Article Text

Download PDFPDF

EP387/#852  Gynecological cancers in sub-Saharan Africa: management of choriocarcinoma
  1. Valentina Iacobelli1,
  2. Francesco Taliente2,
  3. John Bosco Nsubuga3,
  4. Deusdedit Kateregga3 and
  5. Giovanni Scambia1
  1. 1Catholic University of the sacred Heart, Gynecologic Oncology, Rome, Italy
  2. 2University of the Sacred Heart, Hepatobiliary Surgery Unit,, Rome, Italy
  3. 3Matany Saint Kizito Hospital, Ob/gyn, Kampala, Uganda


Introduction The incidence and mortality of cancer are predicted to rise in sub-Saharan Africa (SSA), with a projected increase in cancer deaths to approximately 1 million per year by 2030. We present the management of an aggressive choriocarcinoma with two main aims: first, to raise the awareness on gynecological cancers in SSA, as clinicians in this context seldom face this diagnosis; second, to highlight the need of expansion of cancer care facilities in these settings.

Methods Our setting is Matany Hospital, Region of Karamoja, Northern Uganda. A 29-year-old woman presented with intractable vaginal bleeding, dyspnea, and low abdominal pain, ultimately diagnosed with choriocarcinoma after endometrial biopsy. Despite advice for immediate referral for chemotherapy at a cancer institute, the patient refused due to economic reasons and subsequently died from pulmonary embolism.

Results This presentation highlights the frustration associated with cancer management in rural settings in developing countries and emphasizes the need for expansion of cancer care facilities in these regions. Chorioncarcinoma is a curable disease; therefore is unaccettable that a young woman could die today because she is not guaranteed access to cancer treatment.

Conclusion/Implications Universal health coverage is advocated to reduce out-of-pocket costs for essential cancer therapy and promote equitable access to screening, diagnosis, and management, ultimately reducing deaths from gynecological cancers in SSA. Paradigmatic shifts in governmental policies and engagement with traditional, complementary, and alternative medical practices are necessary to reduce missed diagnoses and late referrals. Tailored context-based guidelines for cost-effective cancer management algorithms are encouraged to be developed by interdepartmental working groups.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.