Trends in cervical cancer incidence in sub-Saharan Africa

Jedy‐Agba, Elima; Joko, Walburga Yvonne; Liu, Biying; Buziba, Nathan; Borok, Margaret; Korir, Anne; Masamba, Leo; Manraj, Shyam; Finesse, Anne; Wabinga, Henry; Somdyala, Nontuthuzelo; Parkin, Donald Maxwell

doi:10.1038/s41416-020-0831-9

Cited by 131 publications

(107 citation statements)

References 27 publications

(37 reference statements)

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“…Cervical cancer continues to be responsible for the highest cancer mortality in Africa, accounting for 2,000,000 deaths in 2018 ( 2 ), and its incidence rates continue to increase in most Sub-Saharan African countries ( 232 ). However, studies on cervical cancer genetics/genomics only represented 3% of the publications we retrieved.…”

Section: Resultsmentioning

confidence: 99%

A Review of Cancer Genetics and Genomics Studies in Africa

Rotimi

Salhia

2021

Front. Oncol.

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Cancer is the second leading cause of death globally and is projected to overtake infectious disease as the leading cause of mortality in Africa within the next two decades. Cancer is a group of genomic diseases that presents with intra- and inter-population unique phenotypes, with Black populations having the burden of morbidity and mortality for most types. At large, the prevention and treatment of cancers have been propelled by the understanding of the genetic make-up of the disease of mostly non-African populations. By the same token, there is a wide knowledge gap in understanding the underlying genetic causes of, and genomic alterations associated with, cancer among black Africans. Accordingly, we performed a review of the literature to survey existing studies on cancer genetics/genomics and curated findings pertaining to publications across multiple cancer types conducted on African populations. We used PubMed MeSH terms to retrieve the relevant publications from 1990 to December 2019. The metadata of these publications were extracted using R text mining packages: RISmed and Pubmed.mineR. The data showed that only 0.329% of cancer publications globally were on Africa, and only 0.016% were on cancer genetics/genomics from Africa. Although the most prevalent cancers in Africa are cancers of the breast, cervix, uterus, and prostate, publications representing breast, colorectal, liver, and blood cancers were the most frequent in our review. The most frequently reported cancer genes were BRCA1, BRCA2, and TP53. Next, the genes reported in the reviewed publications’ abstracts were extracted and annotated into three gene ontology classes. Genes in the cellular component class were mostly associated with cell part and organelle part, while those in biological process and molecular function classes were mainly associated with cell process, biological regulation, and binding, and catalytic activity, respectively. Overall, this review highlights the paucity of research on cancer genomics on African populations, identified gaps, and discussed the need for concerted efforts to encourage more research on cancer genomics in Africa.

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Section: Resultsmentioning

confidence: 99%

A Review of Cancer Genetics and Genomics Studies in Africa

Rotimi

Salhia

2021

Front. Oncol.

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“…There are important exceptions to this temporal pattern, such as in Kampala, Uganda, one of the few longstanding sub-Saharan African PBCR included in CI5 ( Ferlay et al, 2018a ). Indeed, a recent study of trends, examined over a period of 10–25 years in 10 PBCR in eight sub-Saharan Africa countries, confirms a uniformity in the increasing incidence rates in the region other than in Mauritius ( Jedy-Agba et al, 2020 ). Such observations may partially reflect variations in registration activity, but likely also relate to ongoing generational changes in risk due to changing sexual behaviour and exposure to high-risk HPV types.…”

Section: The Uses Of Pbcr To Assess Cervical Cancer Control: Examplesmentioning

confidence: 89%

The role and utility of population-based cancer registries in cervical cancer surveillance and control

Piñeros

Saraiya

Baussano

et al. 2021

Preventive Medicine

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Population–based cancer registries (PBCR) are vital to the assessment of the cancer burden and in monitoring and evaluating national progress in cervical cancer surveillance and control. Yet the level of their development in countries exhibiting the highest cervical cancer incidence rates is suboptimal, and requires considerable investment if they are to document the impact of WHO global initiative to eliminate cervical cancer as a public health problem. As a starting point we propose a comprehensive cancer surveillance framework, positioning PBCR in relation to other health information systems that are required across the cancer control continuum. The key concepts of PBCR are revisited and their role in providing a situation analysis of the scale and profile of the cancer-specific incidence and survival, and their evolution over time is illustrated with specific examples. Linking cervical cancer data to screening and immunization information systems enables the development of a comprehensive set of measures capable of assessing the short- and long-term achievements and impact of the initiative. Such data form the basis of national and global estimates of the cancer burden and permit comparisons across countries, facilitating decision-making or triggering cancer control action. The initiation and sustainable development of PBCR must be an early step in the scale-up of cervical cancer control activities as a means to ensure progress is successfully monitored and appraised.

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“…Now that treatment of communicable diseases has improved, and life expectancies have increased, a large focus of healthcare has shifted to treatment of chronic diseases, including cancer ( 1 ). In 2018, cervical cancer was the leading cancer in half of the countries in SSA and responsible for 21.7% of all cancer deaths in SSA women ( 2 ). While the probability of developing cancer for a woman living in Uganda or Zimbabwe is 30% lower than a Western European woman, her probability of death is almost twice as high ( 3 ).…”

Section: Prevalence Of Gynecological Malignancies In Sub-saharan Afrimentioning

confidence: 99%

Gynecologic Oncology Sub-Specialty Training in Ghana: A Model for Sustainable Impact on Gynecologic Cancer Care in Sub-Saharan Africa

Erem¹,

Appiah‐Kubi

Konney

et al. 2020

Front. Public Health

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African women have double the risk of dying from cancer than women in high-income countries. In Ghana, most women with gynecological malignancies present with advanced-stage disease when treatment is less effective. Barriers to improved cancer outcomes include the availability of cancer screening, affordability of treatment, and access to gynecologic oncology specialists. In response to a paucity of gynecologic oncology providers, an in-country fellowship training program was established at Komfo Anokye Teaching Hospital (KATH) in 2013. Historically, Ghanaian resident physicians were sent to other countries for fellowship training and were unlikely to repatriate. The establishment of an in-country training program not only addresses the challenge of “brain drain,” but also builds local capacity in gynecologic oncology education and emphasizes culturally relevant and accessible healthcare. The four-years gynecologic oncology fellowship program at KATH was developed as part of a longitudinal multi-decade partnership between the University of Michigan and academic medical centers in Ghana. The fellowship trains obstetricians and gynecologists to provide subspecialist clinical and surgical care to patients with gynecologic malignancies. Fellows collaborate with the radiation, oncology and pathology departments, participate in monthly inter-institutional tumor board meetings, conduct research, advise on health policy issues, and train subsequent cohorts. This fellowship is representative of emerging twenty-first-century trends in which subspecialty training programs in low-income countries are strengthened by international collaborations. Providing specialized training in gynecologic oncology can help develop and maintain resources that will improve clinical outcomes for women in low-resources settings.

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Trends in cervical cancer incidence in sub-Saharan Africa

Cited by 131 publications

References 27 publications

A Review of Cancer Genetics and Genomics Studies in Africa

A Review of Cancer Genetics and Genomics Studies in Africa

The role and utility of population-based cancer registries in cervical cancer surveillance and control

Gynecologic Oncology Sub-Specialty Training in Ghana: A Model for Sustainable Impact on Gynecologic Cancer Care in Sub-Saharan Africa

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