Pathological Services in Sub-Saharan Africa, a Barrier to Effective Cancer Care

Abstract

Cancer constitutes a significant public health burden in developing countries where more than 50% of new cases of cancers occurring worldwide are seen. In most of these less developed nations, sterling quality pathology services is either unavailable, or it is often sub-standard in quality. Where pathology services are available, the role of the pathologist may be poorly understood, and his services under-utilized. Inadequate pathology services can lead to a cycle of ineffective healthcare knowledge and practice. This chapter seeks to give an update on the efforts and the contributions of pathologists towards the diagnosis and the management of cancers. A detailed review of the available technical capacity in most countries, including pathologists and histo-technologists, the infrastructure, and the existing facilities for routine pathology tests and for ancillary investigations like immunohistochemistry and molecular diagnostics is presented. The various challenges mitigating against the provision of sterling quality pathology services in the region are enumerated. These include shortage of personnel, poor funding, lack of infrastructure, lack of standard operating procedures, and poor external and internal quality assurance schemes. Highlighted also are various recommendations for ensuring accurate and timely histopathology reports in the low income settings in SSA including the need for local and international collaborations amongst pathologists in order to establish regional training centers and develop clinical and translational research.