{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T01:39:24Z","timestamp":1761183564237,"version":"build-2065373602"},"reference-count":12,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"11","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Glob Oncol"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Cervical cancer remains a leading cause of cancer mortality in low- and middle-income countries (LMICs). The International Gynecologic Cancer Society (IGCS) Global Gynecologic Oncology Fellowship aims to build human capacity to address the burden of cervical cancer in LMICs. This study assesses resource constraints experienced at fellowship sites with regard to management of cervical cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>From September to December 2020, one fellow from each of the 12 existing IGCS fellowship programs participated in a survey that assessed capacity for cervical cancer management, including access to care, diagnostics and treatment, cancer surveillance, and palliative care. Descriptive statistics were used for analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Patients at IGCS sites experienced significant delays to care, especially for chemotherapy and radiation therapy. Less than half of the sites had a gynecology-trained pathologist, and only 58% of sites had access to a magnetic resonance imaging machine, though with many delays in obtaining imaging reads. For treatment, neoadjuvant chemotherapy is not commonly used. Access to radiation therapy is poor, with 58% of sites reporting wait times of 5-8 weeks or more. The radiation machine downtime ranges from 1 to 3 months per year, creating gaps where no patients can access this treatment. Palliative care is practiced by variable members of the health care team although hospice services are rare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>This study demonstrates significant resource constraints experienced by gynecologic oncology providers in various LMICs when managing cervical cancer. This includes delays to diagnosis, poor access to chemoradiation services, and need for palliative care. Despite these limitations, the IGCS Global Gynecologic Oncology Fellowships have built workforce capacity to manage cervical cancer, serving as local champions to address this disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/go-25-00015","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T19:59:18Z","timestamp":1761163158000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Challenges and Opportunities in the Treatment of Invasive Cervical Cancer in Low-Resource Settings: A Survey of the International Gynecologic Cancer Society Fellowship Programs"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4098-613X","authenticated-orcid":true,"given":"Parisa N.","family":"Fallah","sequence":"first","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center, Houston, TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"Medley","sequence":"additional","affiliation":[{"name":"University Hospital of the West Indies, Kingston, Jamaica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malede","family":"Birara Fanta","sequence":"additional","affiliation":[{"name":"St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryam H.","family":"Shaki","sequence":"additional","affiliation":[{"name":"Uganda Cancer Institute, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Daley","sequence":"additional","affiliation":[{"name":"Falmouth Public General Hospital, Falmouth, Jamaica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3614-2401","authenticated-orcid":true,"given":"Biruck","family":"Gashawbeza Batu","sequence":"additional","affiliation":[{"name":"St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tran Thi Nhu","family":"Quynh","sequence":"additional","affiliation":[{"name":"Da Nang Oncology Hospital, Da Nang, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5155-3161","authenticated-orcid":true,"given":"Husnia Hussen","family":"Lobi","sequence":"additional","affiliation":[{"name":"Black Lion Specialized Hospital, Addis Ababa, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6481-3110","authenticated-orcid":true,"given":"Anisa","family":"Mburu","sequence":"additional","affiliation":[{"name":"Aga Khan Hospital, Mombasa, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ngoc","family":"Phan","sequence":"additional","affiliation":[{"name":"Da Nang Oncology Hospital, Da Nang, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faiza A.","family":"Nassir","sequence":"additional","affiliation":[{"name":"Coast General Teaching and Referral Hospital, Mombasa, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawit","family":"Worku","sequence":"additional","affiliation":[{"name":"University Teaching Hospital of Kigali (CHUK), Kigali, Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2803-3384","authenticated-orcid":true,"given":"Pius","family":"Mulamira","sequence":"additional","affiliation":[{"name":"Uganda Cancer Institute, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3782-8234","authenticated-orcid":true,"given":"Ricardina","family":"Rangeiro","sequence":"additional","affiliation":[{"name":"Hospital Central de Maputo, Maputo, Mozambique"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dercia Idite","family":"Changule","sequence":"additional","affiliation":[{"name":"Hospital Central de Maputo, Maputo, Mozambique"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mukatimui","family":"Kalima-Munalula","sequence":"additional","affiliation":[{"name":"Women and Newborn Hospital, Lusaka, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Origa","sequence":"additional","affiliation":[{"name":"Uganda Cancer Institute, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed Taha Hussein","family":"Alsayed","sequence":"additional","affiliation":[{"name":"Women Wellness and Research Center, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5184-556X","authenticated-orcid":true,"given":"Erick E.","family":"Estrada","sequence":"additional","affiliation":[{"name":"Hospital