National Cancer Control Plans Research Articles

Cost–benefit analysis of mammography screening: the perspective of Nigerian healthcare providers

IntroductionThere is no national breast cancer screening implemented in Nigeria. The National Cancer Control Plan (NCCP) has a goal of making screening services and early detection of cancer available for...

Beliefs on Causes of Cancer in the General Population, and the Association With Risk Perception and Lifestyle in a Multiethnic Setting.

Beliefs on causes of cancer, although sometimes aligned with known risk factors, may be influenced by personal experiences, cultural narratives, and misinformation. We investigated the prevalence of beliefs on causes of cancer and their association with cancer risk perception and lifestyle in a multiethnic Asian population. In total, 2,008 Malaysian adults with no previous cancer were surveyed using a 42-item questionnaire adapted from the Awareness Measure and the Cancer Awareness Measure-Mythical Causes Scale. Partial least squares structural equation modeling was used to evaluate measurement models. Despite high educational attainment, only about half of the respondents believed that 7 of the 21 listed established risk factors caused cancer. Factors associated with accurate beliefs included higher socioeconomic status (SES) and having family or friends with cancer. However, 14 of the 21 listed mythical/unproven factors were correctly believed as not cancer-causing by the majority. Women and those with lower SES were more likely to hold misconceptions. Beliefs on established risk factors were significantly associated with perceived risk of cancer. Individuals with stronger beliefs in established risk factors were less likely to be associated with healthy behaviors. Conversely, stronger beliefs in mythical or unproven factors were more likely to be associated with healthy lifestyles. Findings highlight the importance of prioritizing cancer literacy as a key action area in national cancer control plans. The counterintuitive associations between cancer beliefs and lifestyle emphasize the complexity of this relationship, necessitating nuanced approaches to promote cancer literacy and preventive behaviors.

Barriers and facilitators to implementation of the Ethiopian national cancer control plan strategies: Implications for cervical cancer services in Ethiopia.

Following an upsurge in cervical cancer incidence and mortality, Ethiopia developed its first National Cancer Control Plan (NCCP) to support efforts toward the prevention and control of cancer. The NCCP outlines strategies for reducing the incidence of cancer through prevention, screening, early diagnosis, treatment, and palliative care. This study examined barriers and facilitators to the implementation of the NCCP using a qualitative approach. The study entailed doing key informant interviews and reviewing secondary data. Using customized topic guidelines, fifteen interviews were conducted covering a wide range of topics, including political commitment, priority setting, interagency cooperation, the role of evidence, citizen empowerment, and incentives. All interviews were recorded (with consent), transcribed in Amharic, and then translated into English for thematic analysis. Review of secondary data focused on establishing the NCCP's implementation status for HPV vaccination, cervical cancer screening, and treatment, and strategic links to five other national policy documents centered on public awareness, cervical cancer services, HPV immunization, and sexually transmitted infections control. We found that in 2022, 55% of eligible Ethiopian women were screened for cervical cancer (against the annual target), with roughly half of those with a positive result receiving treatment. Overall, 900,000 (8.4%) of the 10.7 million eligible women in the country underwent screening. The study revealed inadequate implementation of the NCCP strategies toward achieving the WHO's 90-70-90 cervical cancer targets by 2030. A key positive strategy was the involvement of high-ranking government officials in the National Cancer Committee, which aided the NCCP implementation. On the other hand, inadequate political support, funding constraints, suboptimal public messaging, lack of incentives, and inadequate partnership arrangements emerged as important barriers. We recommend that decision-makers intensify coordinated efforts, prioritize dealing with identified challenges and optimizing facilitators, and mobilize additional resources to enhance cervical cancer services in Ethiopia.

Psychosocial and palliative care in African national cancer control plans: A qualitative study.

Low and middle income countries of Africa account for a disproportionate amount of the global health burden of cancer. Providing patients access to psychosocial oncology and palliative care through policy structures such as the National Cancer Control Plans (NCCP) is essential to improving the care provided to patients and their families. The first phase of this study sought to determine the extent to which palliative care and psychosocial oncology were integrated in NCCPs in African countries. A qualitative thematic analysis of the plans was used using Nvivo, with two-raters coding and continuous team discussions. Data were organized into an infographic map showing the coverage of themes across African countries. Fifty-eight NCCPs and NCD plans were analyzed in the 54 countries in Africa. The findings illustrate a lack of standardization across countries' NCCPs in addressing psychosocial oncology and palliative care themes. Certain areas presented good coverage across several plans, such as barriers to access, education, awareness, and health behaviors, coordination of care, families, caregivers and community involvement, and palliative care. Other themes presented low coverage, such as doctor-patient communication, mental health, bereavement, psychosocial care, survivorship care, and traditional medicine. One may consider further developing NCCP areas as they pertain to psychosocial oncology and palliative care to ensure their proper place on the policy agenda for a healthier Africa.

