SynthesisBMJ open2023
Delays in seeking, reaching and access to quality cancer care in sub-Saharan Africa: a systematic review.
Synthesis in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 5 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
49 citing papers in PubMed, 5 syntheses or guidelines pooled it, 75 citations in OpenAlex.
- Pooled it
- The Association of Food Insecurity and Risk of Mortality: A Systematic Review and Meta-Analysis of Large-Scale Cohorts.Nutrients · 2025Pooled it
- Implementation of mHealth to support cancer diagnosis in Sub-Saharan Africa: A systematic review.African journal of primary health care & family medicine · 2025Pooled it
- Experiences with diagnostic delay among underserved racial and ethnic patients: a systematic review of the qualitative literature.BMJ quality & safety · 2025Pooled it
- Barriers to Radiotherapy Access in Sub-Saharan Africa for Patients with Cancer: A Systematic Review.International journal of environmental research and public health · 2024Pooled it
- Paving the way for more accessible cancer care in low-income countries with optimization.Health care management science · 2026Article
- Multidisciplinary Team Care for Early-Stage Lung Cancer in Low- and Middle-Income Countries and Emerging Economies: Current Position and Call for Action.Thoracic cancer · 2026Review
- Article
- Access and time to chemotherapy among Ethiopian cancer patients: a population-based registry study.The oncologist · 2026Article
- Adherence to Survivorship Care Visits in Patients With Cervical Cancer in Botswana.JCO global oncology · 2026Observational
- Multilevel onsite training and mentorship model to accelerate early childhood cancer diagnosis in Northwest Ethiopia: A quasi-experimental mixed method study.PLoS medicine · 2026Article
- Challenges and enablers in accessing paediatric inguinal hernia surgical care in Sierra Leone: a qualitative exploratory study.BMJ open · 2026Article
- A framework for a national cancer imaging repository in Nigeria.Scientific reports · 2026Article
- A 67-year-old man with metastatic carcinoma ex pleomorphic adenoma of the parotid gland: case report and review of the literature.Journal of surgical case reports · 2026Article
- Disparities in disease presentation and survival after pathological fracture surgery at a middle- and a high-income centre.BMC surgery · 2026Article
- Women's experiences with traditional medicine for the treatment of cervical cancer: a qualitative study.BMC complementary medicine and therapies · 2026Article
- Inequalities in mammograms and cervical biopsies provision in the public and private sectors of the Brazilian healthcare system and the availability of gynecology and obstetrics specialists.Clinics (Sao Paulo, Brazil) · 2026Article
- Global, regional, and national burden of early-onset prostate cancer, 1990-2021: a systematic analysis for the global burden of disease study 2021.World journal of surgical oncology · 2026Article
- Social Determinants of Health Impact Cervical Cancer Stage at Presentation among Women in Zambia.Research square · 2026Article
- Rethinking paediatric sepsis care through local provider voices and lived systems: a mixed-methods study in two hospitals in Ghana.BMJ global health · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 6 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesLate presentation and delays in diagnosis and treatment consistently translate into poor outcomes in sub-Saharan Africa (SSA). The aim of this study was to collate and appraise the factors influencing diagnostic and treatment delays of adult solid tumours in SSA.
designSystematic review with assessment of bias using Risk of Bias in Non-randomised Studies of Exposures (ROBINS-E) tool. DATA SOURCES: PubMed and Embase, for publications from January 1995 to March 2021. ELIGIBILITY CRITERIA: Inclusion criteria: quantitative or mixed-method research, publications in English, on solid cancers in SSA countries. EXCLUSION CRITERIA: paediatric populations, haematologic malignancies, and assessments of public perceptions and awareness of cancer (since the focus was on patients with a cancer diagnosis and treatment pathways). DATA EXTRACTION AND SYNTHESIS: Two reviewers extracted and validated the studies. Data included year of publication; country; demographic characteristics; country-level setting; disease subsite; study design; type of delay, reasons for delay and primary outcomes.
results57 out of 193 full-text reviews were included. 40% were from Nigeria or Ethiopia. 70% focused on breast or cervical cancer. 43 studies had a high risk of bias at preliminary stages of quality assessment. 14 studies met the criteria for full assessment and all totaled to either high or very high risk of bias across seven domains. Reasons for delays included high costs of diagnostic and treatment services; lack of coordination between primary, secondary and tertiary healthcare sectors; inadequate staffing; and continued reliance on traditional healers and complimentary medicines.
conclusionsRobust research to inform policy on the barriers to quality cancer care in SSA is absent. The focus of most research is on breast and cervical cancers. Research outputs are from few countries. It is imperative that we investigate the complex interaction of these factors to build resilient and effective cancer control programmes.
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Registered trials
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.