General San Juan de Dios, Guatemala City, Guatemala"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julius","family":"Nkalubo Kyemwa","sequence":"additional","affiliation":[{"name":"Uganda Cancer Institute, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saida","family":"Bowe","sequence":"additional","affiliation":[{"name":"Rand Memorial Hospital, Freeport, Bahamas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mubiru","family":"Musa","sequence":"additional","affiliation":[{"name":"Kawempe National Referral Hospital, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Mitchell","sequence":"additional","affiliation":[{"name":"University Hospital of the West Indies, Kingston, Jamaica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saujanya","family":"Karmacharya","sequence":"additional","affiliation":[{"name":"Nepal Armed Police Force Hospital, Chandragiri, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Mitchell","sequence":"additional","affiliation":[{"name":"University Hospital of the West Indies, Kingston, Jamaica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry","family":"Chege","sequence":"additional","affiliation":[{"name":"Nyeri County Referral Hospital, Nyeri, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bethel","family":"Dereje","sequence":"additional","affiliation":[{"name":"St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5028-0598","authenticated-orcid":true,"given":"Edward L.","family":"Trimble","sequence":"additional","affiliation":[{"name":"National Cancer Institute, National Institutes of Health, Bethesda, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Ralph","sequence":"additional","affiliation":[{"name":"International Gynecologic Cancer Society (IGCS), Chicago, IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linus","family":"Chuang","sequence":"additional","affiliation":[{"name":"International Gynecologic Cancer Society (IGCS), Chicago, IL"},{"name":"Danbury Hospital\u2014Nuvance Health, Danbury, CT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8901-9212","authenticated-orcid":true,"given":"Joseph","family":"Ng","sequence":"additional","affiliation":[{"name":"International Gynecologic Cancer Society (IGCS), Chicago, IL"},{"name":"National University Hospital, Singapore City, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0761-9562","authenticated-orcid":true,"given":"Asima","family":"Mukhopadhyay","sequence":"additional","affiliation":[{"name":"International Gynecologic Cancer Society (IGCS), Chicago, IL"},{"name":"Kolkata Gynecological Oncology Trials and Translational Research Group, Kolkata, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Steller","sequence":"additional","affiliation":[{"name":"International Gynecologic Cancer Society (IGCS), Chicago, IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9670-4189","authenticated-orcid":true,"given":"Kathleen M.","family":"Schmeler","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center, Houston, TX"},{"name":"International Gynecologic Cancer Society (IGCS), Chicago, IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas C.","family":"Randall","sequence":"additional","affiliation":[{"name":"International Gynecologic Cancer Society (IGCS), Chicago, IL"},{"name":"Columbia University Irving Medical Center, New York City, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2020.11754"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(22)00501-0"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.13869"},{"key":"e_1_3_6_5_2","volume-title":"Global Gynecologic Oncology Fellowship: 2023 Impact Report","author":"International Gynecologic Cancer Society (IGCS)","year":"2023","unstructured":"International Gynecologic Cancer Society (IGCS): Global Gynecologic Oncology Fellowship: 2023 Impact Report. 2023. https:\/\/igcs.org\/mentorship-and-training\/global-curriculum\/"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/ijgc-2021-002480"},{"key":"e_1_3_6_7_2","volume-title":"WHO Framework for Strengthening and Scaling-up of Services for the Management of Invasive Cervical Cancer","author":"World Health Organization (WHO)","year":"2020","unstructured":"World Health Organization (WHO): WHO Framework for Strengthening and Scaling-up of Services for the Management of Invasive Cervical Cancer. Washington, DC, World Health Organization (WHO), 2020"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.33795"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/ijgc-2019-000653"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60160-X"},{"key":"e_1_3_6_11_2","article-title":"Global access to radiotherapy services: Have we made progress during the past decade?","author":"Yap ML","unstructured":"Yap ML, Zubizarreta E, Bray F, et al: Global access to radiotherapy services: Have we made progress during the past decade? JCO Glob Oncol 10.1200\/JGO.2015.001545","journal-title":"JCO Glob Oncol"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semradonc.2016.11.005"},{"key":"e_1_3_6_13_2","article-title":"Palliative care in the global setting: ASCO resource-stratified practice guideline","author":"Osman H","unstructured":"Osman H, Shrestha S, Temin S, et al: Palliative care in the global setting: ASCO resource-stratified practice guideline. JCO Glob Oncol 10.1200\/JGO.18.00026","journal-title":"JCO Glob Oncol"}],"container-title":["JCO Global Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/GO-25-00015","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T19:59:19Z","timestamp":1761163159000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/GO-25-00015"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":12,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1200\/GO-25-00015"],"URL":"https:\/\/doi.org\/10.1200\/go-25-00015","relation":{},"ISSN":["2687-8941"],"issn-type":[{"value":"2687-8941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2025-01-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-23","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e2500015"}}