Defining national research priorities for prostate cancer in Zambia: using the Delphi process for comprehensive cancer policy setting in sub-Saharan Africa

ObjectivesLocally led research on cancer is needed in sub-Saharan Africa to set feasible research priorities that inform national policy. The aim of this project was to develop a research agenda...

Determining the cost and cost-effectiveness of childhood cancer treatment in Haiti.

Haiti is a low-income country with one of the lowest human development index rankings in the world. Its childhood cancer services are provided by a single hospital with the only dedicated paediatric oncology department in the country. Our objective was to assess the cost and cost-effectiveness of all types of childhood cancer in Haiti to help prioritise investments and to support national cancer control planning. All costing data were collected from the year 2017 or 2018 hospital records. Costs were classified into 11 cost categories, and the proportion of the overall budget represented by each was calculated and converted from Haitian Gourde to United States dollars. The 5-year survival rate was retrieved from hospital records and used to calculate the cost-effectiveness of disability-adjusted life year (DALY) averted, using a healthcare costing perspective. Additional sensitivity analyses were conducted accounting for late-effect morbidity and early mortality and discounting rates of 0%, 3% and 6%. The annual cost of operating a paediatric oncology unit in Haiti treating 74 patients with newly diagnosed cancer was $803,184 overall or $10,854 per patient. The largest cost category was pharmacy, constituting 25% of the overall budget, followed by medical personnel (20%) and administration (12%). The cost per DALY averted in the base-case scenario was $1,128, which is 76% of the gross domestic product per capita, demonstrating that treating children with cancer in Haiti is very cost-effective according to the World Health Organisation Choosing Interventions that are Cost-Effective (WHO-CHOICE) threshold. In the most conservative scenario, the cost per DALY averted was cost-effective by WHO-CHOICE criteria. Our data will add to the growing body of literature illustrating a positive return on investment associated with diagnosing and treating children with cancer in even the most resource-limited environments. We anticipate that these data will aid local stakeholders and policymakers when identifying cancer control priorities and making budgetary decisions.

Psychosocial distress and associated factors among adult cancer patients at oncology: a case of Ethiopia.

Psychosocial distress is a chronic burden for cancer survivors, which impacts both their quality of life and their oncologic prognosis. Although the national cancer prevention and control program in Ethiopia has made efforts in cancer prevention, control, and management by implementing the national cancer control plan 2016-2020, there was no enough evidence about psychosocial distress among adult cancer patients. So, it is critical to understand the magnitude of psychosocial distress and the factors that contribute to it. The purpose of this study was to assess the prevalence of psychosocial distress and associated factors among adult cancer patients at oncology units in the Amhara regional state, Ethiopia. 2022. A multicenter institution-based cross-sectional study was conducted among a sample of 605 adult cancer patients from 30 April to 22 June 2022. A systematic random sampling technique was employed to select the study units. In addition, data were collected through interviewers administered questionnaires by using the validated and pretested tools. Distress was assessed using the Questionnaire on Stress in Cancer Patients Revised 10. Both bivariable and multivariable logistic regression was used to describe the association between dependent and independent variables. Independent variable with p < 0.25 in the bivariable logistic regression analyses were entered into multivariable logistic regression model. Variables with p < 0.05 in the multivariable logistic regression analyses were considered as statistically significant associated factors of psychosocial distress. A total of 593 adult cancer patients took part in this study with mean age of 46.86 ± 14.5 years. The overall prevalence of psychosocial distress was 63.74%. Variables such as being female [AOR = 1.98, 95% confidence interval (CI): 1.24-3.17], patients who lives in rural areas (AOR = 2.3, 95% CI: 1.49-3.54), community-based health insurance utilization (AOR = 0.34, 95% CI: 0.23-0.51), patients on chemotherapy treatment (AOR = 2.72, 95% CI: 1.38-5.39), patients with comorbidity (AOR = 3.2, 95% CI: 1.67-6.10), and symptom burdens such as severe fatigue (AOR = 1.65, 95% CI:1.09-2.39) and severe nausea (AOR = 2.07, 95% CI: 1.43-3.00) were statistically associated with psychosocial distress. In general, the findings of this study showed a relatively high magnitude in which around two-thirds of patients experienced psychosocial distress. It is better to establish and enforce the integration and coordination of psychosocial oncology service programs at national level with parallel guidelines and policies.

