central Cancer Registry were used to analyze the time trends from 2000 to 2015 through Joinpoint regression, and annual average percent changes of breast cancer incidence and mortality were calculated. Association between Human Development Index and breast cancer incidence and mortality were estimated by linear regression. RESULTS There were approximately 2.3 million new breast cancer cases and 685,000 breast cancer deaths worldwide in 2020. Its incidence and mortality varied among countries, with the age-standardized incidence ranging from the highest of 112.3 per 100,000 population in Belgium to the lowest of 35.8 per 100,000 population in Iran, and the age-standardized mortality from the highest of 41.0 per 100,000 population in Fiji to the lowest of 6.4 per 100,000 population in South Korea. The peak age of breast cancer in some Asian and African countries were over 10 years earlier than in European or American countries. As for the trends of breast cancer, the age-standardized incidence rates significantly increased in China and South Korea but decreased in the United States of America (USA) during 2000-2012. Meanwhile, the age-standardized mortality rates significantly increased in China and South Korea but decreased in the United Kingdom, the USA, and Australia during 2000 and 2015. CONCLUSIONS The global burden of breast cancer is rising fast and varies greatly among countries. The incidence and mortality rates of breast cancer increased rapidly in China and South Korea but decreased in the USA. Increased health awareness, effective prevention strategies, and improved access to medical treatment are extremely important to curb the snowballing breast cancer burden, especially in the most affected countries.
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Affiliation(s)
- Shaoyuan Lei
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing100021P. R. China
| | - Rongshou Zheng
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing100021P. R. China
| | - Siwei Zhang
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing100021P. R. China
| | - Shaoming Wang
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing100021P. R. China
| | - Ru Chen
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing100021P. R. China
| | - Kexin Sun
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing100021P. R. China
| | - Hongmei Zeng
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing100021P. R. China
| | - Jiachen Zhou
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing100021P. R. China
- Department of Epidemiology and BiostatisticsSchool of Public HealthXi'an Jiaotong University Health Science CenterXi'anShaanxi710061P. R. China
| | - Wenqiang Wei
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing100021P. R. China
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Jeong S, Lee N, Park MJ, Jeon K, Song W. Currently Used Laboratory Methodologies for Assays Detecting PD-1, PD-L1, PD-L2 and Soluble PD-L1 in Patients with Metastatic Breast Cancer. Cancers (Basel) 2021; 13:cancers13205225. [PMID: 34680373 PMCID: PMC8534186 DOI: 10.3390/cancers13205225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/07/2021] [Accepted: 10/13/2021] [Indexed: 12/20/2022] Open
Abstract
Simple Summary Several methods targeting the programmed death protein-1 (PD-1) axis have been developed and evaluated for the detection of immune checkpoint levels that are strongly involved in immunotherapy for patients with metastatic breast cancer. Variations in different assays used in diverse studies have affected their result interpretation and clinical utility. When applying these assays to the laboratory, a comprehensive understanding of the characteristics of them should be recognized. We reviewed applied laboratory techniques for detecting PD-1, PD-ligand (L)1, PD-L2, and soluble PD-L1, which are important for selecting metastatic cancer patients for immunotherapy. Advances in methodologies according to the epoch are also investigated to gain insight into immunologic techniques and to facilitate appropriate laboratory settings for evaluating the PD-1 axis status, which are useful for estimating outcomes and planning patient-tailored immunotherapy strategies. Abstract Approximately 20% of breast cancer (BC) patients suffer from distant metastasis. The incidence and prevalence rates of metastatic BC have increased annually. Immune checkpoint inhibitors are an emerging area of treatment, especially for metastatic patients with poor outcomes. Several antibody drugs have been developed and approved for companion testing of the programmed death protine-1 (PD-1) axis. We reviewed currently used laboratory methodologies for assays determining PD-1 axis to provide a comprehensive understanding of principles, advantages, and drawbacks involved in their implementation. The most commonly used method is immunohistochemistry (92.9%) for PD-L1 expression using tissue samples (96.4%). The commonly used anti-PD-L1 antibody clone were commercially available 22C3 (30.8%), SP142 (19.2%), SP263 (15.4%), and E1L3N (11.5%). Enzyme-linked immunosorbent assay and electrochemiluminescent immunoassay that target soluble PD-ligand (L)1 were developed and popularized in 2019–2021, in contrast to 2016–2018. Easy accessibility and non-invasiveness due to the use of blood samples, quantitative outputs, and relatively rapid turnaround times make them more preferable. Regarding scoring methods, a combination of tumor and immune cells (45.5% in 2016–2018 to 57.1% in 2019–2021) rather than each cell alone became more popular. Information about antibody clones, platforms, scoring methods, and related companion drugs is recommended for reporting PD-L1 expression.
