Continuing barriers to care of Wilms tumor in a low‐income country

Abstract

Multidisciplinary team management and chemotherapy based on tumor histology might have resulted in slight improvement of outcome since our last report. However, to ensure survival that may approach global benchmarks, there is need for public health measures to improve time to diagnosis, and improvement of facilities and healthcare funding to ensure compliance to all phases of standard therapy.

Wilms tumor in Africa: A systematic review of management challenges and outcome in two decades (2000‐2019)

“…Wilms tumor (WT) is one of the major successes of pediatric oncology with tremendous advances and improvement of outcome over the past 50 years 1,2 . The improved survival has been attributed to early diagnosis; focused research; collaborative efforts among surgeons, pathologists, pediatricians, and radiation oncologists; and better supportive care 1–3 . Despite this great progress, there is evidence that survival in most low‐income countries (LICs) is substantially lower than that in the high‐income countries (HICs) 1,4 .…”

“…Despite this great progress, there is evidence that survival in most low‐income countries (LICs) is substantially lower than that in the high‐income countries (HICs) 1,4 . Recent publications indicate that the overall survival in HICs approximates 90%, while survival in most LICs is less than 50% 1–5 . However, the statistic assumes a frightening dimension when considered against the backdrop of the finding that more than 80% of children with cancer worldwide live in LICs, where the situation is more difficult and the level of care considerably lower than the global benchmark 6 …”

“…Reported challenges that contribute to this disparity of outcome are late presentation (with most cases presenting with advanced disease), dearth of trained personnel, malnutrition, failure to complete treatment, and poorer facilities both for the specific cancer treatment and for supportive care 1,3,4,7 . In Africa, with heterogeneous economic, social, and cultural endowments, these challenges are not uniformly applicable in all the countries 2,3,7–13 . In addition, levels of care and treatment protocols vary from country to country.…”

“…To address these challenges, the last decade has witnessed reports of some interventions such as capacity building, stratification of cases based on tumor histology, central provision of chemotherapy drugs, strategies to enable parents to complete treatment, and multiregional management 3,5,14,15 . In addition, public enlightenment to ensure earlier presentation, social support, improved supportive care, and a treatment guideline adapted to local circumstances have been suggested 3,7,9,12 . Nonetheless, studies have shown that these interventions have been variably applied 7,10,14 .…”

Access to Breast Cancer Care in Jos, North Central

“…This inadequate access to radiotherapy may not be unconnected to the high population of Nigeriawith over 200 million people who depend on only six low capacity radiotherapy centers spread across the country. As such, the radiotherapy machines are overstretched frequently developing faults with associated long waiting lists and patient frustration [18,19]. Consequently, many patients fail to access radiotherapy as and when needed.…”