JCO Global Oncology最新文献

{"title":"Exploring Pediatric Oncology Care Practices Influencing the Relationships Among Children, Caregivers, and Health Care Providers: A Multi-Institutional Study From Pakistan.","authors":"Shahzadi Resham, Sadaf Altaf, Farwa Ayub, Areesh Bhatti, Areeba Syed, Rida Iqbal, Afia Tul Quanita, Clariana Vitória Ramos de Oliveira, Zehra Fadoo, Naureen Mushtaq, Uzma Imam, Muhammad Rafie Raza, Aisha Khizar Yousafzai","doi":"10.1200/GO-24-00347","DOIUrl":"https://doi.org/10.1200/GO-24-00347","url":null,"abstract":"<p><strong>Purpose: </strong>The quality of relationships between health care professionals (HCPs) and patients is an important factor influencing people's experiences with their health systems. In Pakistan, pediatric oncologists highlight the need for effective communication to support relationships between HCPs and children and families. Existing communication toolkits on the basis of the evidence from high-income countries are ineffective and culturally unsuitable in the context of low- and middle-income countries. Therefore, we aim to describe how characteristics of current pediatric oncology care practices for children with life-threatening illnesses (LTIs) influence their relationships and communication about illness and treatment.</p><p><strong>Materials and methods: </strong>A phenomenological qualitative study was conducted. In-depth interviews (N = 60) were conducted with children (8-18 years) with LTI receiving treatment at one of three pediatric oncology units in Karachi, their families, and HCPs. Themes were generated after inductive coding.</p><p><strong>Results: </strong>Five themes were identified, and four key findings are highlighted. First, HCPs valued effective communication. Practices were influenced by the sociocultural environment using a range of approaches, often without formal training, to respond to local needs. Second, families and HCPs were concerned about treatment-related fears, leading to reluctance in sharing illness information with children regardless of age. Third, both groups felt that disclosing diagnosis, involving families and children in treatment plans, and age-appropriate communication would strengthen the therapeutic alliance. Finally, HCPs emphasized the importance of faith and a multidisciplinary team approach in enhancing therapeutic relationships.</p><p><strong>Conclusion: </strong>The need for effective communication with children with LTI and families while respecting sociocultural norms will allow for trust building and stronger therapeutic alliances.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400347"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a Patient Navigation Program on Cancer Treatment in Kenya.","authors":"Shahid Umar, Andriy Chybisov, Erica Krisel, Hayley Freedman, Catherine Nyongesa, Anastacia Bosire, Sitna Mwanzi, Anurag K Agrawal, Kristie McComb","doi":"10.1200/GO-24-00579","DOIUrl":"https://doi.org/10.1200/GO-24-00579","url":null,"abstract":"<p><strong>Purpose: </strong>Patient navigation (PN) is a critical intervention in the United States to overcome barriers to cancer care, including logistical, financial, and informational barriers, ensuring patients receive timely and coordinated care. However, there are few studies assessing effectiveness of PN in low- and middle-income countries (LMICs). Here, we aim to begin to fill this gap by assessing the effectiveness of the Kenyatta National Hospital (KNH) patient navigation program (PNP) in improving patient-reported outcomes (PROs).</p><p><strong>Materials and methods: </strong>We used repeated cross-sectional survey design by collecting data from randomly selected 1,126 adults with cancer in three surveys conducted in 2018, 2019, and 2022. The study also drew on qualitative data collected from patients with cancer, caregivers, and program team members as part of an external outcome evaluation.</p><p><strong>Results: </strong>Logistic regression showed that a higher number of navigation encounters was associated with increased likelihood of improving patients' understanding of their diagnosis, duration of treatment, and satisfaction with information received about needed clinical services. Compared with the 2018 survey, participants of the 2019 (odds ratio [OR], 12.00, 8.00-17.99) and 2022 (OR, 17.18, 10.88-27.14) surveys had markedly higher odds of receiving help finding their way around the facility. Moreover, compared with the 2018 survey, participants of the 2019 survey had lower odds of delaying the start or continuation of their treatment (OR, 0.50, 0.32-0.78).