Using the Network's framework in Africa

Bristol Myers Squibb Foundation invited the Lung Cancer Policy Network to its Annual Africa Grantee Summit to explore the Network’s framework and how lung cancer screening can be advanced in partner countries across the continent.
 

Context

The prevalence of lung cancer and number of deaths caused by the disease varies significantly across different regions throughout Africa. While lung cancer is most scarce among women in West Africa, it is most common among men in North Africa but more deadly among those in Southern Africa. Limited diagnostic infrastructure and incomplete data from cancer registries may, however, contribute to underestimated rates.

Many people living with lung cancer in Africa are diagnosed at a late stage due to misdiagnosis, delayed referrals and poor health literacy. Ensuring more people have their lung cancer detected earlier is key to improving outcomes across the continent. Public health efforts should include establishing screening programmes for high-risk populations, as well as raising awareness of symptoms. In Africa, risk factors such as occupational carcinogens, tuberculosis and exposure to indoor cooking fuels ultimately contribute to many people developing lung cancer, underscoring the urgency of targeted public health interventions.

To help advance lung cancer screening, the Lung Cancer Policy Network was invited by Bristol Myers Squibb Foundation to deliver a workshop to their partners across seven countries: Ethiopia, Kenya, Malawi, South Africa, Tanzania, Zambia and Zimbabwe. The workshop focused on exploring the Network’s implementation framework for lung cancer screening.

How the framework was used to support the implementation of lung cancer screening

The implementation framework played a central role in shaping the structure and content of the half-day workshop designed to support countries in planning and delivering low-dose computed tomography (LDCT) screening for lung cancer. It provided a practical foundation for discussions, helping to ensure that conversations were focused, relevant and aligned with real-world challenges.

The workshop was organised around three key priority areas identified by participants:

1. eligibility and recruitment
2. LDCT screening delivery
3. data monitoring and evaluation.

Tailored questions drawn from the framework helped guide conversations around eligibility and recruitment, and data monitoring and evaluation. To enrich these discussions, participants also used resources from the implementation toolkit, such as a summary document of potential barriers to and solutions for engaging participants in screening.

In the session on LDCT screening delivery, participants worked in groups with a sample screening pathway from the implementation framework. They were asked to adapt this pathway to reflect the realities of their respective health systems, creating an ideal version tailored to their local context. Participants were also encouraged to reflect on existing screening pathways in their countries (for other cancers, for example, or for tuberculosis), identifying elements that worked well and areas in need of improvement. Discussions highlighted key considerations for planning phased screening approaches where feasible, including how limited workforce and infrastructure capacity could be managed through a step-wise approach, with a fully scaled programme as the longer-term goal. Small groups then fed back to the full workshop delegation, providing participants with the opportunity to share insights from their settings and learn from one another.

The workshop laid the groundwork for a shared vision of improved lung cancer screening and earlier detection across Africa. Overall, the framework helped ensure the structure of the workshop was methodical but still flexible. It ensured discussions were grounded in evidence-based guidance, while still leaving space for local adaptation and innovation. This approach not only supported shared learning across countries, but also helped participants move from high-level planning to practical next steps for context-appropriate, evidence-informed implementation.

Next steps

The workshop delegates were a specific pool of experts in lung cancer and oncology, representing seven diverse countries. With this in mind, participants were encouraged to share the materials and insights from the session with colleagues and their wider network of peers, helping to broaden engagement in efforts to detect lung cancer earlier and strengthen screening practice.