Implications of deferring cancer prevention services in connection to COVID-19: The case of Ethiopia

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Most African countries including Ethiopia have recently adopted public health measures to contain the COVID-19 pandemic similar to developed countries.

Confirmed COVID-19 cases are gradually increasing in Ethiopia with expected high impact due to the precarious economic situation.

As part of the mitigation strategy for COVID-19, various health services are scheduled for an indefinite time.

Cancer prevention measure are not part of the current guideline recommendations (1).

Awareness creation, screening, early detection, diagnosis and treatment are key community level interventions for cancer control in Ethiopia.

Postponement of cancer prevention activities during COVID-19 pandemic could also have an unprecedented impact as it was evident in west Africa during the Ebola outbreak with maternal health outcomes (2).

In developing countries including Ethiopia, breast and cervical cancers are the major cancers that are claiming the lives of many women (3).

Now, due to the COVID-19 pandemic most of such interventions including cervical cancer screening programs are deferred and the health seeking behaviour of the community for cancers is expected to be reduced or diverted to the COVID-19 prevention activities.

Therefore, the recently started prevention of cervical cancer through screening will be halted and the number of cases may rise on population level.

Moreover, due to unfavourable transportation access oncology services may not be reached by the symptomatic patients since these services are delivered at higher health facility level.

In this context, cancer’s stage shifting to advanced stage is expected and adjuvant treatment for e.g. breast cancer will become complex or impossible and thus result in preventable deaths.

Therefore, as a matter of saving life and protecting vulnerable population some measures should be considered.

First, the health care resilience strategy should consider cancer prevention activities equally to cancer treatment as most of the prevention activities done at the primary health care level where not designated COVID-19 isolation centres.

Second, the media can be used to remind the community about preventive health measures since now most are at home and often purse related information.

Third, simple technological application and locally adaptable innovative practice should be employed.

Finally, while we are applying the recommended COVID-19 preventive precautions, it is critical that we think ahead of the pandemic at the same time.


References

1. Burki TK. Cancer guidelines during the COVID-19 pandemic. The Lancet Oncology 2020.

2. Menéndez C, Lucas A, Munguambe K, Langer A. Ebola crisis: The unequal impact on women and children’s health. The Lancet Global Health 2015; 3(3):e130.

3. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68(6):394–424.

Source: ecancer

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