Research demonstrates that the burden of cancer is increasing in low- and middle-income countries, with a disproportionate burden of mortality- to- incidence ratio in Africa. Although this trend is forecasted to increase by 2030, there is a paucity of real-world data on the capacity of the oncology workforce, providing cancer care to the increasing number of cancer patients being diagnosed annually in Africa.

As national and international organizations develop cancer control plans to scale up cancer care in Africa, the knowledge derived by quantifying the landscape of cancer workload is critical for understanding the current gaps that exist in resources for cancer care delivery in the region.

How did we answer these questions?

In our最近发表的研究，与其他国家的肿瘤学家相比，我们评估了非洲肿瘤学家的癌症工作量，辅助服务和工作满意度。

We analyzed data from an online survey which included question on workload, treatment modalities and job satisfaction. We received responses from 36 oncologists practicing in 18 different African countries compared to 1079 oncologists practicing in 47 other countries outside of Africa

我们的数据揭示了什么？

In short, oncologists in Africa are overworked. Although we hypothesized that cancer workload would be higher in Africa compared to other countries (90% of which were high- income (HIC) and upper- middle income countries (UMIC)), we were struck by the magnitude of the difference. The median number of new cancer consults seen per oncologist in Africa was 325, compared to 175 in other countries.

非洲每位肿瘤科医生看到的新癌症咨询的中位数为325，而其他国家为175。

Additionally, approximately a third of African oncologists saw more than 500 new patient consults in a year! To contextualize this, oncologists in Africa see approximately double the new patient clinic volume of providers in high-income countries, which is astonishing since most oncology clinics in HICs tend to be at full capacity.

Furthermore, when surveyed about barriers to care, oncologists in the comparative group listed shortage of oncologists and nurses as one of the top five barriers, suggesting that even 175 new consults per oncologist is sub-optimal, and African oncologists are seeing twice that number.

非洲肿瘤学家更有可能治疗所有癌症疾病部位的事实进一步加剧了非洲肿瘤学家的不可思议的工作量。与其他国家的提供者相比，相同的肿瘤学家同时处方化学疗法和放射疗法也更有可能。

与其他国家 /地区的肿瘤学家相比，非洲肿瘤学家每月更有可能是每月几天的两倍。一般而言，非洲肿瘤学家缺乏支持服务，例如电子病历，大多数患者笔记都是手写的。

这些限制对非洲癌症治疗的影响有什么？

Our results highlight the heroic efforts of oncologists in Africa, who are attempting to deliver the best care with significantly less resources. However the potentially adverse effects on patients cannot be discounted. The high cancer workload per oncologists is likely to result in prolonged waiting times for newly diagnosed patients awaiting management and treatment decisions. In addition, the high patient volume suggests that new patient visits with an oncologist are very short in Africa.

Our results highlight the heroic efforts of oncologists in Africa, who are attempting to deliver the best care with significantly less resources.

我们的调查分析还表明，非洲肿瘤学家列出的前五个障碍中有四个与患者获得护理有关。这包括无法支付的患者，无法获得化学疗法，放射治疗和新的靶向药物。

因此，对于很大一部分诊断出的癌症患者，治疗的途径涉及长期等待去看肿瘤学家，进行短期的诊所就诊，然后开处方了您负担不起的药物，或者在国家 /地区的库存中有缺货。当你负担得起的时候。这预示着非洲新诊断的癌症患者的预后不佳，并导致在非洲观察到的癌症生存结果较差。

What are the impacts of these limitations on oncologists in Africa?

考虑到非洲肿瘤学家的时间投资和癌症工作量的数量，我们的调查结果表明，非洲只有17％的肿瘤学家报告了高水平的工作满意度。尽管尚未在非洲的医疗保健部门正式研究倦怠，但我们的发现预测了非洲肿瘤学家的未来倦怠。

In an era where Africa continues to grapple with the effects of brain drain in the healthcare sector, it is important that the any efforts to address human personnel capacity building for cancer include targeted efforts to provide supportive services that promote a higher level of job satisfaction and incentives to provide cancer care in Africa.

What are the next steps?

这项研究的结果是惨淡的。对于在非洲实践的医生，这项研究证实了在非洲担任肿瘤学家的日常压力。对于政府和国际卫生机构，我们的数据强调了迫切需要提高肿瘤学家与患者比率并开发新的医疗保健能力建设模型，以大大增加非洲提供高质量癌症护理的劳动力和资源。