Thursday, November 21, 2024
11/21/2024
Title: Barriers and facilitators of cancer care and financial burden of cancer care in Kinshasa, the Democratic Republic of the Congo ABSTRACT Growing cancer morbidity and mortality is a major public health problem globally, which disproportionality affects low- and middle-income countries. In sub-Saharan Africa, cancer incidence has doubled in the past 30 years. Most cancer patients in SSA present at an advanced stage of disease, impacting prognosis and survival, which may be attributed to significant barriers to access care. HIV and cancer comorbidity is significant and people living with HIV are less likely to access cancer care. High poverty rates in SSA countries exacerbate multiple barriers to HIV and cancer care. In most countries, cancer management is not included in the core health services and most cancer care expenses are paid for out of pocket. To better understand barriers to and facilitators of cancer care in the Democratic Republic of Congo (DRC), financial burden of cancer care and its impact, we leverage the Central Africa International Epidemiology databases to Evaluate AIDS infrastructures and the ongoing collaboration between Montefiore Einstein Comprehensive Cancer Center and the DRC’s National Cancer Program (CNLC). Using a mixed method design, we will collect qualitative data from stakeholders and cancer patients to identify factors associated with access to and adherence to cancer care and the economic burden of care for patients living with and without HIV (Aim 1). We will use cognitive interviewing to adapt and validate widely used cost assessment and quality of life tools for use in Kinshasa. We will use the adapted measures to survey 300 cancer patients in Kinshasa to determine the financial burden of cancer care and assess its impact on completion of cancer care cascade and quality of life (Aim 2). The results of this study can have a significant public health impact in both the DRC and other low-income SSA countries with growing cancer incidence. CNLC in close coordination with the DRC government is launching a major effort to scale up cancer care in the DRC and establish new cancer centers. Our results will inform and strengthen this ongoing effort by providing data to stakeholders to inform optimal design of care and better targeting for equity. Title: Leveraging Existing Infrastructures and Expertise to Enhance Cancer Control in sub-Saharan Africa ABSTRACT As part of the global socioeconomic transition, many low-and middle-income countries (LMICs) are witnessing a shift in cancer profiles, influenced by the adoption of Westernized diets and lifestyles similar to those seen in high-income nations. While high-income countries have robust cancer surveillance systems, reliable cancer data is scarce in sub-Saharan Africa, hindering comprehensive understanding of the disease burden and international comparisons. Population-based cancer registries (PBCRs) are crucial tools for gathering this critical information. This supplement proposes to address this critical gap by establishing PBCRs in the Democratic Republic of Congo (DRC), Burundi, and Cameroon. Leveraging our existing infrastructure in these countries through CA-IeDEA and building on our proven expertise from a successfully implemented cancer registry in Rwanda, this project seeks to fill this critical gap. These registries will equip governments with crucial data for informed decision-making on cancer control and enhance international collaboration, fostering knowledge exchange and contributing to global cancer initiatives. Additionally, this supplement supports the primary aim of the parent grant to evaluate the adverse clinical outcomes in people living with HIV (PWH), including the increasing cancer burden. Currently, the lack of cancer tracking significantly limits our understanding of cancer diagnoses and the overall burden of morbidity and mortality. Developing cancer registration in these three countries will substantially improve our ability to measure cancer diagnoses and outcomes in CA-IeDEA.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
