AFRICA – The World Health Organization (WHO) has published insights from a breast cancer surgeon in Nairobi County, Kenya on preventing and treating breast cancer in a bid to address late-stage diagnosis and inadequate access to quality breast cancer care in sub-Saharan Africa.

According to the World Health Organization, preventing and treating breast cancer is a pressing public health issue in sub-Saharan Africa where breast cancer survival rates five years after diagnosis stand at a dismal 40% as compared to over 90% in most high-income countries.

In sub-Saharan Africa, late-stage diagnosis and inadequate access to quality breast cancer care lead to high death rates. Most women are diagnosed at advanced stages when treatment is difficult, costly and less likely to achieve a cure,” highlights the global health agency.

WHO aims to reduce global breast cancer mortality by 2.5% per year by 2040 through Global Breast Cancer Initiative’s (GBCI) three pillars namely health promotion and early detection, timely diagnosis along with comprehensive breast cancer management.

World Health Organization supports governments to provide centralized services for breast cancer with the aim of ensuring that 80% of breast cancer patients undergo full-course multimodality treatment.

The WHO Global Breast Cancer Initiative strives to address barriers in early cancer diagnosis through its first pillar entitled health promotion and early detection that aims to reduce stigma associated with breast health and improve public awareness of the signs and symptoms of breast cancer.

The Global Breast Cancer Initiative’s second pillar aims to ensure timely diagnosis specifically GBCI strives to minimize delays between the time a breast cancer patient first interacts with the health system and when treatment starts.

For instance, countries will receive an evidence-based technical package through the Global Breast Cancer Initiative that incorporates existing World Health Organization’s cancer tools and products to strengthen national health systems.

The initiative’s third pillar is comprehensive breast cancer management since cancer treatment requires the collaboration of multiple specialties to provide surgery, chemotherapy and radiotherapy in the correct sequence as well as rehabilitation for women after treatment with palliative services.

Breast surgical oncologist in Nairobi Dr Miriam Mutebi disclosed that paying out of pocket to access breast cancer care routinely results in catastrophic health costs and financial hardship for families often leading to treatment delays that make cancer treatment less effective.

Cancers related to a woman’s reproductive system are often erroneously linked to sexual promiscuity or equated with failure to fulfil one’s role as a caregiver. A number of cancer patients are abandoned by their partners or families after receiving a cancer diagnosis because of stigma,” Dr Miriam added.

Socio-cultural barriers further limit access to cancer treatment in sub-Saharan Africa particularly in cases where women lack agency to seek healthcare on their own including cancer myths and widespread stigma that deter women from cancer screening or completing their treatment once diagnosed.

In addition, Dr Mutebi explained that health provider diagnostic delays contribute to poor prognoses for women with breast cancer in sub-Saharan Africa hence the critical need to ensure timely diagnosis aimed at closing the gap between diagnosis and treatment

To ensure timely referrals for diagnosis, health workers must be trained to identify the signs and symptoms of early breast cancer. Every patient who visits a clinic provides an opportunity to engage in prevention education and timely interventions for cancer management,” Dr Miriam Mutebi advised.

Dr Mutebi noted that there is a growing recognition in the sub-Saharan Africa region regarding the need for multidisciplinary approaches to cancer management based on the concept of personalized care where treatment is tailored to each patient.

Dr Miriam Mutebi further said that there has been an encouraging increase in the number of countries with national cancer control programs in sub-Saharan Africa that emphasize the Global Breast Cancer Initiative’s three-pronged approach of breast cancer care.

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