Lung cancer awareness and palliative care interventions implemented in Africa: A systematic scoping review’

Abstract

Background: Lung cancer is the most common cancer and cause of cancer-related deaths, responsible for nearly one in five deaths across the globe. In low and middle-income countries (LMICs), lung cancer is often diagnosed at a late stage due to poor public knowledge and awareness of the signs and symptoms of lung cancer. It is believed that increasing the awareness about lung cancer is key to reducing the diagnosis and treatment delays. Early implementation of palliative care has also been reported to improve a patient’s quality of life, symptom burden, and even survival. The aim of this paper was to map evidence on lung cancer awareness and palliative care interventions implemented in Africa.Methods: A scoping review was performed following the method of Arksey and O’Malley. Systematic searches were performed using EBSCOhost platform. A keyword search from the following electronic databases were conducted: PubMed/MEDLINE, Google Scholar, Science Direct, World Health Organization (WHO) library, and grey literature. The screening was guided by the inclusion and exclusion criteria. The quality of the included studies was determined by Mixed Method Appraisal Tool (MMAT). A thematic content analysis was used to present the narrative account of the reviews, and NVivo version 11 was employed to extract themes from all included studies.Results: A total of 2886 articles were screened, and 236 met the eligibility criteria. Furthermore, 167 articles were also excluded following abstract screening. Sixty-nine (69) articles were selected for full-article screening by two researchers with 9 being selected for independent detailed data extraction for this synthesis. These studies were also subjected to methodological quality assessment. Of the nine included studies, eight studies described at least one lung cancer warning signs and symptoms, while one study described the effectiveness of palliative care for lung cancer. Eight articles recognized the level of lung cancer knowledge, risk factors and awareness of warning signs and symptoms in LMICs, mostly Africa and Asia.Conclusions: Most of the participants were aware of tobacco use as a risk factor for lung cancer, but the majority still had limited knowledge on the other pre-disposing risk factors. There is limited evidence on the palliative treatment of symptoms, and majority of patients continued to suffer from uncontrolled symptoms and unmet needs. Therefore, the urgent need for timely access to palliative care to be introduced from diagnosis to end of life to improve the quality of life of the lung cancer patients and their families.

The effects of a lung cancer awareness intervention in KwaZulu-Natal (KZN): a stratified cluster based study in five representative communities

“…An England study demonstrated increases in the public's recognition of persistent coughing as a symptom of lung cancer, together with prompt referrals of suspected lung cancer patients by GPs, and lung cancer diagnoses (43). As demonstrated by recent systematic and scoping reviews, no intervention studies have been conducted in the African region recently (44,45). The South African referral pathways and use of public health sector facilities trends introduce delays in the diagnosis of lung cancer (1,46).…”

“…They perform various duties, which have led them to be classified either as generalists or disease-specific CHWs (44). In South Africa, they have been an invaluable component of healthcare teams since the early 1930s (45). Their roles and duties have been variously defined as that of treatment defaulter and contact tracing, screening, condom distribution, and participating in community campaigns, especially in the prevention and control of human immune-deficiency virus (HIV) and tuberculosis (TB) (37,46).…”