Evidence map›Paper›PMID 30582433›Full record

ArticleJournal of global oncology2018

Patient Characteristics, Early Outcomes, and Implementation Lessons of Cervical Cancer Treatment Services in Rural Rwanda.

Paul H Park, Sonya Davey, Alexandra E Fehr, John Butonzi, Cyprien Shyirambere, Vedaste Hategekimana, Jean Bosco Bigirimana, Ryan Borg, Regis Uwizeye, Neo Tapela and 4 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of global oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
  6. Observational
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Paul H ParkPaul H. Park, Alexandra E. Fehr, Cyprien Shyirambere, Jean Bosco Bigirimana, Ryan Borg, Regis Uwizeye, and Egide Mpanumusingo, Partners In Health/Inshuti Mu Buzima, Rwinkwavu; John Butonzi, Vedaste Hategekimana, and Tharcisse Mpunga, Butaro District Hospital, Rwanda Ministry of Health, Butaro, Rwanda; Sonya Davey and Lawrence N. Shulman, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Paul H. Park and Neo Tapela, Brigham and Women's Hospital; Paul H. Park, Harvard Medical School; Thomas Randall, Harvard Medical School, and Massachusetts General Hospital, Boston, MA; and Neo Tapela, Oxford University, Oxford, United Kingdom.
Sonya DaveyPaul H. Park, Alexandra E. Fehr, Cyprien Shyirambere, Jean Bosco Bigirimana, Ryan Borg, Regis Uwizeye, and Egide Mpanumusingo, Partners In Health/Inshuti Mu Buzima, Rwinkwavu; John Butonzi, Vedaste Hategekimana, and Tharcisse Mpunga, Butaro District Hospital, Rwanda Ministry of Health, Butaro, Rwanda; Sonya Davey and Lawrence N. Shulman, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Paul H. Park and Neo Tapela, Brigham and Women's Hospital; Paul H. Park, Harvard Medical School; Thomas Randall, Harvard Medical School, and Massachusetts General Hospital, Boston, MA; and Neo Tapela, Oxford University, Oxford, United Kingdom.
Alexandra E FehrPaul H. Park, Alexandra E. Fehr, Cyprien Shyirambere, Jean Bosco Bigirimana, Ryan Borg, Regis Uwizeye, and Egide Mpanumusingo, Partners In Health/Inshuti Mu Buzima, Rwinkwavu; John Butonzi, Vedaste Hategekimana, and Tharcisse Mpunga, Butaro District Hospital, Rwanda Ministry of Health, Butaro, Rwanda; Sonya Davey and Lawrence N. Shulman, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Paul H. Park and Neo Tapela, Brigham and Women's Hospital; Paul H. Park, Harvard Medical School; Thomas Randall, Harvard Medical School, and Massachusetts General Hospital, Boston, MA; and Neo Tapela, Oxford University, Oxford, United Kingdom.
John ButonziPaul H. Park, Alexandra E. Fehr, Cyprien Shyirambere, Jean Bosco Bigirimana, Ryan Borg, Regis Uwizeye, and Egide Mpanumusingo, Partners In Health/Inshuti Mu Buzima, Rwinkwavu; John Butonzi, Vedaste Hategekimana, and Tharcisse Mpunga, Butaro District Hospital, Rwanda Ministry of Health, Butaro, Rwanda; Sonya Davey and Lawrence N. Shulman, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Paul H. Park and Neo Tapela, Brigham and Women's Hospital; Paul H. Park, Harvard Medical School; Thomas Randall, Harvard Medical School, and Massachusetts General Hospital, Boston, MA; and Neo Tapela, Oxford University, Oxford, United Kingdom.
Cyprien ShyiramberePaul H. Park, Alexandra E. Fehr, Cyprien Shyirambere, Jean Bosco Bigirimana, Ryan Borg, Regis Uwizeye, and Egide Mpanumusingo, Partners In Health/Inshuti Mu Buzima, Rwinkwavu; John Butonzi, Vedaste Hategekimana, and Tharcisse Mpunga, Butaro District Hospital, Rwanda Ministry of Health, Butaro, Rwanda; Sonya Davey and Lawrence N. Shulman, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Paul H. Park and Neo Tapela, Brigham and Women's Hospital; Paul H. Park, Harvard Medical School; Thomas Randall, Harvard Medical School, and Massachusetts General Hospital, Boston, MA; and Neo Tapela, Oxford University, Oxford, United Kingdom.
