Challenges and opportunities in ovarian cancer care: A qualitative study of clinician perspectives from 24 low- and middle-income countries
Bajwa A. Chidebe R.C.W. Adams T. Funston G. Soerjomataram I. Cohen R. Adel R.S. Phan N. Kaidarova D. Bolatbekova R. Refky B. Noll F. Eiken M. Origa M. Mukhopadhyay A. Nasser S. Lau I. Konney T. Shaffi A.F. Makondi P.T. Woo Y.L. Rangeiro R. Mustapha A. Msadabwe S. Benhima N. Zahirova N. Andrade C.E.M.C. Pareja R. Cantú de León D. Chávez-Chirinos C. Bambury I. Pervin S. Pariyar J. Estrada E. Strömsholm E.-M. MacKay C. Charlton P. Reid F.
June 2025Elsevier Ltd
Journal of Cancer Policy
2025#44
Background: Ovarian cancer poses a significant and growing burden, particularly in low- and middle-income countries (LMICs) where incidence and mortality are projected to increase by over 50 % by 2050. However, there is a critical lack of qualitative data on the challenges and opportunities for improvement in treatment and care for women with ovarian cancer in these regions. The aim of this research is to investigate clinicians’ perspectives on the matter in 24 LMICs. Methods: As part of the multi-country observational Every Woman Study™ (EWS), semi-structured interviews were conducted with clinicians between June 2022 and June 2023. The interview guide was developed by the EWS LMIC Oversight Committee, including patients, clinicians and data specialists. Relational content and inductive thematic analyses were employed and categories synthesized using the World Health Organizations six building blocks of the Health Systems Framework. Results: 24 clinicians (54 % female; 79 % gynaecologic oncologists, 8 % gynaecologists, 8 % clinical oncologists not specializing in gynaecological cancers, and 4 % clinical oncologists specializing in gynaecological cancers; 42 % from Africa, 29 % from Asia, 29 % from Latin America) participated. Six dominant themes were identified: “Poor Ovarian Cancer Data, “Inequity in Access to Treatment”, “In-Country Inequities in Access to Care”, “Role of Cultural Norms on Womens Health”, “Increased Engagement of Men in Ovarian Cancer Control”, and “Advocacy and Education for Empowering Women”. Content analysis revealed system-level challenges such as delayed drug payments, lack of population-based cancer data, and limited imaging facilities. Patient-level challenges included disparities in access to specialists, limited medication affordability, poor symptom recognition, and reliance on alternative treatments. Conclusions and policy summary: This study reveals the complexity of ovarian cancer treatment and care in LMICs and the need to mitigate disparities in these regions, underscoring the need for patient-centred, context specific and intersectoral strategies to be considered in cancer planning to improve ovarian cancer care quality and equity in LMICs.
Cancer , Care , Challenges , Diagnosis , LMIC , Opportunities , Ovarian , Planning , Treatment
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World Ovarian Cancer Coalition, Toronto, Canada
Project PINK BLUE – Health & Psychological Trust Centre, Abuja, Nigeria
Department of Sociology & Gerontology & Scripps Gerontology Center, Miami University, Oxford, OH, United States
Department of Obstetrics and Gynaecology, Groote Schuur Hospital, Cape Town, SA SA MRC UCT GCRC ( South African Medical Research Centre Gynaecological Cancer Research Centre), South Africa
Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
Cancer Surveillance Branch, International Agency for Research on Cancer+, Lyon, France
Sandy Rollman Ovarian Cancer Foundation, Philadelphia, PA, United States
Cancer Bangladesh, Founder, Dhaka, Bangladesh
Da Nang Oncology Hospital, Gynecologic Oncology, Da Nang, Viet Nam
Kazakh Institute of Oncology and Radiology, Almaty, Kazakhstan
Mansoura University Hospital, Oncology Centre, Mansoura, Egypt
Sanatorio Allende Cerro, Gynecologic Oncology Department, Cordoba, Argentina
International Gynecologic Cancer Society, Head Office, Chicago, United States
Uganda Cancer Institute, Gynecologic Oncology, Kampala, Uganda
Chittaranjan National Cancer Institute, Kolkata Gynecological Oncology Trials and Translational Research Group, Kolkata, India
Charite University Hospital Campus Virchow Klinikum, Gynecology and Gynecological, Oncology, Berlin, Germany
Pusat Perubatan Universiti Malaya, Obstetrics and Gynaecology, Kuala Lumpur, Malaysia
Kwame Nkrumah University Of Science and Technology/Komfo Anokye Teaching Hospital, Kumasi, Ghana
Moi Teaching Referral Hospital, Kenya
Kamuzu Central Hospital - National Cancer Center, Lilongwe, Malawi
University of Malaya & ROSE Foundation, Kuala Lumpur, Malaysia
Maputo Central Hospital, Mozambique
Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
Department of Radiation Oncology, Cancer Diseases Hospital, Lusaka, Zambia
Medical Oncology Department, Mohammed VI University Hospital, Marrakech, 40080, Morocco
Gynecological Oncology Department, Republican Specialized Scientific and Practical Center of Oncology and Radiology, Tashkent, Uzbekistan
Department of Oncogenetics, Barretos Cancer Hospital, Barretos, Brazil
Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Colombia
Dirección de Investigación, Instituto Nacional de Cancerología, Mexico City, Mexico
Departamento de Cirugía Oncológica, Instituto Regional de Enfermedades Neoplásicas Sur, Arequipa, 04000, Peru
Departments of Obstetrics and Gynaecology and Pathology, University of the West Indies, Mona, Kingston, Jamaica
Department of Gynae Oncology, National Institute of Cancer Research and Hospital, Dhaka, 1213, Bangladesh
Gynecologic Oncology Unit, Civil Service Hospital, Kathmandu, Nepal
Hospital General San Juan de Dios, Gynecology and Obstetrics, Guatemala City, Guatemala
Gynecological Cancerpatients in Finland, Espoo, Finland
World Ovarian Cancer Coalition
Project PINK BLUE – Health & Psychological Trust Centre
Department of Sociology & Gerontology & Scripps Gerontology Center
Department of Obstetrics and Gynaecology
Wolfson Institute of Population Health
Cancer Surveillance Branch
Sandy Rollman Ovarian Cancer Foundation
Cancer Bangladesh
Da Nang Oncology Hospital
Kazakh Institute of Oncology and Radiology
Mansoura University Hospital
Sanatorio Allende Cerro
International Gynecologic Cancer Society
Uganda Cancer Institute
Chittaranjan National Cancer Institute
Charite University Hospital Campus Virchow Klinikum
Pusat Perubatan Universiti Malaya
Kwame Nkrumah University Of Science and Technology/Komfo Anokye Teaching Hospital
Moi Teaching Referral Hospital
Kamuzu Central Hospital - National Cancer Center
University of Malaya & ROSE Foundation
Maputo Central Hospital
Ahmadu Bello University Teaching Hospital
Department of Radiation Oncology
Medical Oncology Department
Gynecological Oncology Department
Department of Oncogenetics
Department of Gynecologic Oncology
Dirección de Investigación
Departamento de Cirugía Oncológica
Departments of Obstetrics and Gynaecology and Pathology
Department of Gynae Oncology
Gynecologic Oncology Unit
Hospital General San Juan de Dios
Gynecological Cancerpatients in Finland
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