{"id":"https://openalex.org/W3045974722","doi":"https://doi.org/10.1200/go.20.11000","title":"Access to Breast Cancer Diagnostic Devices in the East African Community: Moving the Needle","display_name":"Access to Breast Cancer Diagnostic Devices in the East African Community: Moving the Needle","publication_year":2020,"publication_date":"2020-07-01","ids":{"openalex":"https://openalex.org/W3045974722","doi":"https://doi.org/10.1200/go.20.11000","mag":"3045974722"},"language":"en","primary_location":{"id":"doi:10.1200/go.20.11000","doi":"https://doi.org/10.1200/go.20.11000","is_oa":true,"landing_page_url":"https://doi.org/10.1200/go.20.11000","pdf_url":null,"source":{"id":"https://openalex.org/S4210209558","display_name":"JCO Global Oncology","issn_l":"2687-8941","issn":["2687-8941"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","jufo-1","ki-jl-1","medline","norway-1","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"JCO Global Oncology","raw_type":"journal-article"},"volume":null,"type":"conference-abstract","is_traditional":false,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1200/go.20.11000","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5069075885","display_name":"Claire M. Wagner","orcid":"https://orcid.org/0000-0003-3767-4239","observed_orcids":["https://orcid.org/0000-0003-3767-4239","https://orcid.org/0000-0002-5886-4130"]},"institutions":[{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Claire M. Wagner","raw_affiliation_strings":["Harvard University, Boston, MA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Harvard University, Boston, MA","institution_ids":["https://openalex.org/I136199984"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5068751861","display_name":"Fidel Rubagumya","orcid":"https://orcid.org/0000-0002-8129-5714","observed_orcids":["https://orcid.org/0000-0002-8129-5714","https://orcid.org/0009-0003-0482-3135"]},"institutions":[{"id":"https://openalex.org/I4210165170","display_name":"Ministry of Health","ror":"https://ror.org/05prysf28","country_code":"RW","type":"government","lineage":["https://openalex.org/I4210165170"]}],"countries":["RW"],"is_corresponding":false,"raw_author_name":"Fidel Rubagumya","raw_affiliation_strings":["Ministry of Health, Kigali, Rwanda"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Ministry of Health, Kigali, Rwanda","institution_ids":["https://openalex.org/I4210165170"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5038029306","display_name":"Miriam Claire Mutebi","orcid":"https://orcid.org/0000-0002-0809-5812","observed_orcids":["https://orcid.org/0000-0002-0809-5812"]},"institutions":[{"id":"https://openalex.org/I2799649065","display_name":"Aga Khan University Hospital Nairobi","ror":"https://ror.org/03rppv730","country_code":"KE","type":"healthcare","lineage":["https://openalex.org/I118185606","https://openalex.org/I2799649065","https://openalex.org/I4210108070","https://openalex.org/I4210114929"]}],"countries":["KE"],"is_corresponding":false,"raw_author_name":"Miriam Mutebi","raw_affiliation_strings":["Aga Khan Hospital, Nairobi, Kenya"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Aga Khan Hospital, Nairobi, Kenya","institution_ids":["https://openalex.org/I2799649065"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5028361175","display_name":"David Mutiibwa","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I141930137","display_name":"Mbarara University of Science and Technology","ror":"https://ror.org/01bkn5154","country_code":"UG","type":"education","lineage":["https://openalex.org/I141930137"]}],"countries":["UG"],"is_corresponding":false,"raw_author_name":"David Mutiibwa","raw_affiliation_strings":["Mbarara University of Science and Technology, Mbarara, Uganda"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Mbarara University of Science and Technology, Mbarara, Uganda","institution_ids":["https://openalex.org/I141930137"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5084970491","display_name":"Louis Ngendahayo","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I208899625","display_name":"Universit\u00e9 du Burundi","ror":"https://ror.org/003vfy751","country_code":"BI","type":"education","lineage":["https://openalex.org/I208899625"]}],"countries":["BI"],"is_corresponding":false,"raw_author_name":"Louis Ngendahayo","raw_affiliation_strings":["University