Vedaste HategekimanaPaul H. Park, Alexandra E. Fehr, Cyprien Shyirambere, Jean Bosco Bigirimana, Ryan Borg, Regis Uwizeye, and Egide Mpanumusingo, Partners In Health/Inshuti Mu Buzima, Rwinkwavu; John Butonzi, Vedaste Hategekimana, and Tharcisse Mpunga, Butaro District Hospital, Rwanda Ministry of Health, Butaro, Rwanda; Sonya Davey and Lawrence N. Shulman, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Paul H. Park and Neo Tapela, Brigham and Women's Hospital; Paul H. Park, Harvard Medical School; Thomas Randall, Harvard Medical School, and Massachusetts General Hospital, Boston, MA; and Neo Tapela, Oxford University, Oxford, United Kingdom.
Jean Bosco BigirimanaPaul H. Park, Alexandra E. Fehr, Cyprien Shyirambere, Jean Bosco Bigirimana, Ryan Borg, Regis Uwizeye, and Egide Mpanumusingo, Partners In Health/Inshuti Mu Buzima, Rwinkwavu; John Butonzi, Vedaste Hategekimana, and Tharcisse Mpunga, Butaro District Hospital, Rwanda Ministry of Health, Butaro, Rwanda; Sonya Davey and Lawrence N. Shulman, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Paul H. Park and Neo Tapela, Brigham and Women's Hospital; Paul H. Park, Harvard Medical School; Thomas Randall, Harvard Medical School, and Massachusetts General Hospital, Boston, MA; and Neo Tapela, Oxford University, Oxford, United Kingdom.
Ryan BorgPaul H. Park, Alexandra E. Fehr, Cyprien Shyirambere, Jean Bosco Bigirimana, Ryan Borg, Regis Uwizeye, and Egide Mpanumusingo, Partners In Health/Inshuti Mu Buzima, Rwinkwavu; John Butonzi, Vedaste Hategekimana, and Tharcisse Mpunga, Butaro District Hospital, Rwanda Ministry of Health, Butaro, Rwanda; Sonya Davey and Lawrence N. Shulman, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Paul H. Park and Neo Tapela, Brigham and Women's Hospital; Paul H. Park, Harvard Medical School; Thomas Randall, Harvard Medical School, and Massachusetts General Hospital, Boston, MA; and Neo Tapela, Oxford University, Oxford, United Kingdom.
Regis UwizeyePaul H. Park, Alexandra E. Fehr, Cyprien Shyirambere, Jean Bosco Bigirimana, Ryan Borg, Regis Uwizeye, and Egide Mpanumusingo, Partners In Health/Inshuti Mu Buzima, Rwinkwavu; John Butonzi, Vedaste Hategekimana, and Tharcisse Mpunga, Butaro District Hospital, Rwanda Ministry of Health, Butaro, Rwanda; Sonya Davey and Lawrence N. Shulman, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Paul H. Park and Neo Tapela, Brigham and Women's Hospital; Paul H. Park, Harvard Medical School; Thomas Randall, Harvard Medical School, and Massachusetts General Hospital, Boston, MA; and Neo Tapela, Oxford University, Oxford, United Kingdom.
Neo TapelaPaul H. Park, Alexandra E. Fehr, Cyprien Shyirambere, Jean Bosco Bigirimana, Ryan Borg, Regis Uwizeye, and Egide Mpanumusingo, Partners In Health/Inshuti Mu Buzima, Rwinkwavu; John Butonzi, Vedaste Hategekimana, and Tharcisse Mpunga, Butaro District Hospital, Rwanda Ministry of Health, Butaro, Rwanda; Sonya Davey and Lawrence N. Shulman, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Paul H. Park and Neo Tapela, Brigham and Women's Hospital; Paul H. Park, Harvard Medical School; Thomas Randall, Harvard Medical School, and Massachusetts General Hospital, Boston, MA; and Neo Tapela, Oxford University, Oxford, United Kingdom.
Lawrence N ShulmanPaul H. Park, Alexandra E. Fehr, Cyprien Shyirambere, Jean Bosco Bigirimana, Ryan Borg, Regis Uwizeye, and Egide Mpanumusingo, Partners In Health/Inshuti Mu Buzima, Rwinkwavu; John Butonzi, Vedaste Hategekimana, and Tharcisse Mpunga, Butaro District Hospital, Rwanda Ministry of Health, Butaro, Rwanda; Sonya Davey and Lawrence N. Shulman, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Paul H. Park and Neo Tapela, Brigham and Women's Hospital; Paul H. Park, Harvard Medical School; Thomas Randall, Harvard Medical School, and Massachusetts General Hospital, Boston, MA; and Neo Tapela, Oxford University, Oxford, United Kingdom.