</p><p><strong>Conclusion: </strong>This study contributes to a limited pool of studies to assess PROs of PNPs specifically for cancer treatment in LMICs, making an important contribution to the existing body of knowledge in global cancer patient support. This study provides evidence that PNPs can function effectively and complementarily in LMICs.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400579"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the Demand and Supply for Oncology Workforce in Jordan: Current Status and Future Projections.","authors":"Ahmed Salem, Layth Al-Ramahi, Sami Alodeh, Waleed Al-Sarayrah, Ayham Mohammad Hussein, Mohammad Al-Qudah, Hikmat Abdel-Razeq, Khaldoon Bashaireh, Fanar Alsmarat","doi":"10.1200/GO-24-00638","DOIUrl":"10.1200/GO-24-00638","url":null,"abstract":"<p><strong>Purpose: </strong>Jordan, a lower-middle-income country in the Middle East, faces a growing cancer burden coupled with a shortage of skilled oncologists, which challenges the delivery of high-quality cancer care. This study assessed the current and future oncology workforce to evaluate Jordan's capacity to meet cancer care demands.</p><p><strong>Materials and methods: </strong>This multifaceted study evaluated the supply and demand for oncologists in Jordan by quantifying the current workforce and projecting future growth, considering the number of physicians passing board exams over the past 5 years and medical students' interest in oncology, as indicated by survey data collected from Jordanian medical students.</p><p><strong>Results: </strong>In 2023, Jordan had 110 medical oncologists (9.8 per million population [PMP]), 64 radiation oncologists (5.7 PMP), and 36 surgical oncologists (3.2 PMP). Workforce density in the United States was 4.2 times and in the United Kingdom 2.1 times higher than in Jordan, whereas Saudi Arabia's workforce density was 1.5 times higher. Iraq and Syria had lower densities. Over 5 years, 40 medical oncologists and 27 radiation oncologists passed board exams, with oncologists comprising only 1.41% of Jordan's total physicians. Surveyed Jordanian medical students showed low interest in oncology (1.68%). Cancer cases in Jordan are projected to rise by 149.7% by 2050, whereas the workforce is expected to grow by 188.4%, peaking at 25.5 oncologists per 1,000 cancer cases by 2034, before declining due to enrollment limits in medical schools.</p><p><strong>Conclusion: </strong>Our study reveals significant gaps and challenges in meeting future oncology care demands with low interest among medical students in pursuing oncology specialties. This highlights the need to improve medical student interest in oncological specialties rather than rely on large medical student enrollment and graduation rates.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400638"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer Care in Jordan: Multidisciplinary Solutions Needed for Complex Disparities.","authors":"Ali Aljassabi, Tarek Zieneldien, Janice Kim, Lubna Hammoudeh, Ghazi Sharkas, Jonas Willmann, Erin Jay G Feliciano, Edward Christopher Dee","doi":"10.1200/GO-24-00600","DOIUrl":"https://doi.org/10.1200/GO-24-00600","url":null,"abstract":"","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400600"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phase I Study of Subcutaneous Rituximab Hyaluronidase Combined With CHOP Chemotherapy for the Treatment of Diffuse Large B-Cell Lymphoma in Uganda.","authors":"Manoj P Menon, Henry Ddungu, Kelvin R Mubiru, Scott V Adams, Jacqueline Asea, Rosemary Namagembe, Prossy Namuli, Joyce Kambugu, Andrea M H Towlerton, Camille Puronen, Thomas S Uldrick, Jackson Orem, Edus H Warren","doi":"10.1200/GO-24-00489","DOIUrl":"10.1200/GO-24-00489","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with diffuse large B-cell lymphoma (DLBCL) who are treated in low-resource settings have inferior outcomes compared with those in high-resource settings. Rituximab, an anti-CD20 monoclonal antibody, when combined with chemotherapy, improves overall survival (OS) for DLBCL. However, in part due to the limited availability of infusion centers in low-resource countries, rituximab is rarely used. Subcutaneous rituximab (sqR) is a potential solution; however, its safety and efficacy have not been tested in low-income countries.