Addressing the gap in health economics data to support national cancer control plans in low- and middle-income countries: The Childhood Cancers Budgeting Rapidly to Incorporate Disadvantaged Groups for Equity (CC-BRIDGE) tool.

National cancer control plans (NCCPs) are complex public health programs that incorporate evidence-based cancer control strategies to improve health outcomes for all individuals in a country. Given the scope of NCCPs, small and vulnerable populations, such as patients with childhood cancer, are often missed. To support planning efforts, a rapid, modifiable tool was developed that estimates a context-specific national budget to fund pediatric cancer programs, provides 5-year scale-up scenarios, and calculates annual cost-effectiveness. The tool was codeveloped by teams of policymakers, clinicians, and public health advocates in Zimbabwe, Zambia, and Uganda. The 11 costing categories included real-world data, modeled data, and data from the literature. A base-case and three 5-year scale-up scenarios were created using modifiable inputs. The cost-effectiveness of the disability-adjusted life years averted was calculated. Results were compared with each country's projected gross domestic product per capita for 2022 through 2026. The number of patients/total budget for year 1 was 250/$1,109,366 for Zimbabwe, 280/$1,207,555 for Zambia, and 1000/$2,277,397 for Uganda. In year 5, these values were assumed to increase to 398/$5,545,445, 446/$4,926,150, and 1594/$9,059,331, respectively. Base-case cost per disability-adjusted life year averted/ratio to gross domestic product per capita for year 1, assuming 20% survival, was: $807/0.5 for Zimbabwe, $785/0.7 for Zambia, and $420/0.5 for Uganda. This costing tool provided a framework to forecast a budget for childhood-specific cancer services. By leveraging minimal primary data collection with existing secondary data, local teams obtained rapid results, ensuring that childhood cancer budgeting is not neglected once in every 5 to 6years of planning processes.

Abstract A124: NICRAT: The institute pioneering a new approach to cancer research and treatment in sub-Saharan Africa

Abstract Background: Cancer is a major public health challenge in several sub-Saharan African countries, and some of these nations have established their national cancer institutes as a focal point to address this threat. Similarly, the Nigerian government founded the National Institute for Cancer Research and Treatment (NICRAT) in 2017. The purpose of this report is to provide an understanding of the opportunities in establishing a new cancer institute in Nigeria, the most populous Black country in the world and the most populous country in Africa. We reviewed the history, mission and strategy of the National Institute for Cancer Research and Treatment (NICRAT). Methods: The data sources reviewed were publications in professional journals, government reports, news articles, and the NICRAT website. Results: Some of the concerns that justified the establishment and initiation of a national cancer institute in Nigeria include the lack of a coordinated effort to study and combat the disease in Nigeria. The NICRAT was created to centralize cancer research efforts, provide funding for cancer research, and coordinate research activities across the country. These institutes are a science-based governmental institutions dedicated to cancer research, prevention, and treatment. Accordingly, the institution will promote the fight against cancer, providing a centralized focus for cancer research and treatment efforts, and facilitating collaboration between researchers, healthcare providers, and patients, as well as guidance for cancer policy formulation and implementation for decision-makers. Modelled on the US National Cancer Institute (NCI), the NICRAT has institutionalised Nigeria’s capacity to coordinate research efforts to support the use of evidence-based practices in designated Cancer Centers to reduce the impact of cancer. The NICRAT is also the focal point for the implementation of the National Cancer Control Plan (NCCP), and will coordinate the National System of Cancer Registries and the Cancer Health Fund. Discussion: Cancer institutes in sub-Saharan Africa are currently in early stages of evolution. Over the next 5 years, NICRAT’s mission is to work in partnership with other arms of Government and partners to continue its efforts in advancing cancer research, prevention, and treatment. The NICRAT will also focus on improving cancer care delivery and access to care, enhancing cancer prevention and education efforts, and strengthening collaborations with international partners to address the cancer challenge. How successful the institute becomes in its mission will be determined by its capacity to develop the right partnerships, including with the private sector, adopting innovative approaches, and mobilising adequate resources. Building a national cancer institute requires strong commitment, planning and action. The experience of setting up the NICRAT can inform similar efforts in other African countries. Citation Format: Sani A. Malami, Usman M. Aliyu, Uchechukwu E. Nwokwu, Waziri U. Mohammed. NICRAT: The institute pioneering a new approach to cancer research and treatment in sub-Saharan Africa [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A124.