Thomas RandallPaul H. Park, Alexandra E. Fehr, Cyprien Shyirambere, Jean Bosco Bigirimana, Ryan Borg, Regis Uwizeye, and Egide Mpanumusingo, Partners In Health/Inshuti Mu Buzima, Rwinkwavu; John Butonzi, Vedaste Hategekimana, and Tharcisse Mpunga, Butaro District Hospital, Rwanda Ministry of Health, Butaro, Rwanda; Sonya Davey and Lawrence N. Shulman, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Paul H. Park and Neo Tapela, Brigham and Women's Hospital; Paul H. Park, Harvard Medical School; Thomas Randall, Harvard Medical School, and Massachusetts General Hospital, Boston, MA; and Neo Tapela, Oxford University, Oxford, United Kingdom.
Egide MpanumusingoPaul H. Park, Alexandra E. Fehr, Cyprien Shyirambere, Jean Bosco Bigirimana, Ryan Borg, Regis Uwizeye, and Egide Mpanumusingo, Partners In Health/Inshuti Mu Buzima, Rwinkwavu; John Butonzi, Vedaste Hategekimana, and Tharcisse Mpunga, Butaro District Hospital, Rwanda Ministry of Health, Butaro, Rwanda; Sonya Davey and Lawrence N. Shulman, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Paul H. Park and Neo Tapela, Brigham and Women's Hospital; Paul H. Park, Harvard Medical School; Thomas Randall, Harvard Medical School, and Massachusetts General Hospital, Boston, MA; and Neo Tapela, Oxford University, Oxford, United Kingdom.
Tharcisse MpungaPaul H. Park, Alexandra E. Fehr, Cyprien Shyirambere, Jean Bosco Bigirimana, Ryan Borg, Regis Uwizeye, and Egide Mpanumusingo, Partners In Health/Inshuti Mu Buzima, Rwinkwavu; John Butonzi, Vedaste Hategekimana, and Tharcisse Mpunga, Butaro District Hospital, Rwanda Ministry of Health, Butaro, Rwanda; Sonya Davey and Lawrence N. Shulman, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Paul H. Park and Neo Tapela, Brigham and Women's Hospital; Paul H. Park, Harvard Medical School; Thomas Randall, Harvard Medical School, and Massachusetts General Hospital, Boston, MA; and Neo Tapela, Oxford University, Oxford, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeLow- and middle-income countries account for 86% of all cervical cancer cases and 88% of cervical cancer mortality globally. Successful management of cervical cancer requires resources that are scarce in sub-Saharan Africa, especially in rural settings. Here, we describe the early clinical outcomes and implementation lessons learned from the Rwanda Ministry of Health's first national cancer referral center, the Butaro Cancer Center of Excellence (BCCOE). We hypothesize that those patients presenting at earlier stage and receiving treatment will have higher rates of being alive.

methodsThe implementation of cervical cancer services included developing partnerships, clinical protocols, pathology services, and tools for monitoring and evaluation. We conducted a retrospective study of patients with cervical cancer who presented at BCCOE between July 1, 2012, and June 30, 2015. Data were collected from the electronic medical record system and by manually reviewing medical records. Descriptive, bivariable and multivariable statistical analyses were conducted to describe patient demographics, disease profiles, treatment, and clinical outcomes.

resultsIn all, 373 patients met the study inclusion criteria. The median age was 53 years (interquartile rage, 45 to 60 years), and 98% were residents of Rwanda. Eighty-nine percent of patients had a documented disease stage: 3% were stage I, 48% were stage II, 29% were stage III, and 8% were stage IV at presentation. Fifty percent of patients were planned to be treated with a curative intent, and 54% were referred to chemoradiotherapy in Uganda. Forty percent of patients who received chemoradiotherapy were in remission. Overall, 25% were lost to follow-up.

conclusionBCCOE illustrates the feasibility and challenges of implementing effective cervical cancer treatment services in a rural setting in a low-income country.

Indexed as

FemaleHumansMiddle AgedRwandaUterine Cervical Neoplasms

Identifiers

PMID30582433
PMCPMC7010450

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.