</p><p><strong>Methods: </strong>This open-label phase I study enrolled patients 18 years or older with newly diagnosed DLBCL. The first cohort (n = 6) received intravenous rituximab plus CHOP. This cohort received sqR for subsequent cycles. The second cohort (n = 12) received sqR plus CHOP for all cycles. Safety and tolerability were evaluated; secondary outcomes included response rates and treatment completion.</p><p><strong>Results: </strong>Between October 25, 2019, and October 7, 2022, 18 patients, with a median age of 36.5 years, were enrolled; 10 were male, and 10 presented with advanced-stage disease. The most common hematologic toxicity was neutropenia (n = 9, 50%). Fifteen of the 18 participants completed treatment; 14 (93.3%) patients achieved a complete response, and one patient (6.7%) had a partial response. The OS and progression-free survival (PFS) at 12 months were 83% (95% CI, 68 to 100) and 67% (95% CI, 48 to 92), respectively. The OS and PFS at 24 months were 66% (95% CI, 47 to 92) and 67% (95% CI, 48 to 92), respectively.</p><p><strong>Conclusion: </strong>As demonstrated in other parts of the world, sqR together with CHOP was safe, well-tolerated, and efficacious among Ugandan patients with DLBCL. The very high OS rates are nearly double those of historical controls and comparable with outcomes expected in resource-rich settings. This study demonstrated the feasibility, safety, and efficacy of sqR-CHOP, increased the research infrastructure in Uganda, and will improve care in other resource-limited settings.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400489"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological Manifestations of Patients With CNS Metastases: Experience From a Single Center in an Upper-Middle-Income Country.","authors":"Bernardo Cacho-Díaz, Alberto González-Aguilar, Gervith Reyes-Soto, José O Navarro-Fernández, Federico Maldonado-Magos, Oscar Arrieta, Talia Wegman-Ostrosky, Orwa Aboud, Mónica Serrano-Murillo","doi":"10.1200/GO-24-00465","DOIUrl":"https://doi.org/10.1200/GO-24-00465","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to report the neurological manifestations of patients with CNS metastases (CNSm) and to determine their association with survival in patients with brain metastases (BrMs).</p><p><strong>Materials and methods: </strong>A retrospective analysis of patients with CNSms (BrMs or neoplastic meningitis) seen at two referral centers between 2010 and 2022. The neurological manifestations and their association with survival were measured and presented.</p><p><strong>Results: </strong>Among 822 patients with CNSms, the most common neurological manifestations were headache, focal weakness, visual disorders, nausea/vomiting, seizures, and altered mental status (53%, 35%, 24%, 23%, 22%, and 18%, respectively). In patients with BrMs, neurological manifestations associated with survival were asymptomatic (hazard ratio [HR], 0.48 [95% CI, 0.31 to 0.73]; <i>P</i> = .001), focal weakness (HR, 1.26 [95% CI, 1.02 to 1.54]; <i>P</i> = .027), or visual disorders (HR, 1.26 [95% CI, 1.01 to 1.58]; <i>P</i> = .045).</p><p><strong>Conclusion: </strong>Neurological manifestations in patients with BrMs are associated with survival and can aid in prognostic stratification.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400465"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Model for Predicting Gaps in Surgical Oncology Care Among Patients With Stage I-III Rectal Cancer From KwaZulu-Natal, South Africa.","authors":"Yoshan Moodley, Willie Brink, Jacqueline van Wyk, Shakeel Kader, Steven D Wexner, Alfred I Neugut, Ravi P Kiran","doi":"10.1200/GO-24-00480","DOIUrl":"https://doi.org/10.1200/GO-24-00480","url":null,"abstract":"<p><strong>Purpose: </strong>Gaps in surgical oncology care (GISOC), including delayed or nonreceipt of surgery, are detrimental to cancer control. This research sought to develop a risk model for predicting GISOC in South African rectal cancer (RC) patients with localized disease.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed data from an existing colorectal cancer patient registry. GISOC was defined as surgery received >62 days after diagnosis with stage I-III RC or nonreceipt of surgery for stage I-III RC. Patient demographics, comorbidity, disease staging, and neoadjuvant therapy receipt were included as covariates in the analysis. A supervised logistic regression machine learning algorithm was used to train and test an appropriate risk model, which was translated into a nomogram. Receiver operating characteristic curve analyses and AUC assessments were used to establish the nomogram's performance.