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Affiliation(s)
- Seri Jeong
- Department of Laboratory Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07440, Korea; (S.J.); (N.L.); (M.-J.P.)
| | - Nuri Lee
- Department of Laboratory Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07440, Korea; (S.J.); (N.L.); (M.-J.P.)
| | - Min-Jeong Park
- Department of Laboratory Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07440, Korea; (S.J.); (N.L.); (M.-J.P.)
| | - Kibum Jeon
- Department of Laboratory Medicine, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07440, Korea;
| | - Wonkeun Song
- Department of Laboratory Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07440, Korea; (S.J.); (N.L.); (M.-J.P.)
- Correspondence: ; Tel.: +82-2-829-5259
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Ma R, Zhu K, Yuan D, Gong M, Li Y, Li K, Meng L. Downregulation of the FBXO43 gene inhibits tumor growth in human breast cancer by limiting its interaction with PCNA. J Transl Med 2021; 19:425. [PMID: 34645483 PMCID: PMC8513237 DOI: 10.1186/s12967-021-03100-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The function and regulatory mechanism of FBXO43 in breast cancer (BC) are still unclear. Here, we intended to determine the role and mechanism of FBXO43 in BC. METHODS FBXO43 expression in BC was evaluated by analysis of The Cancer Genome Atlas (TCGA). RT-qPCR and western blotting were utilized to detect FBXO43 expression in BC cell lines. Lentivirus was applied to downregulate FBXO43 in human BC cells. Proliferation assays were performed to evaluate the proliferative ability of BC cells. The apoptosis and cell cycle analysis of BC cells were analyzed by flow cytometry. Cell migration and invasion were investigated via Transwell assays. The function of FBXO43 in vivo was evaluated by constructing a xenograft mouse model. The proteins that might interact with FBXO43 in BC were identified by mass spectrometry, bioinformatics analysis, and co-immunoprecipitation (Co-IP) assays. Finally, rescue experiments were conducted to validate the recovery effects of the proteins interacting with FBXO43. RESULTS FBXO43 was highly expressed in BC and was significantly downregulated after FBXO43 knockdown. The proliferation, migration, and invasion of BC cells were inhibited, and cell apoptosis was induced by FBXO43 knockdown. In addition, an in vivo experiment indicated that FBXO43 knockdown could inhibit the cell growth of BC. The results of the Co-IP assay showed that FBXO43 interacted with PCNA. Further rescue experiments confirmed that overexpression of PCNA significantly reversed the effects of FBXO43 knockdown on BC cells. CONCLUSION Downregulation of FBXO43 inhibits the tumor growth of BC by limiting its interaction with PCNA. FBXO43 might be a new potential oncogene and a therapeutic target for BC.
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Affiliation(s)
- Rulan Ma
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Kun Zhu
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Dawei Yuan
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Meijun Gong
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Yijun Li
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Kang Li
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China.
| | - Lei Meng
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China.
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Motah M, Gams Massi D, Fouda Bekolo F, Akweseh Nju N, Ndoumbe A, Moumi M, Sango A, Shu P, Eyenga V. Epidemiological profile of brain tumors in Cameroon: a retrospective study. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2021. [DOI: 10.1186/s41983-021-00381-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Brain tumors represent group of neoplasms originating from intracranial tissues and the meninges. The aim of this study was to determine the epidemiological profile of brain tumors seen in a referral health center in Cameroon. We carried out a 10-year retrospective study in the neurosurgical, neurology, pathology, oncology and radiotherapy units of our hospital.