Genetic testing and counseling challenges in personalized breast cancer care: review article with insights from Türkiye.

According to current evidence, testing for germline BRCA pathogenic variants in newly diagnosed breast cancer (BC) patients has the potential to reduce the burden of the disease through targeted therapies and secondary prevention. A personalized approach to testing can lead to improved individual outcomes for patients. Despite the proven clinical utility and therapeutic impact of BRCA1/2 tests in shaping therapy for metastatic BC, awareness and access to these tests are limited in many developing countries, including Türkiye. This limitation impacts the healthcare economy as delayed or missed interventions can lead to increased long-term costs. The limited access is mainly due to fear of stigmatization among patients, country-specific legislation and costs, a lack of awareness, vagueness surrounding the tests and access restrictions. This review offers a perspective for policymakers and healthcare providers in Türkiye to establish pathways that integrate the patient experience into comprehensive care pathways and national cancer control plans.

Setting the policy agenda for cancer control reform: Australia's first national cancer control plan.

Setting the policy agenda for cancer control reform: Australia's first national cancer control plan.

PATIENT ADVOCACY-01 WHY IS NEURO- ONCOLOGY MISSING FROM CIVIL SOCIETY CANCER ADVOCACY AGENDA?

Abstract BACKGROUND Cancer civil society and patient groups across Africa play a major role in pressuring governments to develop, fund, and implement national cancer control plans and to keep their commitments to international declarations. Additionally, community cancer awareness is mainly driven by lay cancer advocates and cancer survivors. The cancer policy and legislation landscape in Kenya has largely been shaped by the civil society through consistent advocacy OBJECTIVE Explore barriers and enablers to meaningful engagement of cancer civil society advocates in advancing neuro-oncology in Africa. METHODOLOGY This is a desk review of current developments and literature in advocacy for neuro-oncology with insights and perspectives of practicing oncology nurses and civil society cancer advocates in Kenya. FINDINGS Cancer advocacy in Kenya has traditionally focused on creating awareness on the more common cancers, breast, cervical prostate and Gastro-intestinal cancers. Over the last 10 years’ attention has gradually shifted to access and cost of care. Cancers of the central nervous system such as gliomas, neuroblastomas and meningiomas, though not uncommon do not feature prominently in advocacy discourses. This is due the fact that they are perceived as ‘rare’, complex, difficult to explain and with poor outcomes. DISCUSSION AND IMPLICATIONS There is a growing appreciation of the need to develop a framework through which civil society can contribute to the development of quality neuro oncology services. Cancer civil society organizations, neurosurgeons, neurologists, oncologists, academicians, and other healthcare professionals must work together to overcome structural barriers so that neuro oncology is not left behind in the national cancer plans. Stakeholders will need to establish guidelines with well defined mechanism for engaging, involving and acknowledging the contribution of cancer advocates in advancing neuro-oncology. This will require a cultural shift from neuro-oncology professionals to accommodate the input of lay civil society advocates.

Psychosocial care for cancer survivors: A global review of national cancer control plans.

National Cancer Control Plans (NCCPs) are high-level policy documents that prioritise actions to be taken to improve cancer control activities. As the number of cancer survivors grows globally, there is an urgent need to assess whether and how psychosocial care across the cancer care continuum is included in NCCPs. This review aimed to ascertain the extent to which NCCPs referenced psycho-oncology care for cancer survivors in the post-treatment phase. NCCPs were obtained from the International Cancer Control Partnership (ICCP) portal (in November 2021) and reviewed in two phases. In Phase 1, all available NCCPs were screened to determine whether they mentioned psycho-oncology or survivorship. In Phase 2, reviewers extracted data from the NCCPs identified in Phase 1 on the degree that each plan articulated objectives/goals to improve psychosocial care in the post-treatment survivorship phase. We screened 237 NCCPs. Of these, initial potential reference to psycho-oncology and survivorship content were identified in 97 plans (41%). In Phase 1, 57/97 (59%) had reference to psycho-oncology or survivorship content within defined criteria. In Phase 2, 27/97 (28%) had little mention of psycho-oncology specifically in survivorship, 47/97 (48%) had some (general or brief) mention, and the remaining 23/97 (24%) had substantial content/specific sections and clearly articulated goals and/or objectives. Common goals for improving psychosocial care in the post-treatment period included building capacity of healthcare professionals, implementing rehabilitation models, and increasing the utilisation of community services. Most NCCPs did not reference psycho-oncology and only one-quarter contained clear objectives specifically in the post-treatment survivorship phase.

