# Assessing delays in accessing and completing radiotherapy for cervical cancer treatment: A multicenter survey of oncology providers in go further-funded countries in Sub-Saharan Africa

## TL;DR

This study finds that many cervical cancer treatment centers in Sub-Saharan Africa face delays and lack resources for radiotherapy, worsening patient outcomes.

## Contribution

The study provides new insights into radiotherapy delays and infrastructure gaps in Go Further-funded countries for cervical cancer treatment.

## Key findings

- Nearly half of providers reported wait times of two months or more for chemoradiotherapy consultation.
- Only 26.7% reported treatment times within 56 days for over 95% of patients.
- Transportation, funding, and patient fear were major barriers to timely treatment.

## Abstract

•Many cervical cancer treatment facilities in Sub-Saharan Africa lack adequate radiotherapy infrastructure.•Delays in diagnosis and treatment initiation contribute to suboptimal cervical cancer outcomes.•Key barriers to accessing care include transportation challenges, treatment fear, and financial hardship.•Limited patient support services hinder adequate advanced-stage cervical cancer treatment.•These findings highlight the urgent need to expand advanced-stage cervical cancer treatment efforts by Go Further.

Many cervical cancer treatment facilities in Sub-Saharan Africa lack adequate radiotherapy infrastructure.

Delays in diagnosis and treatment initiation contribute to suboptimal cervical cancer outcomes.

Key barriers to accessing care include transportation challenges, treatment fear, and financial hardship.

Limited patient support services hinder adequate advanced-stage cervical cancer treatment.

These findings highlight the urgent need to expand advanced-stage cervical cancer treatment efforts by Go Further.

Cervical cancer is a leading cause of cancer death in Sub-Saharan Africa. Go Further provides funds for prevention and screening in Sub-Saharan Africa, but access to treatment for invasive disease remains limited. This survey aims to assess delays in accessing curative-intent chemoradiotherapy for cervical cancer in countries receiving Go Further funding.

Oncology providers in countries receiving Go Further funding (Botswana, Eswatini, Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Tanzania, Uganda, Zambia, Zimbabwe) and South Africa were invited to participate in a web-based survey beginning September 2023.

Fifteen oncology providers responded, with all countries except Malawi represented. Nearly half (46.3 %) reported wait time of ≥two months for chemoradiotherapy consultation. 93.3 %, 71.4 %, 53.7 % and 73.3 % had access to at least one CT, linear accelerator, cobalt, and brachytherapy machine, respectively. Majority (60 %) reported wait time of <one month to initiate chemoradiotherapy after staging. However, 28.6 % reported >95 % of patients complete external radiotherapy within 42 days, and 33 % reported >95 % of these patients receive brachytherapy. Only 26.7 % reported overall treatment time within 56 days for >95 % of patients. Lack of transportation, funding, and patient fear, were other treatment barriers reported.

These results highlight the need for additional chemoradiotherapy resources in Go Further-funded countries. In addition to expanding radiotherapy, supplemental avenues to improve access in Sub-Saharan Africa include addressing barriers that increase wait times along the care continuum and implementing social support. This survey serves as a call to Go Further, highlighting the urgent need for resource allocation for cervical cancer treatment.