Efficacy of Botswana's National Cancer Treatment Strategy: A Preliminary Analysis of Radiation Therapy in Breast Cancer Patients

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dc.contributor.advisorGrover, Surbhien
dc.contributor.committeeMemberChang, Maryen
dc.contributor.committeeMemberNwachukwu, Chikaen
dc.creatorShah, Sidrah Mariamen
dc.creator.orcid0000-0003-0770-3641
dc.date.accessioned2023-06-07T18:32:44Z
dc.date.available2023-06-07T18:32:44Z
dc.date.created2021-05
dc.date.issued2021-05-01T05:00:00.000Z
dc.date.submittedMay 2021
dc.date.updated2023-06-07T18:32:45Z
dc.descriptionThe general metadata -- e.g., title, author, abstract, subject headings, etc. -- is publicly available, but access to the submitted files is restricted to UT Southwestern campus access and/or authorized UT Southwestern users.en
dc.description.abstractBACKGROUND: Breast cancer is a significant threat to public health in low- and middle-income countries (LMIC) globally, with the observation of an alarming increase in incidence in sub-Saharan Africa. Radiation Therapy (RT) is an essential component of breast cancer treatment and many LMIC currently lack access to RT. In Botswana, cancer care for citizens is paid for by the government, which has resulted in a unique investment in RT compared to other countries in the region. However, breast cancer mortality remains high, warranting further investigation into patient access to and receipt of RT. OBJECTIVE: This project seeks to investigate and present preliminary data on the percentage of breast cancer patients in Botswana qualifying for RT who actually went on to initiate RT. Demographic and clinical characteristics of breast cancer patients in Botswana are also presented. METHODS: Demographic, clinical, and treatment information was collected prospectively on all breast cancer patients presenting to the Breast Multidisciplinary Team (MDT) clinic at Princess Marina Hospital (PMH) in Gaborone, Botswana from January 2015 to October 2020. Patients with incomplete treatment information were excluded from the analysis. Patients who should have received RT were identified based on National Comprehensive Cancer Network (NCCN) guidelines. RESULTS: A total of 131 patients were included in the analysis. Of these, 29.8% were HIV-positive and 77.5% presented with advanced-stage disease. The vast majority of patients underwent mastectomy, and only 35% received chemotherapy. Based on NCCN guidelines, 121 patients qualified for receipt of radiation. In this population of breast cancer patients in Botswana, 92.6% of patients who needed RT received it. CONCLUSION: Based on this preliminary analysis, the investment of Botswana's Ministry of Health in RT for its citizens is seeing encouraging success among breast cancer patients. This analysis was limited by incomplete treatment information on the majority of breast cancer patients in this cohort, limiting the sample size in the final analysis. Further study is needed to characterize completion of RT in this population and factors that affect this.en
dc.format.mimetypeapplication/pdfen
dc.identifier.oclc1381370372
dc.identifier.urihttps://hdl.handle.net/2152.5/10099
dc.language.isoenen
dc.subjectBotswanaen
dc.subjectBreast Neoplasmsen
dc.subjectGuideline Adherenceen
dc.subjectTreatment Outcomeen
dc.titleEfficacy of Botswana's National Cancer Treatment Strategy: A Preliminary Analysis of Radiation Therapy in Breast Cancer Patientsen
dc.typeThesisen
dc.type.materialtexten
thesis.degree.departmentUT Southwestern Medical Schoolen
thesis.degree.disciplineGlobal Healthen
thesis.degree.grantorUT Southwestern Medical Centeren
thesis.degree.levelDoctoralen
thesis.degree.nameM.D. with Distinctionen

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