</p><p><strong>Results: </strong>The analysis included 490 patients (training data set = 245, testing data set = 245). Overall, there were 242 patients who experienced GISOC (49.4%), of whom 33 (13.6%) did not receive surgery and 209 (86.4%) had a delay in receiving surgery. The trained risk model consisted of patient race (Indian, odds ratio [OR] = 0.24; White, OR = 0.23; <i>v</i> Black), comorbidity (OR = 2.29 <i>v</i> no comorbidity), and neoadjuvant therapy receipt (OR = 18.40 <i>v</i> nonreceipt). AUCs for the risk model were >0.800.</p><p><strong>Conclusion: </strong>An accurate, setting-specific risk model and nomogram was developed for predicting GISOC in patients with RC. The nomogram can be implemented without the use of technology to identify patients at high risk for GISOC, who can then be targeted with risk-reduction interventions. The impact of the nomogram on existing surgical unit workflows requires further investigation.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400480"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving the Sensitivity-Specificity Balance of Human Papillomavirus Testing on Self- and Clinician-Collected Samples in South Africa.","authors":"Gbenankpon M Houvessou, Rakiya Saidu, Rosalind Boa, Nomonde Mbatani, Jennifer Moodley, Louise Kuhn","doi":"10.1200/GO-25-00037","DOIUrl":"https://doi.org/10.1200/GO-25-00037","url":null,"abstract":"<p><strong>Purpose: </strong>Human papillomavirus (HPV) testing on self-collected samples may increase coverage of cervical cancer screening, but previous studies have observed lower specificity of HPV testing in self- versus clinician-collected samples. Here we investigate strategies to improve the sensitivity-specificity balance of a round of HPV testing on self-collected samples.</p><p><strong>Materials and methods: </strong>Women living with and without HIV, age 30-65 years, were recruited in South Africa. Self-collected vaginal samples and clinician-collected cervical samples were tested with Xpert HPV, an assay that detects the 14 high-risk HPV types in five separate channels: (P1) HPV 16; (P2) HPV 18, 45; (P3) HPV 31, 33, 35, 52, 58; (P4) HPV 51, 59; and (P5) HPV 39, 56, 66, 68. All women underwent colposcopy with histology sampling, and diagnosis of cervical intraepithelial neoplasia grade 2 or greater (CIN2+) was determined by adjudicated pathology. The AUC and related performance parameters were calculated using logistic regression with the cycle threshold (Ct) values of the channels as predictors.</p><p><strong>Results: </strong>HPV prevalence in women without and with HIV was higher in self-collected (25.1% <i>v</i> 61.5%) than in clinician-collected samples (16.2% <i>v</i> 48.4%). The optimal model to predict CIN2+ used Ct values from the three channels that detect HPV 16, 18, 45, 31, 33, 35, 52, and/or 58. AUC was superior for testing on clinician-collected (0.908) than on self-collected samples (0.878; <i>P</i> = .0261) in women without HIV, as well as for women living with HIV (0.868 <i>v</i> 0.819; clinician <i>v</i> self; <i>P</i> = .0002). Alternate approaches to handling multiple types and sequential testing approaches did not allow self-testing to achieve equivalent performance to testing on clinician-collected samples.</p><p><strong>Conclusion: </strong>Using more stringent Ct cutoffs on the three channels that detect the eight highest-risk HPV types can improve the sensitivity-specificity balance of a round of screening in both self- and clinician-collected samples. Although performance of HPV testing on self-collected samples is excellent, performance parameters are better on clinician-collected samples.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500037"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review of Soft Tissue Sarcomas in Latin America.","authors":"Marlid Cruz-Ramos, Dorian Yarih García-Ortega, Renata Becerra-Herrera, Denise Carolina Cabello-Díaz, Sara Aileen Cabrera-Nieto, Gabriela A Martínez-Nava, Claudia Haydeé Saraí Caro-Sanchéz","doi":"10.1200/GO-24-00508","DOIUrl":"https://doi.org/10.1200/GO-24-00508","url":null,"abstract":"<p><strong>Purpose: </strong>Soft tissue sarcomas (STSs) are rare malignant neoplasms posing significant public health challenges globally, especially in Latin America with limited research resources. This systematic review provides an overview of the epidemiology, clinical characteristics, treatment, and outcomes of STSs in Latin America, emphasizing the impact of insufficient investment in research and health care infrastructure.