Intention to Undergo Clinical Breast Examination and Its Associated Factors among Women Attending Rural Primary Healthcare Facilities in South Central Ethiopia

Background: Breast cancer is a global public health problem with higher mortality in developing countries. The Ethiopian National Cancer Control Plan recommends clinical breast examination (CBE) for all women aged >18 years. However, there is low breast examination practice in Ethiopia. Therefore, this study aimed to describe level of intention to undergo CBE and associated factors among women visited selected rural healthcare facilities in south central Ethiopia using Theory of Planned Behavior (TPB). Methods: This study used facility-based cross-sectional study design. A total of 420 women participated in this study. Interviewer-administered structured questionnaire was adopted from previously published research works and Ajzen’s TPB manual. Statistical Package for Social Sciences (SPSS), version 27, was used for analysis. Binary logistic regression model was used to determine factors associated with intention to undergo CBE. Results: In this study, nine out of ten women had never had CBE. Mean score for intention to undergo CBE was 12.55 (SD ± 3.22; min 5, max 20). Intention to undergo CBE was negatively associated with being in the second and middle wealth quantiles compared to the highest wealth quantile, and with the spouse not being able to read or write compared to having attended formal education. Positive attitude and higher subjective norm had relevant association with intention to undergo CBE. Conclusion: The high score for intention to undergo CBE should encourage primary healthcare facilities to offer CBE. Behavioral change communication interventions could address women’s attitude, subjective norm, and spouse’s education associated with intention to undergo CBE.

The current status of National Cancer Control Plans in Africa: Data from 32 countries

BackgroundCancer incidence and mortality are rapidly rising in Africa. National Cancer Control Plans (NCCPs have contributed to a reduction in the burden of some preventable cancers, availing early diagnosis and adequate treatment modalities and palliative care, while sustaining them with sufficient monitoring systems. knowledge we undertook a cross-sectional survey across continental Africa to understand the presence of NCCPs, availability of early detection and screening policies and the status of health financing pertaining to cancer. MethodsThrough an online survey, we approached key cancer care staff in 54 countries. Questions were themed in 3 main areas - Cancer registries and national cancer control plans (NCCPs) availability in countries, Cancer screening, diagnosis and management capacity, Financing in cancer care. ResultsOn 54 approached respondents, we received 32 responses. 88 % of responding countries have active national cancer registries, 75 % with NCCPs and 47 % with cancer screening policies and practices. Universal Health Coverage is available in 40 % of countries. ConclusionOur study shows that there is a scarcity of NCCPs in Africa. Deliberate investment in cancer registry and clinical services is key to improving access to care and ultimately reduce cancer mortality in Africa.

Cancer survivorship care: challenges and opportunities in Japan.

This article discusses the current international scope and practices of cancer survivorship care and the challenges and opportunities of survivorship care in Japan. Cancer is a common illness in Japan; however, the national cancer control plan focuses only on limited survivorship-related issues, and there is no official national-level survivorship care strategy that addresses the diverse unmet needs of survivors. There is an urgent need to discuss and implement measures for quality survivorship care delivery under the current healthcare system in Japan. The Development of Survivorship Care Coordination Model Research Group, 2022, organized under the National Cancer Center Japan research grant from 2019 to 2022, identified four tasks that are required to realize quality survivorship care: (i) providing education opportunities for survivorship care stakeholders to raise awareness about the concept and the necessity of cancer survivorship care, (ii) providing training opportunities and cancer survivorship care certification for community healthcare providers, (iii) enforcing the economic basis of survivorship care and (iv) creating simpler systems that are organically linked with existing care systems. Collaboration among multiple players is indispensable to developing the philosophy of survivorship care and efficient care delivery. For this purpose, we need a platform where diverse players can participate equally towards the same goal: cancer survivors' optimal wellness.

