Hooks, Danetta

ABSTRACTObjectiveThis scoping review explores the multifaceted experience of cancer survivorship in Sub‐Saharan Africa (SSA), with a focus on the post‐treatment phase. The primary objective is to examine the psychosocial, cultural, and economic factors that influence post‐treatment survivorship care and outcomes.MethodsA comprehensive literature review was conducted using databases such as Web of Science Core Collection to identify studies published between 2000 and 2023. Eligible studies focused on post‐treatment cancer survivorship in SSA. Data were extracted, analyzed, and synthesized to identify key themes and research gaps.ResultsThe review identified substantial psychological distress among survivors, including depression, anxiety, and insomnia, often exacerbated by financial toxicity and limited access to psychosocial support services. Cultural factors, such as spiritual beliefs, reliance on traditional healers, and cancer‐related stigma, influenced healthcare‐seeking behaviors and overall well‐being. Despite these challenges, social support networks, religiosity, and targeted psychosocial interventions improved emotional resilience and quality of life. However, major gaps remain, including insufficient integration of cultural beliefs into survivorship care, inadequate long‐term follow‐up (LTFU) programs, limited oncofertility support, and a lack of regionally diverse and longitudinal data.ConclusionsCancer survivorship in SSA is shaped by intricate psychosocial, cultural, and economic dynamics that extend beyond clinical care. Addressing these challenges requires culturally sensitive, evidence‐based interventions, including financial counseling, spiritual care integration, and the establishment of structured LTFU programs. Additionally, expanding access to oncofertility support and integrating culturally relevant psychosocial services can further enhance survivorship outcomes. Strengthening collaboration between policymakers, healthcare providers, and researchers—through interdisciplinary task forces, psycho‐oncology workforce development, and community‐driven initiatives—is essential for improving post‐treatment outcomes and advancing cancer survivorship care in SSA.

Abstract Introduction: Understanding the behavioral aspects of cancer care in Sub-Saharan Africa (SSA) is crucial for developing effective interventions and improving outcomes, particularly during the peri-treatment phase. Synthesizing knowledge sets the stage for prioritizing cancer-focused research in SSA. Therefore, this scoping review aims to synthesize current knowledge on cancer behavioral research during the peri-treatment phase in SSA, focusing on the behavioral and psychosocial aspects of care. Method: Comprehensive literature searches were conducted across multiple databases and grey literature sources. Studies were selected if they included participants > 18 years old undergoing peri-treatment care, randomized controlled trials, or qualitative/quantitative methodologies focused on behavioral oncology. Only full-text articles published in English were included. Data from the selected studies were systematically extracted and organized. Results: A total of 1,897 cancer patients were included across 18 out of the 24 articles analyzed, with participants aged 8-80 years old. The studies mainly included participants recently diagnosed with cancer or undergoing treatment, covering various cancer types, including prostate, cervical, gastric, liver, and colon cancer, from stage I-III. Only three of the 24 studies referenced theoretical frameworks. Each study identified behavioral factors and outcomes among their sample population. Key findings across the studies underscored significant psychological distress manifested through a spectrum of emotional and psychosocial challenges, including poor social and psychological well-being, depression, anxiety, insomnia, and agoraphobia. Cultural influences, cost considerations, and non-interference of symptoms with day-to-day activities delayed healthcare seeking, especially among women. Despite these challenges, instances of psychological resilience were noted, driven by perceived social support, religiosity, hope, and optimism. The review highlighted the complex interplay between cultural norms, stigma, and health behaviors, with stigma often rooted in cultural beliefs. Spiritual beliefs and practices were central to many participants’ cancer journey, shaping their views on illness, treatment, and recovery. Key factors affecting cancer care include healthcare accessibility, financial limitations, social support networks, healthcare provider attitudes, family involvement in treatment decisions, and emotional support. Conclusion: The findings from this scoping review reveal significant psychological distress and barriers to care among cancer patients in SSA, highlighting the urgent need for comprehensive, culturally sensitive interventions that addresses emotional, social, and cultural dimensions. This approach should integrate accessible mental health services, enhance social support networks, and promote culturally appropriate educational programs to reduce stigma and encourage timely healthcare-seeking. Citation Format: Opeyemi O. Bolajoko, Danetta S. Hooks, Motolani Adedipe, Jessica Saintibert, OluwaSeyi Toye, Clifton Sheri, Folakemi T Odedina. Evidence of behavioral research before and during cancer care in Sub-Saharan Africa: A scoping review [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B172.

Abstract Introduction: In Sub-Saharan Africa (SSA), high cancer incidence is compounded by limited healthcare access and out-of-pocket costs. Additional factors like limited research funding, socioeconomic disparities, and cultural influences further affect cancer survivors' well-being. While some studies identify factors improving psychosocial well-being, there is a gap in understanding SSA-specific contextual and behavioral influences. This study addresses this gap through a scoping review of post-treatment cancer behavioral research, synthesizing current knowledge to inform interventions aimed at enhancing psychosocial support and improving health outcomes for survivors in the region. Methods: Guided by Arksey and O'Malley's 5-step framework, we conducted a scoping review to map cancer-focused behavioral research in Sub-Saharan Africa, aiming to inform policy and identify research gaps. Through comprehensive literature searches and eligibility criteria based on the PICOS framework, we identified relevant studies. Searches were executed from September-October 2023. Our search strategy encompassed multiple databases and supplementary methods to ensure thorough coverage. Screening, extraction, and analysis of the selected articles were conducted independently by at least two reviewers, using Microsoft Excel and Covidence and resolving discrepancies through discussion. Ultimately, seven articles met our inclusion criteria. Data were charted and summarized, covering demographics, study design, barriers, facilitators, cultural factors, support mechanisms, and recommendations. Results: Seven articles from four SSA countries were reviewed, with Nigeria contributing the most studies. The study articles, spanning from 1998 to 2023, used diverse methodologies and theoretical frameworks. The studies covered various cancer types and stages, highlighting significant psychological distress, financial toxicity, and post-traumatic growth among survivors. Cultural influences, including stigma and spiritual beliefs, were prominent. Barriers to care included financial constraints and limited access, while facilitators were social support and positive healthcare relationships. Effective support mechanisms like social and psychological interventions were crucial for enhancing survivors' well-being and promoting long-term follow-up care. Conclusion: This scoping review highlights the significant psychological, financial, and cultural challenges faced by cancer survivors in SSA. Addressing these challenges requires targeted interventions and policies that consider the unique contextual factors of SSA, aiming to enhance psychosocial support and improve overall health outcomes for cancer survivors. Future research should focus on comprehensive and culturally competent approaches to mitigate barriers and leverage facilitators, ultimately fostering a more supportive environment for cancer survivorship in the region. Citation Format: Motolani Ogunsanya, Opeyemi Bolajoko, Jessica Saintibert, Danetta Hooks, Oluwaseyi Toye, Shari Clifton, Folakemi Odedina. Mapping behavioral research in post-treatment cancer care in Sub-Saharan Africa: A scoping review [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C033.