Assessing delays in accessing and completing radiotherapy for cervical cancer treatment: A multicenter survey of oncology providers in go further-funded countries in Sub-Saharan Africa.

Objective: Cervical cancer is a leading cause of cancer death in Sub-Saharan Africa. Go Further provides funds for prevention and screening in Sub-Saharan Africa, but access to treatment for invasive disease remains limited. This survey aims to assess delays in accessing curative-intent chemoradiotherapy for cervical cancer in countries receiving Go Further funding. Methods: Oncology providers in countries receiving Go Further funding (Botswana, Eswatini, Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Tanzania, Uganda, Zambia, Zimbabwe) and South Africa were invited to participate in a web-based survey beginning September 2023. Results: Fifteen oncology providers responded, with all countries except Malawi represented. Nearly half (46.3 %) reported wait time of ≥two months for chemoradiotherapy consultation. 93.3 %, 71.4 %, 53.7 % and 73.3 % had access to at least one CT, linear accelerator, cobalt, and brachytherapy machine, respectively. Majority (60 %) reported wait time of <one month to initiate chemoradiotherapy after staging. However, 28.6 % reported >95 % of patients complete external radiotherapy within 42 days, and 33 % reported >95 % of these patients receive brachytherapy. Only 26.7 % reported overall treatment time within 56 days for >95 % of patients. Lack of transportation, funding, and patient fear, were other treatment barriers reported. Conclusion: These results highlight the need for additional chemoradiotherapy resources in Go Further-funded countries. In addition to expanding radiotherapy, supplemental avenues to improve access in Sub-Saharan Africa include addressing barriers that increase wait times along the care continuum and implementing social support. This survey serves as a call to Go Further, highlighting the urgent need for resource allocation for cervical cancer treatment.