Results
We found 150 complete case files accounting for 0.7% of total admissions in the various units. Males accounted for 50.7% of the cases. Children less than 14 years represented 12.7% of cases (n = 19). Primary brain tumors constituted 92% (n = 138). Most patients with primary brain tumors were between 25 and 54 years of age, making up 57% of cases (n = 79). The most prevalent histological type of brain tumor was meningioma (26%, n = 39), followed by astrocytoma (24.7%, n = 37), and pituitary adenomas (18%, n = 27). The majority of cases presented with signs of raised intracranial pressure with headache being the most frequent symptom (88%). Some patients presented with seizures (34%), neurological deficit (13%), visual disturbances (10%), and cognitive disorders (7%).
Conclusion
Young adults represent the most affected age group. Meningioma, astrocytoma and pituitary adenomas were the most frequent brain tumors in adults. Further studies are needed to assess the long-term outcome of patients with BTs.
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Badodekar N, Sharma A, Patil V, Telang G, Sharma R, Patil S, Vyas N, Somasundaram I. Angiogenesis induction in breast cancer: A paracrine paradigm. Cell Biochem Funct 2021; 39:860-873. [PMID: 34505714 DOI: 10.1002/cbf.3663] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/22/2021] [Accepted: 06/29/2021] [Indexed: 12/14/2022]
Abstract
Breast cancer is the most prevalent type of cancer among women globally. Angiogenesis contributes significantly to breast cancer progression and dissemination. Neovascularization is concurrent with the progression and growth of breast cancer. Breast cancer cells control angiogenesis by secreting pro-angiogenic factors like fibroblast growth factor, vascular endothelial growth factor, interleukin, transforming growth factor-β, platelet-derived growth factor and several others. These pro-angiogenic factors trigger neovascularization, and thereby lead to breast cancer development and metastasis. The hypoxia-inducible factor (HIF)-regulated angiogenesis cascade is a crucial underlying factor in breast cancer growth and metastasis. To that end, several efforts have been made to identify druggable targets within the HIF-angiogenesis components. However, escape pathways are a major hindrance for targeted therapies against angiogenesis. Thus, understanding the key factors that trigger breast cancer angiogenesis is critical in elucidating ways to inhibit breast cancer. The current review provides an overview of the key growth factors that trigger breast cancer angiogenesis.
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Affiliation(s)
| | - Akshita Sharma
- Department of Stem Cell and Regenerative Medicine, D. Y. Patil Education Society, Kolhapur, India
| | | | | | - Rakesh Sharma
- Department of Obstetrics and Gynaecology, D. Y. Patil Medical College, Kolhapur, India
| | - Shankargouda Patil
- Department of Maxilofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | | | - Indumathi Somasundaram
- Department of Stem Cell and Regenerative Medicine, D. Y. Patil Education Society, Kolhapur, India
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Sanyang O, Lopez-Verdugo F, Mali M, Moustafa M, Nellermoe J, Sorensen J, Bittaye M, Njie R, Singhateh Y, Sambou NA, Goldsmith A, Mohammed NI, Brownson KE, Price RR, Sutherland E. Geospatial analysis and impact of targeted development of breast cancer care in The Gambia: a cross-sectional study. BMC Health Serv Res 2021; 21:943. [PMID: 34503503 PMCID: PMC8428029 DOI: 10.1186/s12913-021-06963-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 08/31/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Gambia has one of the lowest survival rates for breast cancer in Africa. Contributing factors are late presentation, delays within the healthcare system, and decreased availability of resources. We aimed to characterize the capacity and geographic location of healthcare facilities in the country and calculate the proportion of the population with access to breast cancer care. METHODS A facility-based assessment tool was administered to secondary and tertiary healthcare facilities and private medical centers and clinics in The Gambia. GPS coordinates were obtained, and proximity of service availability and population analysis were performed. Distance thresholds of 10, 20, and 45 km were chosen to determine access to screening, pathologic diagnosis, and surgical management. An additional population analysis was performed to observe the potential impact of targeted development of resources for breast cancer care. RESULTS All 102 secondary and tertiary healthcare facilities and private medical centers and clinics in The Gambia were included. Breast cancer screening is mainly performed through clinical breast examination and is available in 52 facilities. Seven facilities provide pathologic diagnosis and surgical management of breast cancer. The proportion of the Gambian population with access to screening, pathologic diagnosis, and surgical management is 72, 53, and 62%, respectively. A hypothetical targeted expansion of resources would increase the covered population to 95, 62, and 84%. CONCLUSIONS Almost half of the Gambian population does not have access to pathologic diagnosis and surgical management of breast cancer within the distance threshold utilized in the study. Mapping and population analysis can identify areas for targeted development of resources to increase access to breast cancer care.
