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An analysis of survivorship care strategies in national cancer control plans in Africa



In 2017, the World Health Organization urged member states to develop and implement national cancer control plans (NCCPs) and to anticipate and promote cancer survivor follow-up care, which is a critical yet often overlooked component of NCCPs. This study aims to examine the inclusion of cancer survivorship-related strategies and objectives in NCCPs of African countries.


Independent reviewers extracted strategies, objectives, and associated indicators related to survivorship care from 21 current or recently expired NCCPs in African countries. Building on a similar analysis of the US state cancer control plans, reviewers categorized these strategies according to an adapted version of the ten recommendations for comprehensive survivorship care detailed in the 2006 National Academy of Medicine report.


A total of 202 survivorship-related strategies were identified, with all NCCPs including between 1 and 23 references to survivorship. Eighty-three (41%) strategies were linked to measurable indicators, and 128 (63%) of the survivorship-related strategies were explicitly focused on palliative care. The most frequent domains referenced were models of coordinated care (65 strategies), healthcare professional capacity (45), and developing and utilizing evidence-based guidelines (23). The least-referenced domains were survivorship care plans (4) and adequate and affordable health insurance (0).


The results of this study indicate that survivorship objectives and strategies should extend beyond palliative care to encompass all aspects of survivorship and should include indicators to measure progress.

Implications for cancer survivors

Stakeholders can use this baseline analysis to identify and address gaps in survivorship care at the national policy level.

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Fig. 1

Data availability

The data that supported the findings of this study are available in the ICCP Portal at Analyzed data are available on request from the corresponding author.



Africa Palliative Care Association


Extension for community healthcare outcomes


Essential medicine list


International Cancer Control Partnership


Low- and middle-income country


Multinational Association of Supportive Care in Cancer


National Academy of Medicine


National cancer control plan


US National Coalition for Cancer Survivorship


Non-communicable disease plan


US National Cancer Institute


United States


World Health Organization


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We thank the experts who reviewed this manuscript: Kalina Duncan (Center for Global Health, National Cancer Institute, National Institutes of Health, Rockville, MD, USA, Mandi L. Pratt-Chapman (George Washington University, Washington D.C., USA), and Timiya S. Nolan (The Ohio State University, Columbus, OH, USA. Thank you to Alicia A. Livinski (NIH Library, NIH, Bethesda, MD, USA) for the manuscript review, editing, and formatting.

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Authors and Affiliations



The work reported in the paper has been performed by the authors, unless clearly specified in the text. All authors aside from the first and last author are listed in alphabetical order.

AK, TO: data analysis, writing-original drafts, writing—review and editing

EMG: conceptualization, methodology, data analysis, project administration, writing—original drafts, writing-review and editing

LH: data extraction, writing—review and editing

MAM, PBJ: conceptualization, methodology, data extraction, writing-original drafts, writing—review and editing

MKC: conceptualization, methodology, data extraction, project administration, writing—original drafts, writing-review and editing

YR, ZT: conceptualization, methodology, data acquisition, data extraction, writing-original drafts, writing—review and editing

ZA, NL, SS: writing—review and editing

Corresponding author

Correspondence to Elise M. Garton.

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The authors declare no competing interests.

Ethics statement

Ethical approval was not required for this study.

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The authors declare no competing interests.


The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute, National Institutes of Health or US government or any of the authors’ organization.

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Garton, E.M., Ali, Z., Cira, M.K. et al. An analysis of survivorship care strategies in national cancer control plans in Africa. J Cancer Surviv 17, 634–645 (2023).

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