Objectives Standard of care for advanced locoregional cervical cancer is primary chemoradiation (pCRT). The majority of patients prescribed pCRT for advanced cervical cancer do not complete their treatment in Northern Tanzania secondary to a complex web of health and socioeconomic stressors. Bugando Medical Center (BMC), a tertiary academic care center in Mwanza, Tanzania, established a cervical cancer navigation program (CCNP) to overcome these barriers.
Methods Funding was provided by the International Mennonite Foundation. CCNP consisted of a navigator, hostel manager, and project manager. Patients were provided food, transportation, housing, labs, imaging, and treatment costs as needed. Patients were also given counseling, education, and social support throughout the course of pCRT.
Results 71 consecutive patients referred to BMC with newly diagnosed cervical cancer were enrolled between January 2020 and December 2020. These patients were not surgical candidates and were prescribed pCRT. Their age range was 30 to 89 years (median 50) and the majority of patients had squamous cell (70, 99%) and 1 patient (1%) had adenocarcinoma. 26 (37%) were HIV positive or unknown and 45 (63%) were HIV negative. During the year, 53 (75%) patients were able to fully complete recommended pCRT and 18 (25%) are still undergoing treatment; no one was lost to follow up during treatment.
Conclusions Social determinants of health play a role in timely completion of pCRT so in order to address these, a pilot CCNP was successfully implemented at BMC and supported 71 patients financially, medically, and psychosocially through their pCRT.
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