Cervical Cancer in Botswana: Current State and Future Steps for Screening and Treatment Programs

Surbhi Grover¹, Mmakgomo Raesima², Memory Bvochora-Nsingo³, Sebathu P Chiyapo⁴, Dawn Balang³, Neo Tapela⁵, Onyinye Balogun⁶, Mukendi K A Kayembe⁷, Anthony H Russell⁸, Barati Monare⁹, Senate Tanyala⁹, Jailakshmi Bhat⁹, Kealeboga Thipe⁹, Metlha Nchunga⁹, Susan Mayisela⁹, Balladiah Kizito⁹, Ari Ho-Foster¹⁰, Babe Eunice Gaolebale⁴, Ponatshego A Gaolebale⁴, Jason A Efstathiou⁸, Scott Dryden-Peterson¹¹, Nicola Zetola¹², Stephen M Hahn¹³, Erle S Robertson¹⁴, Lilie L Lin¹², Chelsea Morroni¹⁵, Doreen Ramogola-Masire¹⁶

Affiliations

¹ Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA ; Botswana University of Pennsylvania Partnership , Gaborone , Botswana.
² National Cervical Cancer Prevention Programme, Ministry of Health , Gaborone , Botswana.
³ Department of Oncology, Gaborone Private Hospital , Gaborone , Botswana.
⁴ Princess Marina Hospital , Gaborone , Botswana.
⁵ Princess Marina Hospital , Gaborone , Botswana ; Division of Global Health Equity, Brigham and Women's Hospital , Boston, MA , USA.
⁶ Department of Radiation Oncology, New York University Perlmutter Cancer Center , New York, NY , USA.
⁷ National Health Laboratory , Gaborone , Botswana.
⁸ Department of Radiation Oncology, Massachusetts General Hospital , Boston, MA , USA.
⁹ Botswana University of Pennsylvania Partnership , Gaborone , Botswana.
¹⁰ Botswana University of Pennsylvania Partnership , Gaborone , Botswana ; Department of Medicine, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA.
¹¹ Division of Infectious Diseases, Brigham and Women's Hospital , Boston, MA , USA.
¹² Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA.
¹³ Division of Radiation Oncology, University of Texas MD Anderson Cancer Center , Houston, TX , USA.
¹⁴ Department of Microbiology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA.
¹⁵ Botswana University of Pennsylvania Partnership , Gaborone , Botswana ; Department of Medicine, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA ; School of Medicine, University of Botswana , Gaborone , Botswana ; Institute for Women's Health, University College London , London , UK ; Institute for Global Health, University College London , London , UK.
¹⁶ Botswana University of Pennsylvania Partnership , Gaborone , Botswana ; Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA ; Department of Obstetrics and Gynecology, Faculty of Medicine, University of Botswana , Gaborone , Botswana.

PMID: 26579491
PMCID: PMC4630577
DOI: 10.3389/fonc.2015.00239

Review

Cervical Cancer in Botswana: Current State and Future Steps for Screening and Treatment Programs

Surbhi Grover et al. Front Oncol. 2015.

. 2015 Nov 3:5:239.

doi: 10.3389/fonc.2015.00239. eCollection 2015.

Authors

Affiliations

¹ Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA ; Botswana University of Pennsylvania Partnership , Gaborone , Botswana.
² National Cervical Cancer Prevention Programme, Ministry of Health , Gaborone , Botswana.
³ Department of Oncology, Gaborone Private Hospital , Gaborone , Botswana.
⁴ Princess Marina Hospital , Gaborone , Botswana.
⁵ Princess Marina Hospital , Gaborone , Botswana ; Division of Global Health Equity, Brigham and Women's Hospital , Boston, MA , USA.
⁶ Department of Radiation Oncology, New York University Perlmutter Cancer Center , New York, NY , USA.
⁷ National Health Laboratory , Gaborone , Botswana.
⁸ Department of Radiation Oncology, Massachusetts General Hospital , Boston, MA , USA.
⁹ Botswana University of Pennsylvania Partnership , Gaborone , Botswana.
¹⁰ Botswana University of Pennsylvania Partnership , Gaborone , Botswana ; Department of Medicine, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA.
¹¹ Division of Infectious Diseases, Brigham and Women's Hospital , Boston, MA , USA.
¹² Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA.
¹³ Division of Radiation Oncology, University of Texas MD Anderson Cancer Center , Houston, TX , USA.
¹⁴ Department of Microbiology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA.
¹⁵ Botswana University of Pennsylvania Partnership , Gaborone , Botswana ; Department of Medicine, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA ; School of Medicine, University of Botswana , Gaborone , Botswana ; Institute for Women's Health, University College London , London , UK ; Institute for Global Health, University College London , London , UK.
¹⁶ Botswana University of Pennsylvania Partnership , Gaborone , Botswana ; Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA ; Department of Obstetrics and Gynecology, Faculty of Medicine, University of Botswana , Gaborone , Botswana.

PMID: 26579491
PMCID: PMC4630577
DOI: 10.3389/fonc.2015.00239

Abstract

Botswana has a high burden of cervical cancer due to a limited screening program and high HIV prevalence. About 60% of the cervical cancer patients are HIV positive; most present with advanced cervical disease. Through initiatives by the Botswana Ministry of Health and various strategic partnerships, strides have been made in treatment of pre-invasive and invasive cancer. The See and Treat program for cervical cancer is expanding throughout the country. Starting in 2015, school-going girls will be vaccinated against HPV. In regards to treatment of invasive cancer, a multidisciplinary clinic has been initiated at the main oncology hospital to streamline care. However, challenges remain such as delays in treatment, lack of trained human personnel, limited follow-up care, and little patient education. Despite improvements in the care of pre-invasive and invasive cervical cancer patients, for declines in cervical cancer-related morbidity and mortality to be achieved, Botswana needs to continue to invest in decreasing the burden of disease and improving patient outcomes of patients with cervical cancer.

Keywords: Botswana; HIV and cancer; cancer screening; cancer treatment; cervical cancer.

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References

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Cervical Cancer in Botswana: Current State and Future Steps for Screening and Treatment Programs

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Cervical Cancer in Botswana: Current State and Future Steps for Screening and Treatment Programs

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