Mapping of radiation oncology and gynecologic oncology services available to treat the growing burden of cervical cancer in Africa.

To meet the demand for cervical cancer care in Africa, access to surgical and radiotherapy services need to be understood. We thus mapped the availability of gynecologic and radiotherapy equipment and staffing for treating cervical cancer. We collected data on gynecologic and radiation oncology staffing, equipment, and infrastructure capacities across Africa. Data was obtained from February to July 2021 through collaboration with international partners using REDCap. Cancer incidence was taken from the International Agency for Research on Cancer's GLOBOCAN 2020 database. Treatment capacity, including the numbers of radiation oncologists, radiation therapists, physicists, gynecologic oncologists, and hospitals performing gynecologic surgeries was calculated per 1000 cervical cancer cases. Adequate capacity was defined as two radiation oncologists and two gynecologic oncologists per 1000 cervical cancer cases. Forty-three of 54 (79.6%%) African countries responded, and data were not reported for 11 (20.4%) countries. Respondents from 31 (57.4%) countries reported access to specialist gynecologic oncology services, but staffing was adequate in only 11(20.4%) countries. Six (11%) countries reported that generalist obstetrician-gynecologists perform radical hysterectomies. Radiation oncologist access was available in 39 (72.2%) countries, but staffing was adequate in only 16 (29.6%) countries. Six (11%) countries had adequate staffing for both gynecologic and radiation oncology; seven (13%) countries had no radiation or gynecologic oncologist. Access to external beam radiation was available in 31 (57.4%) countries, and access to brachytherapy was available in 25 (46.3%) countries. The number of countries with training programs in gynecologic oncology, radiation oncology, medical physics, and radiation therapy were 14 (26%), 16 (30%), 11 (20%), and 17 (31%), respectively. We identified areas needing comprehensive cervical cancer care infrastructure, human resources, and training programs. There are major gaps in access to radiation oncologists and trained gynecologic oncologists in Africa.

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