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A Narrative Synthesis of Literature on the Barriers to Timely Diagnosis and Treatment of Cancer in Sub-Saharan Africa.
Mwamba, M; Lombe, D C; Msadabwe, S; Bond, V; Simwinga, M; Sentoogo Ssemata, A; Muhumuza, R; Seeley, J; Mwaka, A D; Aggarwal, A.
Afiliação
  • Mwamba M; Zambart, School of Public Health, Ridgeway Campus, University of Zambia, Lusaka, Zambia. Electronic address: mondeb@zambart.org.zm.
  • Lombe DC; Regional Cancer Treatment Services MidCentral District Health Board, New Zealand.
  • Msadabwe S; Cancer Diseases Hospital, Lusaka, Zambia.
  • Bond V; Zambart, School of Public Health, Ridgeway Campus, University of Zambia, Lusaka, Zambia; London School of Hygiene & Tropical Medicine (LSHTM), London, UK.
  • Simwinga M; Zambart, School of Public Health, Ridgeway Campus, University of Zambia, Lusaka, Zambia.
  • Sentoogo Ssemata A; The Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine (MRC/UVRI & LSHTM), Uganda Research Unit, Entebbe, Uganda.
  • Muhumuza R; The Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine (MRC/UVRI & LSHTM), Uganda Research Unit, Entebbe, Uganda.
  • Seeley J; The Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine (MRC/UVRI & LSHTM), Uganda Research Unit, Entebbe, Uganda.
  • Mwaka AD; Department of Medicine, Faculty of Medicine, Gulu University, Gulu, Uganda.
  • Aggarwal A; London School of Hygiene & Tropical Medicine (LSHTM), London, UK; Institute of Cancer Policy, King's College London, London, UK.
Clin Oncol (R Coll Radiol) ; 35(9): e537-e548, 2023 09.
Article em En | MEDLINE | ID: mdl-37302880
Poor cancer survival outcomes in sub-Saharan Africa (SSA) have been linked to delays in diagnosis and treatment. Here we present a detailed overview of the qualitative literature evaluating the barriers to receiving timely diagnosis and treatment of cancer in SSA. The PubMed, EMBASE, CINAHL, PsycINFO databases were searched to identify qualitative studies reporting on barriers to timely diagnosis of cancer in SSA published between 1995 and 2020. A systematic review methodology was applied, including quality assessment and narrative data synthesis. We identified 39 studies, of which 24 focused on breast or cervical cancer. Only one study focused on prostate cancer and one on lung cancer. When exploring factors contributing to delays, six key themes emerged from the data. The first theme was health service barriers, which included: (i) inadequate numbers of trained specialists; (ii) limited knowledge of cancer among healthcare providers; (iii) poor co-ordination of care; (iv) inadequately resourced health facilities; (v) negative attitudes of healthcare providers towards patients; (vi) high cost of diagnostic and treatment services. The second key theme was patient preference for complementary and alternative medicine; the third was the limited understanding of cancer among the population. The fourth barrier was a patient's personal and family obligations; the fifth was the perceived impact of cancer and its treatment on sexuality, body image and relationships. Finally, the sixth was the stigma and discrimination faced by patients following a diagnosis of cancer. In conclusion, health system, patient level and societal factors all influence the likelihood of timely diagnosis and treatment for cancer in SSA. The results provide a focus for targeting health system interventions, particular with regards to awareness and understanding of cancer in the region.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Neoplasias do Colo do Útero / Neoplasias Pulmonares Tipo de estudo: Diagnostic_studies / Prognostic_studies / Qualitative_research / Systematic_reviews Limite: Female / Humans / Male País/Região como assunto: Africa Idioma: En Revista: Clin Oncol (R Coll Radiol) Assunto da revista: NEOPLASIAS Ano de publicação: 2023 Tipo de documento: Article País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Neoplasias do Colo do Útero / Neoplasias Pulmonares Tipo de estudo: Diagnostic_studies / Prognostic_studies / Qualitative_research / Systematic_reviews Limite: Female / Humans / Male País/Região como assunto: Africa Idioma: En Revista: Clin Oncol (R Coll Radiol) Assunto da revista: NEOPLASIAS Ano de publicação: 2023 Tipo de documento: Article País de publicação: Reino Unido