Study identifies barriers to breast cancer treatment in Nigeria, Sub-Saharan Africa

Study identifies barriers to breast cancer treatment in Nigeria, Sub-Saharan Africa

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A new research finding has identifies patients travelling long distances to access care ,treatment cost , significant delays and wait times for diagnostic tests as barriers that limits breast cancer patients the ability to complete an appropriate course of treatment in Nigeria, Ghana and Kenya.

“Patients face significant delays, waiting time for surgery (mastectomy or breast conserving) can reach up to 112 days in Nigeria and 145 days in Ghana,” study revealed.

In Nigeria breast cancer is the leading cause of cancer death in women and cervical cancer the second. Cancer is a critical public health problem in this population, according to the World Health Organisation (WHO).

The study states that significant strides have been made in detecting, managing and treating breast cancer, yet it remains one of the most frequently diagnosed malignancy and the leading cause of cancer-related death in women in Nigeria, Kenya and Ghana. A patient’s chance of survival can be impacted by delays in diagnosis and treatment, limitations in access to appropriate and quality cancer care, and financial burdens associated with receiving care.

To better understand the challenges to addressing the full spectrum of breast cancer patient care in sub-Saharan Africa (SSA) and to help identify what solutions are needed throughout the patient journey, the study evaluated real world data on medical resource use, time taken to access recommended interventions and impact of payment options for individual patients.

“This study is a critical first step to understanding the magnitude of the barriers that Nigerian breast cancer patients face in their fight against this disease, both to improve access to quality cancer treatment and ensure that our patients do not face financial catastrophe while fighting this disease,” stated Razaq Oyesegun, co-author of the study and consultant clinical/radiation oncologist, National Hospital, Abuja.

He added: “In line with global momentum toward Universal Healthcare, there is a need for policies that improve standard of care treatment and increase insurance coverage to ultimately improve outcomes and protect breast cancer patients from financial hardship.”

The researchers found that patients travel long distances to access care in Nigeria, Ghana and Kenya, revealing that the commute to a tertiary cancer center was up to 717 (mean 121) Km in Nigeria, 614 (mean 45) km in Ghana and 398 (mean 56) km in Kenya.

The study design and methodology in a retrospective chart review, records of patients with breast cancer treated at one government–operated and one privately operated hospital in each country (six tertiary centers) in Nigeria, Ghana and Kenya were included in the study. The cancer centers include National Hospital Abuja and Lakeshore Cancer Center in Nigeria;Korle-Bu Teaching Hospital and Sweden Ghana Medical Centre in Ghana and Kenyatta National Hospital and Aga Khan University Hospital in Kenya.

In total, health records from 862 breast cancer patients were reviewed; 299 patient records from Ghana, 314 from Kenya and 249 from Nigeria.

The research conducted Roche explores on key findings from the study, titled, “Access to care and financial burden for patients with breast cancer in Ghana, Kenya and Nigeria” were presented at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting held in Chicago, IL, United States earlier this month.

Roche is the world’s largest biotech company, with truly differentiated medicines in oncology, immunology, infectious diseases, ophthalmology and diseases of the central nervous system. Roche is also the world leader in in vitro diagnostics and tissue-based cancer diagnostics, and a frontrunner in diabetes management.

The research also stated that Patients treated in tertiary facilities are not accessing diagnostic procedures, treatment and therapies at standard of care noting that the usage of common screening methods such as a mammogram or breast ultrasound was less than 45 percent in Nigeria, Ghana and Kenya and the use of core needle biopsy was 76 percent in Nigeria and Kenya, but only 50 percent in Ghana.

“Roche is proud to support this study which provides real world data on the breast cancer patient journey in Nigeria, and importantly, provides direction on what specific changes need to be made to improve outcomes for these patients. One way that this can be accomplished is through stronger private-private and public-private partnerships geared towards improving access to breast cancer care as no single player can tackle the barriers alone,” said Hameed Oladipupo,Country Manager, Nigeria at Roche. “When we work together we can increase access and affordability of cancer care – and ultimately, improve outcomes for women in Nigeria facing breast cancer.”

The report further stated that Patients are responsible for a significant share – if not all – of diagnostic tests and treatment costs. This limits patient ability to complete an appropriate course of treatment revealing that Most patients studied in Nigeria (87 to 93 percent) paid for their diagnostic tests entirely out-of-pocket (OOP).The findings were similar in Ghana.

Similar to diagnostic testing, the proportion of patients paying OOP only for treatments were high, ranging from 72 – 89 percent in Nigeria, 45 – 79 percent in Ghana, and 8 – 20 percent in Kenya.

Among those patients receiving HER2 targeted therapy, the average number of cycles was 5 for patients paying OOP only versus 14 for patients with some level of insurance coverage.

However the researcher therefore identifying the barriers present in a patient’s journey to receiving care is a critical first step to understanding what changes need to be made to increase access and affordability of cancer care. The findings of this study demonstrate the urgent need for policies that improve standard of care treatment and increase insurance coverage to improve clinical outcomes and protect breast cancer patients from financial hardship.

 

ANTHONIA OBOKOH



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