To improve cancer outcomes in Sub-Saharan Africa, a collaborative project from the National Comprehensive Cancer Network® (NCCN®), the African Cancer Coalition (ACC), the American Cancer Society, and others recently entered a new phase in Addis Ababa, Ethiopia. Oncologists from 11 African countries—along with Chief Executive Officers of the American Cancer Society and NCCN—attended a meeting hosted by the Ethiopian Health Minister. Attendees helped finalize additional NCCN Harmonized Guidelines for Sub-Saharan Africa, bringing the total to 42 guidelines that provide best practice cancer treatment recommendations for more than 86% of all adult cancer incidence in the region, according to the American Cancer Society.
There are an estimated 811,000 new cases of cancer and 527,000 deaths from cancer each year in Sub-Saharan Africa,1 and the incidence is expected to double by 2040 due to population growth and aging.2 Cancer care in Africa is characterized by late presentation, limited access to treatment, and poor outcomes relative to other geographic regions.
The first NCCN Harmonized Guidelines for Sub-Saharan Africa debuted in November 2017, during the biennial African Organisation for Research and Training in Cancer conference in Kigali, Rwanda. In addition to covering various cancer types, they also provide treatment recommendations for pain management, survivorship, smoking cessation, and other aspects of supportive care.
The medical recommendations have been officially endorsed in a number of countries, including Ethiopia, Malawi, Nigeria, Tanzania, Uganda, and Zambia. Together, those countries are home to 43% of the population of Sub-Saharan Africa. With support from the American Cancer Society, 121 cancer experts from 34 institutions in Africa have attended coalition meetings, as well as representatives from 7 health ministries and 19 experts from NCCN and its Member Institutions.
NCCN Harmonized Guidelines use color coding to represent both the optimal care that low- and mid-resource countries aspire to provide and pragmatic approaches that provide effective treatment options for resource-constrained settings. They are based on the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®).
The Sub-Saharan Africa harmonization of the NCCN Guidelines for Pediatric Acute Lymphoblastic Leukemia is set to publish in early 2020. The organization is also continuing to increase worldwide resources for pediatric cancers with the future publication of NCCN Guidelines for Pediatric B-Cell Lymphomas (including Burkitt lymphoma, which has a higher prevalence in Africa), Pediatric Wilms Tumor, and Pediatric Hodgkin Lymphoma.
The full list of current and upcoming guidelines can be found at NCCN.org/harmonized. ■
1. International Agency for Research on Cancer, World Health Organization: Cancer Today: Data visualization tools for exploring the global cancer burden in 2018. Available at https://gco.iarc.fr/today/home. Accessed September 10, 2019.
2. International Agency for Research on Cancer, World Health Organization: Cancer Tomorrow: A tool that predicts the future cancer incidence and mortality burden worldwide from the current estimates in 2018 up until 2040. Available at https://gco.iarc.fr/tomorrow/home. Accessed September 10 2019.