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. 2025 Jul 18:60:101810.
doi: 10.1016/j.gore.2025.101810. eCollection 2025 Aug.

Assessing delays in accessing and completing radiotherapy for cervical cancer treatment: A multicenter survey of oncology providers in go further-funded countries in Sub-Saharan Africa

Caroline G Kernell  1 , Megan Kassick  2   3 , Jessica M George  4 , Chidinma P Anakwenze  5 , Edward L Trimble  6 , Surbhi Grover  2   3
Affiliations

Assessing delays in accessing and completing radiotherapy for cervical cancer treatment: A multicenter survey of oncology providers in go further-funded countries in Sub-Saharan Africa

Caroline G Kernell et al. Gynecol Oncol Rep. .

Abstract

Objective: Cervical cancer is a leading cause of cancer death in Sub-Saharan Africa. Go Further provides funds for prevention and screening in Sub-Saharan Africa, but access to treatment for invasive disease remains limited. This survey aims to assess delays in accessing curative-intent chemoradiotherapy for cervical cancer in countries receiving Go Further funding.

Methods: Oncology providers in countries receiving Go Further funding (Botswana, Eswatini, Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Tanzania, Uganda, Zambia, Zimbabwe) and South Africa were invited to participate in a web-based survey beginning September 2023.

Results: Fifteen oncology providers responded, with all countries except Malawi represented. Nearly half (46.3 %) reported wait time of ≥two months for chemoradiotherapy consultation. 93.3 %, 71.4 %, 53.7 % and 73.3 % had access to at least one CT, linear accelerator, cobalt, and brachytherapy machine, respectively. Majority (60 %) reported wait time of <one month to initiate chemoradiotherapy after staging. However, 28.6 % reported >95 % of patients complete external radiotherapy within 42 days, and 33 % reported >95 % of these patients receive brachytherapy. Only 26.7 % reported overall treatment time within 56 days for >95 % of patients. Lack of transportation, funding, and patient fear, were other treatment barriers reported.

Conclusion: These results highlight the need for additional chemoradiotherapy resources in Go Further-funded countries. In addition to expanding radiotherapy, supplemental avenues to improve access in Sub-Saharan Africa include addressing barriers that increase wait times along the care continuum and implementing social support. This survey serves as a call to Go Further, highlighting the urgent need for resource allocation for cervical cancer treatment.

Keywords: Access to healthcare; Cervical cancer; Global health; Radiation oncology; Radiotherapy; Sub-Saharan countries.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: SG reports consulting fees for Lumonus, Harbinger Health, and Sustainable Dialogue for Peaceful Uses (SDPU) for serving as a scientific advisor. All other authors report no conflict of interest.

Figures

Fig. 1
Fig. 1
Distribution of survey responses across Sub-Saharan Africa.
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