Abstract 86: The Status of Government-Funded Radiotherapy Centres in Nigeria

Abstract Purpose: Access to radiotherapy (RT) is now one of the stark examples of global cancer inequities. Over 800,000 new cancer cases require potentially curative or palliative RT services in Africa, arguably less than 15% of these patients currently have access to this important service. For a population of over 200 million, Nigeria requires a minimum of 280 RT machines for the increasing number of cancer cases. Painfully the country has only 8 government-funded radiotherapy machines. This study aimed to evaluate the status of the eight (8) Government-funded RT centres in Nigeria regarding RT equipment, workforce and infrastructure to quantify their ability to deliver effective RT to their patients. Methods: A survey addressing ten (10) critical areas was used to assess the eight (8) Government-funded RT centres in Nigeria. Results: Unfortunately, 6 of the 8 centres (75%) surveyed have not treated patients with RT over the last 2 years because they do not have functioning teletherapy machines. Only 2 RT centres have the capability of treating patients using advanced RT techniques. There is no PET-CT scan in any of the Government-funded RTcentres. The workforce capacity and infrastructure across the 8 centres are limited. All of the centres lack residency training programmes for medical physicists and radiation therapy technologists (RTTs) resulting in very few well-trained staff. Conclusion: As the Nigeria government plans for the new National Cancer Control Plan, there is an urgent need to scale up access to radiotherapy by upgrading the RT equipment, workforce and infrastructure to meet the current needs of Nigerian cancer patients. While the shortfall is apparent from a variety of radiotherapy-capacity data bases, this detailed analysis provides essential information for an implementation plan involving solutions from within Nigeria and with global partners. Citation Format: Runcie C.W. Chidebe, Chinedu S. Aruah, Tochukwu C. Orjiakor, Fatima Uba, Uchechukwu N Shagaya, Charles Ugwanyi, Aisha A Umar, Taofeeq Ige, Obinna C. Asogwa, Oiza T Ahmadu, Musa Ali-Gombe, Alabi Adewumi, Vitalis C. Okwor, Mutiu A Jimoh, Basheer Bello, Lucy O. Eriba, Yusuf A. Ahmed, Awwal Bisalla, Ukamaka Itanyi, Ramatallah A Balogun, Suleiman Alabi, David Pistenmaa, Coleman C. Norman, Dosanjh Manjit. The Status of Government-Funded Radiotherapy Centres in Nigeria [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 86.

Impact of the Covid-19 pandemic on the treatment of resectable liver neoplasms: A cross-sectional study from Brazil.

e22524 Background: By 2030, 10 million patients needing surgical oncology procedures will be from low and middle-income countries. Hepatocellular carcinoma is reported as the fifth most common cancer in men and the seventh in women worldwide. Surgical resection is the primary treatment option for patients with solitary hepatic tumors. The overload of health systems caused by the coronavirus pandemic has strongly affected Brazilian public healthcare (SUS), making the diagnosis of hepatocellular carcinoma difficult due to the lack of resources and professionals. Under these circumstances, we aimed to evaluate the impact of COVID-19 on the surgical treatment patterns for liver cancer performed by SUS during the peak of the COVID-19 pandemic. Methods: A retrospective study was conducted following the STROBE checklist. With data from DATASUS’s Hospital Information System; An agency of the Brazilian Ministry of Health; patients' identities are preserved and the conduction of any research with data from DATASUS is ethically approved. All hepatectomies from all hospitals were considered. Based on the PICO principle: People with liver cancer in Brazil from 2013 to 2021 (Population); hepatectomy (Interest); Brazilian region (Context), the study analyzes the absolute numbers of hepatectomies in oncology registered between January 2013 and December 2021 and compares it to the number of hepatic cancer diagnosis and deaths in the same period. Statistical analysis was performed on PAST, version 4.12, by applying ANOVA one way and Tukey’s test to assess the number of procedures compared over the years. Results: The total number of partial hepatectomies performed in SUS from 2013-2021 was 8,341, with an average of 695 procedures per year. In 2020, the number of hepatectomy surgeries decreased by 12.95% compared to 2019, going from 1,019 procedures in 2019 to only 887 in 2020. Decreases of 23.80%, 36.73%, 34.54%, and 23.59% in hepatectomies were reported in May, August, October, and December of 2020 compared to 2019. Despite the start of vaccinations in 2021, there was still a 6.67% decrease in hepatectomies compared to 2019. The total number of liver cancer diagnoses from 2013-2021 was 15,303, gradually increasing until 2021, when there was a 0.15% decrease in diagnoses when compared to the previous year. In 2020, the number of deaths decreased by 23.07%, from 65 in 2019 to 50 in 2020. However, in 2021, this number increased by 12%, to 56 deaths. Conclusions: The decrease in hepatectomies is apparent and may affect the prognosis of the patients who didn't have access to the health system during the Covid 19 pandemic. However, secondary delays in diagnosis could affect our observation. To deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning, and further research is needed to understand the impact of our observation on the outcome of patients.