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Affiliation(s)
- Ousman Sanyang
- Center for Global Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Surgery, Edward Francis Small Teaching Hospital, Banjul, The Gambia
- School of Medicine and Allied Health Sciences, University of The Gambia, Banjul, The Gambia
| | - Fidel Lopez-Verdugo
- Center for Global Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Meghan Mali
- Center for Global Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Moustafa Moustafa
- Center for Global Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Jonathan Nellermoe
- Center for Global Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Justin Sorensen
- J. Willard Marriott Library, University of Utah, Salt Lake City, UT, USA
| | - Mustapha Bittaye
- School of Medicine and Allied Health Sciences, University of The Gambia, Banjul, The Gambia
- The Gambia Ministry of Health, Banjul, The Gambia
| | - Ramou Njie
- Department of Surgery, Edward Francis Small Teaching Hospital, Banjul, The Gambia
- School of Medicine and Allied Health Sciences, University of The Gambia, Banjul, The Gambia
| | | | | | - Alison Goldsmith
- Center for Global Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Nuredin I Mohammed
- Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - Kirstyn E Brownson
- Center for Global Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Raymond R Price
- Center for Global Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Surgery, Intermountain Medical Center, Intermountain Healthcare, Salt Lake City, UT, USA
| | - Edward Sutherland
- Center for Global Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA.
- Ensign College of Public Health, Eastern Region, Kpong, Ghana.
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49
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Stoeter O, Seraphin TP, Chitsike I, Chokunonga E, Kambugu JB, Wabinga H, Parkin DM, Kantelhardt EJ. Trends in childhood cancer incidence in sub-Saharan Africa: Results from 25 years of cancer registration in Harare (Zimbabwe) and Kyadondo (Uganda). Int J Cancer 2021; 149:1002-1012. [PMID: 33945631 DOI: 10.1002/ijc.33619] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/11/2021] [Accepted: 03/26/2021] [Indexed: 11/10/2022]
Abstract
We examined trends in childhood cancer incidence in sub-Saharan Africa using data from two population-based cancer registries in Harare (Zimbabwe) and Kyadondo (Uganda) with cases classified according to the International Classification of Childhood Cancer and explored reasons for observed variations and changes. Over the whole 25-year period (1991-2015) studied, there were only small, and nonsignificant overall trends in incidence. Nevertheless, within the period, peaks in incidence occurred from 1996 to 2001 in Harare (Zimbabwe) and from 2003 to 2006 in Kyadondo (Uganda). Kaposi sarcoma and non-Hodgkin lymphoma accounted for the majority of the cases during these periods. These fluctuations in incidence rates in both registries can be linked to similar trends in the prevalence of HIV, and the availability of antiretroviral therapy. In addition, we noted that, in Harare, incidence rates dropped from 2003 to 2004 and 2007 to 2008, correlating with declines in national gross domestic product. The results indicate that the registration of childhood cancer cases in resource-poor settings is linked to the availability of diagnostic services mediated by economic developments. The findings highlight the need for specialised diagnostic and treatment programmes for childhood cancer patients as well as positive effects of HIV programmes on certain childhood cancers.
