Clinical Oncology Publishes Findings from First-Ever Initiative on Sustainable Breast Cancer Treatment in the Developing World

In response to the growing burden of cancer in the developing world, AstraZeneca, in partnership with Tikur Anbessa Hospital, Addis Ababa, The Ethiopian Ministry of Health and AXIOS, developed a framework two years ago for the first-ever programme to raise awareness, diagnose and treat breast cancer in Ethiopia. The interim results of this five-year initiative are reported in the March edition of Clinical Oncology*.

Breast cancer is the second most often occurring cancer (cervical cancer is first) among women in Ethiopia. It is estimated that around 10,000 Ethiopian women and men have breast cancer with thousands of more cases unreported as women living in rural areas often seek treatment from traditional healers before seeking help from the government health system. In addition, Ethiopia has many competing public health challenges, including a rising incidence of HIV/AIDS.

In recent years, the Ministry of Health has put additional emphasis on chronic disease management including cancer control. However, with competing health challenges resource has been limited for cancer treatment. The AstraZeneca Breast Cancer Initiative at Tikur Anbessa University Hospital is changing this paradigm.

Mammography, treatment protocols and the continuous audit of over 250 patients have led to considerable improvement in managing breast cancer patients in a single institution. Aspects of this programme are now being extended to other regional hospitals in Ethiopia. In addition, close collaboration with local health personnel has enabled Tikur Anbessa hospital to purchase important diagnostic equipment and establish training programmes and initiate new patient management systems.

“Our goal is to create a centre of excellence for breast cancer treatment in Ethiopia and, in doing so, validate a model for how to build this capability in a developing country,” said Dr. Karol Sikora, CancerPartners UK, one of the paper’s authors.

The project, which began in 2005, has turned Tikur Anbessa Hospital into the first treatment centre for breast cancer in Ethiopia and it has had a significant impact on care from reducing the waiting time for surgery to radiotherapy to less than two months compared with more than a year before the start of the project.

Tikur Anbessa Hospital was selected as the site for this programme because it was the base of the country’s only oncologist. It also had the only radiotherapy unit in Ethiopia. In addition, starting the project at the main university hospital of Ethiopia was likely to have a greater impact on medical policies and education.

The project is conducted as a partnership between Tikur Anbessa Hospital, AXIOS (www.axios-group.com) and AstraZeneca (www.astrazeneca.com). AstraZeneca has provided the financial support for the five-year project and has donated (tamoxifen citrate) NOLVADEXÒ and (anastrozole). ARIMIDEXÒ. The Ministry of Health, other Ethiopian University hospitals and private hospitals in Addis Ababa have also collaborated and participated in workshops to develop guidelines.
ARIMIDEX and NOLVADEX are trademarks, the property of the AstraZeneca group of companies.

* The Digital Object Identifier for this article is: 0.1016/j.clon.2007.11.012. Go to: www.sciencedirect.com/science/journal/09366555.
Clinical Oncology is owned by the Royal College of Radiologists.