Colorectal cancer screening in sub-Saharan Africa

Kwakye, Gifty; Dally, Charles K

doi:10.1016/s2214-109x(22)00231-5

Cited by 7 publications

(3 citation statements)

References 5 publications

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“…The reason for lower survival in the younger age group remains unaddressed but suggests the possibility of more aggressive tumour types and delays in diagnosis [ 26 ]. This raises questions about whether biological factors might contribute to these differences [ 27 – 29 ].…”

Section: Discussionmentioning

confidence: 99%

Is the incidence rate of colorectal cancer increasing in Mozambique?

Selemane,

Ferro,

Lorenzoni

et al. 2024

ecancer Journal

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Background Colorectal cancer (CRC) is a significant global health concern, ranking as the third most common cancer and the second leading cause of cancer-related deaths. However, in Africa, CRC is the fifth most common invasive malignancy. Limited data hinder our understanding of the evolving burden of CRC in sub-Saharan Africa. This study explores CRC trends in Mozambique, utilising data from population-based oncological registries. Methods CRC data were gathered from Beira and Maputo population-based cancer registries, along with supplementary information from pathology-based and hospital-based registries. Comparative analyses were performed across different time periods, focusing on trends and epidemiological characteristics. Results Incidence rates of CRC in Maputo and Beira were relatively low historically. However, data from recent years showed an increase, especially in age groups above 50. Analyses from pathology-based and hospital-based registries affirmed the rising trend. The age-standardised incidence rate in Maputo (2015–2017) was 3.17 for males and 2.55 for females. Beira exhibited increasing rates between 2009 and 2020, particularly in individuals aged 50 and above. Conclusion The study reveals an emerging burden of CRC in Mozambique, challenging the perception of low incidence. The rising trend underscores the necessity for tailored interventions, emphasizing early diagnosis, preventive strategies, and investments in healthcare infrastructure to address the increasing CRC burden in the region.

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Section: Discussionmentioning

confidence: 99%

Is the incidence rate of colorectal cancer increasing in Mozambique?

Selemane,

Ferro,

Lorenzoni

et al. 2024

ecancer Journal

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“…South Korea and Japan are regarded as the second category of developed neighboring countries, both with 2 times higher per capita GDPs and 1.3–1.8 times higher CRC prevalence than that of China; in these two countries, nationally organized CRC screenings also exist and FOBT is applied as the primary test 30,31 . Moreover, we tried to make a comparison among the BRICS countries (Brazil, Russia, India, China, and South Africa) regarding the comparable population size and economics 32–34 ; however, based on limited information, it seemed that none of them has existed national organized CRC screening. To sum up, the experiences of scaling‐up organized CRC screening will be learned from the developed countries than the less developed ones, and the economic related restriction would be the main challenges for China to implement a nationally organized CRC program that provides routine screening as other countries.…”

Section: Discussionmentioning

confidence: 99%

Access to colorectal cancer screening in populations in China, 2020: A coverage‐focused synthesis analysis

Li,

Wang,

et al. 2024

Intl Journal of Cancer

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In populations in China, colorectal cancer (CRC) screening can be mainly accessed through organized screening, opportunistic screening, and physical examination. This screening intervention is found to be effective but the exact coverage rate is difficult to measure. Based on data from published articles, official websites, and available program reports, the screening coverage rate and related indicators were quantified. A rapid review was then conducted to estimate the overall and the breakdown coverage rates of the sub‐type screening services, by leveraging the numbers of articles and the by‐type median sample sizes. Up to 2020, two central government‐funded and four provincial/municipal‐level organized CRC screening programs have been initiated and included in this analysis. For populations aged 40–74, the estimated coverage rate of organized programs in China was 2.7% in 2020, and the 2‐year cumulative coverage rate in 2019–2020 was 5.3% and the 3‐year cumulative coverage rate in 2018–2020 was 7.7%. The corresponding coverage rates of 50–74‐year‐olds were estimated to be 3.4%, 7.1%, and 10.3%, respectively. Based on the rapid review approach, the overall screening coverage rate for 40–74 years, considering organized screening programs, opportunistic screening, and physical examinations, was then estimated to be 3.0% in China in 2020. However, comparing the findings of this study with the number of health check‐ups reported in the local national health statistics yearbooks suggests that the number of CRC physical examinations may be underestimated in this study. The findings suggest that further efforts are needed to improve population access to CRC screening in China. Furthermore, evidence for access to opportunistic CRC screening and physical examination is limited, and more quantitative investigation is needed.

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“…Notably, a follow-up colonoscopy for a positive result is likely to be cost prohibitive; in Ghana, it was estimated to cost between 300 and 1000 GH¢ [ 41 ]. In addition, most countries in Africa do not have well-established health insurance systems to cover the cost of care [ 42 ]. However, enrolment in comprehensive insurance plans is positively associated with screening for breast and prostate cancers, demonstrating the effect of one’s financial status on seeking screening [ 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

Barriers and recommendations for colorectal cancer screening in Africa

Lee

Holmes

2023

Global Health Action

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Background Colorectal cancer (CRC) is the third most common cancer worldwide. The incidence of CRC is rising in low- and middle-income countries but decreasing in high-income countries due to the widespread use of surveillance colonoscopy. In Africa, the implementation of screening programs remains a challenge, even in countries, such as Ghana that have established CRC screening guidelines. Objective The purpose of this review was to identify the barriers and recommend strategies for implementing CRC screening in African countries. Methods A literature search using PubMed was conducted with the following search terms: colorectal neoplasm, early detection of cancer, mass screening, colonoscopy, faecal occult blood test, faecal immunochemical test (FIT) and Africa. After inclusion and exclusion criteria were applied, a total of 13 articles were reviewed. Results The most common barriers reported were limited endoscopic capacity, poor knowledge of CRC and CRC screening, health care factors, cultural factors and sociodemographic factors. Recommendations to increase the availability of CRC screening tests were to include the use of FITs, to provide more training for health care providers, and to expand educational programs for patients, physicians, and religious/community leaders. Conclusion The primary barrier to screening for CRC in Africa is the limited endoscopic capacity, specifically the lack of infrastructure and trained personnel, which requires systematic changes by governing bodies. In addition, health care professionals should be involved in educating patients about CRC and CRC screening. Further research is needed to clarify the factors related to subtypes of CRC and to explore the feasibility of using FITs in Africa.

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Colorectal cancer screening in sub-Saharan Africa

Cited by 7 publications

References 5 publications

Is the incidence rate of colorectal cancer increasing in Mozambique?

Is the incidence rate of colorectal cancer increasing in Mozambique?

Access to colorectal cancer screening in populations in China, 2020: A coverage‐focused synthesis analysis

Barriers and recommendations for colorectal cancer screening in Africa

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