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Affiliation(s)
- Ole Stoeter
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Tobias Paul Seraphin
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital, Heinrich-Heine-University, Düsseldorf, Germany
| | - Inam Chitsike
- Department of Paediatrics and Child Health, University of Zimbabwe, Harare, Zimbabwe
| | | | | | - Henry Wabinga
- Kampala Cancer Registry, Makerere University School of Medicine, Kampala, Uganda
| | - Donald Maxwell Parkin
- Cancer Surveillance Unit, International Agency for Research on Cancer, Lyon, France
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- African Cancer Registry Network, INCTR, Oxford, UK
| | - Eva Johanna Kantelhardt
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Department of Gynaecology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
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50
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Mushonga M, Nyakabau AM, Ndlovu N, Iyer HS, Bellon JR, Kanda C, Ndarukwa-Jambwa S, Chipidza F, Makunike-Mutasa R, Muchuweti D, Muguti EG, Cluff Elmore SN. Patterns of Palliative Radiotherapy Utilization for Patients With Metastatic Breast Cancer in Harare, Zimbabwe. JCO Glob Oncol 2021; 7:1212-1219. [PMID: 34343013 PMCID: PMC8457791 DOI: 10.1200/go.20.00656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE In sub-Saharan Africa, radiotherapy (RT) utilization and delivery patterns have not been extensively studied in patients with metastatic breast cancer. METHODS A retrospective cohort study of female patients with metastatic breast cancer seen at Parirenyatwa Radiotherapy Centre in Zimbabwe from 2014 to 2018 was conducted. Demographics, pathology, staging, and treatment data were abstracted through chart review. Fisher's exact test and chi-squared test of independence were used to compare proportions, and independent two-sample t-tests were used to compare means. RESULTS Of 351 patients with breast cancer, 152 (43%) had metastatic disease, median age 51 years (interquartile range: 43-61 years). Of those with metastatic disease, 30 patients (20%) received radiation to various metastatic sites: 16 spine; three nonspine bone metastases; six whole brain; and five chest wall or supraclavicular. Patients who received radiation were younger (46 v 52 years; P = .019), but did not differ significantly by performance status than those who did not. The most common dose prescription was 30 Gy in 10 fractions (33%). Five (17%) patients had treatment interruption and two (7%) had treatment noncompletion. Province of origin and clinical tumor stage were significant predictors of RT receipt (P = .002; and P = .018, respectively). CONCLUSION A minority of patients with metastatic breast cancer received RT (20%), and these were likely to be younger, with advanced tumor stage, and resided in provinces where RT is available. Conventional courses were generally prescribed. There is a need to strongly consider palliative RT as an option for patients with metastatic breast cancer and use of hypofractionated courses (e.g. 8 Gy in one fraction) may support this goal.
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Affiliation(s)
| | - Anna Mary Nyakabau
- Parirenyatwa Hospital Radiotherapy Centre, Harare, Zimbabwe.,Department of Oncology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.,Cancerserve Trust, Harare, Zimbabwe
| | - Ntokozo Ndlovu
- Parirenyatwa Hospital Radiotherapy Centre, Harare, Zimbabwe.,Department of Oncology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Hari Subramaniam Iyer
- Harvard T.H. Chan School of Public Health, Boston, MA.,Dana-Farber Cancer Institute, Boston, MA
| | | | - Caroline Kanda
- Parirenyatwa Hospital Radiotherapy Centre, Harare, Zimbabwe
| | - Sandra Ndarukwa-Jambwa
- Sally Mugabe Central Hospital, Harare, Zimbabwe.,Department of Oncology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Fallon Chipidza
- Dana-Farber Cancer Institute, Boston, MA.,Harvard Radiation Oncology Program, Boston, MA
| | - Rudo Makunike-Mutasa
- Department of Pathology, University of Zimbabwe, Faculty of Medicine and Health Sciences, Harare, Zimbabwe
| | - David Muchuweti
- Department of Surgery, University of Zimbabwe, Faculty of Medicine and Health Sciences, Harare, Zimbabwe
| | - Edwin G Muguti
- Department of Surgery, University of Zimbabwe, Faculty of Medicine and Health Sciences, Harare, Zimbabwe
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