{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:02:36Z","timestamp":1790834556672,"version":"4.1.0"},"reference-count":49,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100031746","name":"Science for Africa Foundation","doi-asserted-by":"publisher","award":["Del\u201022\u2010008"],"award-info":[{"award-number":["Del\u201022\u2010008"]}],"id":[{"id":"10.13039\/100031746","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Although radiotherapy is an essential part of comprehensive cancer care, access is heavily limited in most sub\u2010Saharan African (SSA) countries. Patients' barriers to care can be grouped as availability, accessibility, accommodation, affordability, and acceptability. We aimed to assess cancer patient\u2010 and caregiver\u2010reported barriers in nine SSAn countries (Republic of the Congo, Ethiopia, Gabon, Kenya, Mali, Nigeria, Tanzania, Uganda, and Zimbabwe). We conducted a telephone\u2010based survey among 553 randomly selected patients with breast, cervical, colorectal, and prostate cancer, Kaposi sarcoma and non\u2010Hodgkin lymphoma diagnosed between 2018 and 2019 registered in population\u2010based registries of the African Cancer Registry Network. We inquired about receipt of radiotherapy and barriers irrespective of recalling a recommendation. Among all categories, 21.6% (\n                    <jats:italic>Use of alternative medicine<\/jats:italic>\n                    ) to 39.6% (\n                    <jats:italic>Cost of treatment<\/jats:italic>\n                    ) of patients reported severe barriers. Most common was problematic\n                    <jats:italic>Cost of treatment<\/jats:italic>\n                    (69.0% overall). A high share of patients from Congo, Kenya, Nigeria, and Tanzania reported barriers. Higher education and wealth were associated with reduced problems in all categories except increased problems with\n                    <jats:italic>Fear<\/jats:italic>\n                    and\n                    <jats:italic>Use of alternative medicine<\/jats:italic>\n                    . Receipt of radiotherapy was associated with fewer problems with\n                    <jats:italic>Availability of transport<\/jats:italic>\n                    (odds ratio [OR]: 0.34; 95% confidence interval [CI], 0.13\u20130.88) and\n                    <jats:italic>Trust in healthcare workers<\/jats:italic>\n                    (OR: 0.44; 95% CI, 0.24\u20130.8), and increased\n                    <jats:italic>Fear<\/jats:italic>\n                    (OR: 2.33; 95% CI, 1.33\u20134.05). Seeing that one\u2010third of the patients reported severe problems in all dimensions, shortage of radiotherapy units is not the only problematic aspect of access to radiotherapy. Improvements in affordability, patient\u2013healthcare worker communication, and psychosocial support are needed.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70390","type":"journal-article","created":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T02:54:42Z","timestamp":1771642482000},"page":"595-608","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Patient\u2010 and caregiver\u2010reported barriers to radiotherapy for cancer in sub\u2010Saharan Africa\u2014A survey of population\u2010based registries"],"prefix":"10.1002","volume":"159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7201-6023","authenticated-orcid":false,"given":"Eric Sven","family":"Kroeber","sequence":"first","affiliation":[{"name":"Global and Planetary Health Working Group, Center of Health Sciences Medical Faculty of the Martin Luther University Halle\u2010Wittenberg  Halle (Saale) 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Mary","family":"Amulen","sequence":"additional","affiliation":[{"name":"Kampala Cancer Registry, Kampala Cancer Registry, Department of Pathology\u2014College of Health Sciences Makerere University  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Borok","sequence":"additional","affiliation":[{"name":"Zimbabwe National Cancer Registry, College of Health Sciences University of Zimbabwe  Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gladys","family":"Chesumbai","sequence":"additional","affiliation":[{"name":"Eldoret Cancer Registry Moi Teaching and Referral Hospital  Eldoret Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Chokunonga","sequence":"additional","affiliation":[{"name":"Zimbabwe National Cancer Registry, College of Health Sciences University of Zimbabwe  Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ima\u2010Obong","family":"Ekanem","sequence":"additional","affiliation":[{"name":"Department of Pathology, Calabar Cancer Registry University of Calabar Teaching Hospital  Calabar Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahine","family":"Ivanga","sequence":"additional","affiliation":[{"name":"Institut de Canc\u00e9rologie de Libreville Registre du Cancer du Gabon  Libreville Gabon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bakarou","family":"Kamat\u00e9","sequence":"additional","affiliation":[{"name":"Bamako Cancer Registry L'H\u00f4pital National du Point G  Bamako Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Muller","sequence":"additional","affiliation":[{"name":"Mbeya Cancer Registry Mbeya Referral Hospital  Mbeya 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Christian Medical Centre Cancer Care Centre  Moshi Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Wallwiener","sequence":"additional","affiliation":[{"name":"Department of Gynaecology Martin Luther University Halle\u2010Wittenberg  Halle Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1955-923X","authenticated-orcid":false,"given":"Mazvita","family":"Muchengeti","sequence":"additional","affiliation":[{"name":"National Cancer Registry National Health Laboratory Service  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo Sandro Carvalho","family":"Santos","sequence":"additional","affiliation":[{"name":"Global and Planetary Health Working Group, Center of Health Sciences Medical Faculty of the Martin Luther University Halle\u2010Wittenberg  Halle (Saale) Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald 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