The Burden of Cancer in African Surgical Training Programs

INTRODUCTION: The increasing global burden of cancer disproportionately affects developing countries. The impact of cancer in surgical training programs (STP) in Africa is not well known. We therefore sought to assess the burden of surgical cancer care and availability of resources for cancer care among African STP. METHODS: In October 2021, a pilot survey was distributed to faculty and residents at all Pan-African Academy of Christian Surgeons (PAACS) STP. RESULTS: We received 46 completed surveys (16.7%) of a total of 275 distributed surveys. Breast, colorectal, and prostate cancer were the top 3 cancers treated. Resources were variably present within STP institutions: multidisciplinary tumor board (41.3%), pathology (47.8%), cancer registry (30.4%), medical oncology (41.3%), palliative care (60.9%), oncology navigation services (26.1%), survivorship care (15.2%), and rehabilitation (58.7%). However, no respondent could access radiation oncology at their institution. Limited institutional capacity for complex cancer operative resection (39.1%) as well as infrastructure and ancillary/nursing capability for complex cancer care (45.7%) was noted. Seventeen respondents (37.0%) reported available resources not affordable for the average patient without significant financial disruption or bankruptcy; 29 (63.0%) noted that over half of patient expenses are paid out of pocket (Table). Table. - Resources Available for Cancer Care, Selected Results Resources for cancer care (n = 46) Available at program, n (%) Available in country, n (%) Not available in current country, n (%) Multidisciplinary tumor board 19 (41.3%) 17 (37.0%) 10 (21.7%) Pathology 22 (47.8%) 23 (50.0%) 1 (2.2%) Cancer registry 14 (30.4%) 21 (45.7%) 11 (23.9%) Medical oncology 19 (41.3%) 26 (56.5%) 1 (2.2%) Radiation oncology 0 (0.0%) 34 (73.9%) 12 (26.1%) Oncology navigation services 12 (26.1%) 16 (34.8%) 18 (39.1%) Palliative care 28 (60.9%) 10 (21.7%) 8 (17.4%) Survivorship care 7 (15.2%) 18 (39.1%) 21 (45.7%) Rehabilitation services 27 (587%) 14 (304%) 5 (109%) CONCLUSION: Our results show substantial variation in access to cancer care resources in a limited sample of African STP. Gaps in resources within institutions and countries reveal development opportunities for cancer care support at STP. Further research is required to assess availability of resources more widely for and the burden of surgical cancer care across a larger sample of STP.