title: Cervical Cancer in Botswana: Current State and Future Steps for Screening and Treatment Programs.
abstract: Botswana has a high burden of cervical cancer due to a limited screening program and high HIV prevalence. About 60% of the cervical cancer patients are HIV positive; most present with advanced cervical disease. Through initiatives by the Botswana Ministry of Health and various strategic partnerships, strides have been made in treatment of pre-invasive and invasive cancer. The See and Treat program for cervical cancer is expanding throughout the country. Starting in 2015, school-going girls will be vaccinated against HPV. In regards to treatment of invasive cancer, a multidisciplinary clinic has been initiated at the main oncology hospital to streamline care. However, challenges remain such as delays in treatment, lack of trained human personnel, limited follow-up care, and little patient education. Despite improvements in the care of pre-invasive and invasive cervical cancer patients, for declines in cervical cancer-related morbidity and mortality to be achieved, Botswana needs to continue to invest in decreasing the burden of disease and improving patient outcomes of patients with cervical cancer.
authors.affiliation: Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA ; Botswana University of Pennsylvania Partnership , Gaborone , Botswana.
authors.forename: Surbhi
authors.initials: S
authors.lastname: Grover
authors.affiliation: National Cervical Cancer Prevention Programme, Ministry of Health , Gaborone , Botswana.
authors.forename: Mmakgomo
authors.initials: M
authors.lastname: Raesima
authors.affiliation: Department of Oncology, Gaborone Private Hospital , Gaborone , Botswana.
authors.forename: Memory
authors.initials: M
authors.lastname: Bvochora-Nsingo
authors.affiliation: Princess Marina Hospital , Gaborone , Botswana.
authors.forename: Sebathu P
authors.initials: SP
authors.lastname: Chiyapo
authors.affiliation: Department of Oncology, Gaborone Private Hospital , Gaborone , Botswana.
authors.forename: Dawn
authors.initials: D
authors.lastname: Balang
authors.affiliation: Princess Marina Hospital , Gaborone , Botswana ; Division of Global Health Equity, Brigham and Women's Hospital , Boston, MA , USA.
authors.forename: Neo
authors.initials: N
authors.lastname: Tapela
authors.affiliation: Department of Radiation Oncology, New York University Perlmutter Cancer Center , New York, NY , USA.
authors.forename: Onyinye
authors.initials: O
authors.lastname: Balogun
authors.affiliation: National Health Laboratory , Gaborone , Botswana.
authors.forename: Mukendi K A
authors.initials: MK
authors.lastname: Kayembe
authors.affiliation: Department of Radiation Oncology, Massachusetts General Hospital , Boston, MA , USA.
authors.forename: Anthony H
authors.initials: AH
authors.lastname: Russell
authors.affiliation: Botswana University of Pennsylvania Partnership , Gaborone , Botswana.
authors.forename: Barati
authors.initials: B
authors.lastname: Monare
authors.affiliation: Botswana University of Pennsylvania Partnership , Gaborone , Botswana.
authors.forename: Senate
authors.initials: S
authors.lastname: Tanyala
authors.affiliation: Botswana University of Pennsylvania Partnership , Gaborone , Botswana.
authors.forename: Jailakshmi
authors.initials: J
authors.lastname: Bhat
authors.affiliation: Botswana University of Pennsylvania Partnership , Gaborone , Botswana.
authors.forename: Kealeboga
authors.initials: K
authors.lastname: Thipe
authors.affiliation: Botswana University of Pennsylvania Partnership , Gaborone , Botswana.
authors.forename: Metlha
authors.initials: M
authors.lastname: Nchunga
authors.affiliation: Botswana University of Pennsylvania Partnership , Gaborone , Botswana.
authors.forename: Susan
authors.initials: S
authors.lastname: Mayisela
authors.affiliation: Botswana University of Pennsylvania Partnership , Gaborone , Botswana.
authors.forename: Balladiah
authors.initials: B
authors.lastname: Kizito
authors.affiliation: Botswana University of Pennsylvania Partnership , Gaborone , Botswana ; Department of Medicine, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA.
authors.forename: Ari
authors.initials: A
authors.lastname: Ho-Foster
authors.affiliation: Princess Marina Hospital , Gaborone , Botswana.
authors.forename: Babe Eunice
authors.initials: BE
authors.lastname: Gaolebale
authors.affiliation: Princess Marina Hospital , Gaborone , Botswana.
authors.forename: Ponatshego A
authors.initials: PA
authors.lastname: Gaolebale
authors.affiliation: Department of Radiation Oncology, Massachusetts General Hospital , Boston, MA , USA.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Efstathiou
authors.affiliation: Division of Infectious Diseases, Brigham and Women's Hospital , Boston, MA , USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Dryden-Peterson
authors.affiliation: Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA.
authors.forename: Nicola
authors.initials: N
authors.lastname: Zetola
authors.affiliation: Division of Radiation Oncology, University of Texas MD Anderson Cancer Center , Houston, TX , USA.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Hahn
authors.affiliation: Department of Microbiology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA.
authors.forename: Erle S
authors.initials: ES
authors.lastname: Robertson
authors.affiliation: Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA.
authors.forename: Lilie L
authors.initials: LL
authors.lastname: Lin
authors.affiliation: Botswana University of Pennsylvania Partnership , Gaborone , Botswana ; Department of Medicine, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA ; School of Medicine, University of Botswana , Gaborone , Botswana ; Institute for Women's Health, University College London , London , UK ; Institute for Global Health, University College London , London , UK.
authors.forename: Chelsea
authors.initials: C
authors.lastname: Morroni
authors.affiliation: Botswana University of Pennsylvania Partnership , Gaborone , Botswana ; Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA ; Department of Obstetrics and Gynecology, Faculty of Medicine, University of Botswana , Gaborone , Botswana.
authors.forename: Doreen
authors.initials: D
authors.lastname: Ramogola-Masire
keywords: Botswana; HIV and cancer; cancer screening; cancer treatment; cervical cancer