Effect of the COVID-19 pandemic on radical prostatectomy: A Brazilian retrospective study.

e17101 Background: Prostate cancer is reported as the most common cancer in Brazilian men. Prostatectomy (RP) is fundamental for a better prognosis and outcome. The overload of health systems caused by the coronavirus pandemic has strongly affected surgical care in Brazilian public healthcare (SUS), making the diagnosis of prostate cancer more difficult due to the lack of resources and professionals available. Under these circumstances, we aimed to evaluate the impact of COVID-19 on the surgical treatment patterns for prostate cancer performed by SUS during the peak of the COVID-19 pandemic. Methods: A retrospective cross-sectional study was conducted using the STROBE checklist and secondary data from the Hospital Information System of DATASUS, a Ministry of Health agency. The study analyzes the absolute numbers of prostatectomies in oncology registered between January 2013 and October 2022, updated by December 15, 2022. Based on the PICo principle: People with prostate cancer in Brazil from 2013 to 2022 (Population); prostatectomy (Interest); Brazilian region (Context), the study compared the number of cancer diagnoses in the same period. Statistical analysis was performed by applying ANOVA one way to assess the number of procedures compared over the years. Results: In Brazil, on SUS, between January 2013 and October 2022, there were 31,716 RPs, with an annual average of 2,883 procedures. The total number of prostate cancer surgeries decreased by 27.20% in 2020, going from 3,499 procedures in 2019 to 2547 in the following year. There was a 43.02%, 38.87%, 35.77%, and 35.03% decrease in July, October, May, and August, respectively, compared to 2019. Despite vaccination in 2021, prostatectomies decreased by 22.32% compared to 2019. From 2013 to 2022, there were 293,308 prostate cancer diagnoses, with a 71% increase from 2017 to 2019, a 25% decrease from 2019 to 2020, and a 5% increase in 2021. The results show that the total of deaths in prostatectomies is 142. In 2019, 10 deaths were reported on SUS, and that number increased to 13 in 2020, 16 in 2021, and 18 in 2022, showing a progressive increase after the pandemic. Conclusions: The decrease in the number of RP is apparent and may impact the prognosis of the patients who were unable to access the health system during the COVID-19 pandemic. It is fundamental to know the amount of damming from those surgeries to propose measures to prevent adverse outcomes. For all to receive safe, cost-effective, and timely cancer surgery, it is crucial that surgical procedures are a central component of both global and national cancer control plans.

Status of Government-Funded Radiotherapy Services in Nigeria.

Access to radiotherapy (RT) is now one of the stark examples of global cancer inequities. More than 800,000 new cancer cases require potentially curative or palliative RT services in Africa, arguably <15% of these patients currently have access to this important service. For a population of more than 206 million, Nigeria requires a minimum of 280 RT machines for the increasing number of cancer cases. Painfully, the country has only eight Government-funded RT machines. This study aimed to evaluate the status of the eight Government-funded RT services in Nigeria and their ability to deliver effective RT to their patients. A survey addressing 10 critical areas was used to assess the eight Government-funded RT services in Nigeria. Unfortunately, six of the eight centers (75%) surveyed have not treated patients with RT because they do not have functioning teletherapy machines in 2021. Only two RT centers have the capability of treating patients using advanced RT techniques. There is no positron emission tomography-computed tomography scan in any of the Government-funded RT centers. The workforce capacity and infrastructure across the eight centers are limited. All of the centers lack residency training programs for medical physicists and radiation therapy technologists resulting in very few well-trained staff. As the Nigerian Government plans for the new National Cancer Control Plan, there is an urgent need to scale up access to RT by upgrading the RT equipment, workforce, and infrastructure to meet the current needs of Nigerian patients with cancer. Although the shortfall is apparent from a variety of RT-capacity databases, this detailed analysis provides essential information for an implementation plan involving solutions from within Nigeria and with global partners.