</p><p><strong>Materials and methods: </strong>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic literature review of clinicopathologic characteristics of STSs in Latin American patients. Studies published between January 1986 and August 2024 were included. A comprehensive search across multiple databases yielded 502 papers, refined to 18 publications and three national records included in the study. A meta-analysis was done for survival evaluation.</p><p><strong>Results: </strong>Data from 2,931 patients with mean age 47 years were analyzed, and 340 patients had pretreatment biopsy. The most common sarcoma types were liposarcoma (23.2%) and synovial sarcoma (21.2%), with high-grade tumors (52%) predominating. Treatment primarily involved surgery (863 patients), often combined with radiotherapy (559 patients) and chemotherapy (307 patients). Five-year overall survival was 61%.</p><p><strong>Discussion: </strong>The findings highlight challenges in managing STSs in Latin America, including advanced disease at diagnosis and high-grade tumors. Survival rates correlate with local advanced disease reported by other countries. Barriers include limited access to specialized centers and inadequate use of preoperative biopsies. Improved diagnostic and treatment strategies and collaborations to enhance research and clinical practices are needed.</p><p><strong>Conclusion: </strong>This review underscores critical gaps in STS management in Latin America. Increased investment in research, a cohesive network of specialized care centers, and a multidisciplinary approach are essential to improve outcomes and quality of life for patients in the region.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400508"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and Associated Survival of Patients Diagnosed With Non-Small Cell Lung Cancer in a Designated Lung Cancer Program in Western Kenya.","authors":"Naftali Busakhala, Lawrence Atundo, Hillary Kiprono, Kibet Keitany, Elias Melly, Ruth Ruto, Madrine Wanja, Daniel Chepsiror, Hussain Rangoonwala, Cornelius Kipchirchir, Erick Chesori, John Oguda, Jesse Opakas, Patrick J Loehrer, Lameck Diero, Jennifer Morgan","doi":"10.1200/GO.24.00212","DOIUrl":"10.1200/GO.24.00212","url":null,"abstract":"<p><strong>Purpose: </strong>Although lung cancer is a major cause of cancer incidence and mortality worldwide, lung cancer studies in sub-Saharan Africa are scarce. Here, we present outputs from a designated lung cancer program in western Kenya, part of the Multi-National Lung Cancer Control Program, which focused on case finding, diagnosis, and treatment.</p><p><strong>Methods: </strong>We retrospectively reviewed patients with pathologically confirmed non-small cell lung cancer (NSCLC) enrolled in this program at Moi Teaching and Referral Hospital from January 2018 to December 2022. Clinical data were analyzed using descriptive statistics, Kaplan-Meier methods, and proportional hazards regression model.</p><p><strong>Results: </strong>Two hundred forty-nine patients diagnosed with NSCLC were included with a median age at diagnosis of 61 (IQR, 52-70) years. Most patients were married (n = 177; 71%) and nonsmokers (n = 177; 71%) with 58 (23%) having received tuberculosis treatment and 93 (37%) having Eastern Cooperative Oncology Group (ECOG) performance status (PS) of <math><mrow><mo>≥</mo></mrow></math>2. At diagnosis, adenocarcinoma was the prominent histology (n = 187; 75%) along with clinical stage IV (n = 195; 78% stage IV) or unstaged (n = 40; 16%) disease. Most patients received chemotherapy and radiotherapy (n = 176; 71%) with few palliative care referrals (n = 2; 0.8%). The median overall survival (OS) was only 3.7 months (IQR, 2.7-5.4). ECOG PS (3 or 4) and being unstaged were predictors of poor 1-year OS.</p><p><strong>Conclusion: </strong>Patients with NSCLC enrolled in this program presented with advanced disease and poor survival. Despite a designated case finding effort, late diagnosis remained common and highlights a need for locally relevant interventions targeting community and provider education as well as innovative diagnostics that can improve early recognition of lung cancer. These interventions must also be paired with access to proven treatments including molecular therapies and palliative care which can extend lung cancer survival.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400212"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}