I have just returned from the AORTIC conference in Durban.  AORTIC is an organisation concerned with cancer from an African perspective.  The majority of the talks I went to were about breast cancer and cancer registries in Africa.

Karposi's sarcoma, breast and cervical cancer account for the majority of cancer cases in women in Africa.  In some countries, cervical is commoner.  In others, breast.  Unlike breast cancer, cervical
cancer is associated with an infection: papilloma virus.  In general, deaths due to infectious diseases are decreasing in sub saharan Africa.  Conversely the disease burden due to non communicable disease is increasing as women here adopt a more western life style.

As I have alluded to in previous blogs, women in this country are seen with more advanced disease.  We have referred to the phenomenum of women presenting late.  Dr Joe Harford (NCI) has pointed out that this only tells half the story.  Women in Africa are diagnosed at a later stage.

There are many reasons why women do not seek medical attention.  Doctors are a scarce commodity in Africa.  Ines Buccimazza (Durban) gave an excellent talk looking at the number of doctors in Africa. Africa has 24 % of the global health burden and 3% of the global health spending.

More sobering facts emerged: in Nigeria, 38% of women are divorced within 3 years of having a mastectomy.  In Tanzania and the Congo, over 90% women with breast cancer have locally advanced disease at the time of diagnosis.  We need African solutions to the health crisis in the continent.

On Saturday morning, there was a workshop discussing the training of health professionals in Africa.  How are doctors, once trained as a specialist, persuaded to stay in their country of origin?  Prof Lynette Denny (UCT) emphasised the need for appropriate training for overseas doctors.

The conference was illuminating, sobering and yet full of exciting initiatives.  However, I came to the conclusion that although we spend a lot of time discussing different prognostic factors, the main prognostic factor in the outcome of breast cancer is geographical location.

Let me know if there are geographic disparities in health care in your part of the world.

1 comment:

  1. Thank you for this feedback from the conference, it is much appreciated. The reality that the place that we are born will dictate the prognosis of a treatable disease like breast cancer really saddens me and opens my heart to woman all over Africa.