of Burundi, Bujumbura, Burundi"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Burundi, Bujumbura, Burundi","institution_ids":["https://openalex.org/I208899625"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5076749658","display_name":"Sarah Kutika Nyagabona","orcid":"https://orcid.org/0000-0002-1295-3197","observed_orcids":["https://orcid.org/0000-0002-1295-3197"]},"institutions":[{"id":"https://openalex.org/I4210167355","display_name":"Ocean Road Cancer Institute","ror":"https://ror.org/05tfxp741","country_code":"TZ","type":"facility","lineage":["https://openalex.org/I4210167355"]}],"countries":["TZ"],"is_corresponding":false,"raw_author_name":"Sarah K. Nyagabona","raw_affiliation_strings":["Ocean Road Cancer Institute, Dar es Salaam, Tanzania"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Ocean Road Cancer Institute, Dar es Salaam, Tanzania","institution_ids":["https://openalex.org/I4210167355"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5029622563","display_name":"Oromo Francis Seriano","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I192929712","display_name":"University of Juba","ror":"https://ror.org/02f1kft51","country_code":"SS","type":"education","lineage":["https://openalex.org/I192929712"]}],"countries":["SS"],"is_corresponding":false,"raw_author_name":"Seriano Oromo","raw_affiliation_strings":["University of Juba, Juba, South Sudan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Juba, Juba, South Sudan","institution_ids":["https://openalex.org/I192929712"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5109062335","display_name":"Paul E. Farmer","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Paul E. Farmer","raw_affiliation_strings":["Harvard University, Boston, MA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Harvard University, Boston, MA","institution_ids":["https://openalex.org/I136199984"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5057445720","display_name":"Agn\u00e8s Binagwaho","orcid":"https://orcid.org/0000-0002-6779-3151","observed_orcids":["https://orcid.org/0000-0002-6779-3151"]},"institutions":[{"id":"https://openalex.org/I4210143973","display_name":"University of Global Health Equity","ror":"https://ror.org/04c8tz716","country_code":"RW","type":"education","lineage":["https://openalex.org/I4210143973"]}],"countries":["RW"],"is_corresponding":false,"raw_author_name":"Agnes Binagwaho","raw_affiliation_strings":["University of Global Health Equity, Kigali, Rwanda"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Global Health Equity, Kigali, Rwanda","institution_ids":["https://openalex.org/I4210143973"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5048718528","display_name":"Danny A. Milner","orcid":"https://orcid.org/0000-0002-6685-8208","observed_orcids":["https://orcid.org/0000-0002-6685-8208"]},"institutions":[{"id":"https://openalex.org/I62979925","display_name":"American Society for Clinical Pathology","ror":"https://ror.org/02zhj3b46","country_code":"US","type":"nonprofit","lineage":["https://openalex.org/I62979925"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Dan A. Milner","raw_affiliation_strings":["American Society for Clinical Pathology, Chicago, IL"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"American Society for Clinical Pathology, Chicago, IL","institution_ids":["https://openalex.org/I62979925"]}]}],"institutions":[],"countries_distinct_count":7,"institutions_distinct_count":9,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":{"value":2472,"currency":"USD","value_usd":2472},"apc_paid":{"value":2472,"currency":"USD","value_usd":2472},"fwci":null,"has_fulltext":false,"cited_by_count":1,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":"6","issue":"Supplement_1","first_page":"16","last_page":"16"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11134","display_name":"Breast Lesions and Carcinomas","score":0.3352000117301941,"subfield":{"id":"https://openalex.org/subfields/2734","display_name":"Pathology and Forensic Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11134","display_name":"Breast Lesions and Carcinomas","score":0.3352000117301941,"subfield":{"id":"https://openalex.org/subfields/2734","display_name":"Pathology and Forensic Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13123","display_name":"Advances in Oncology and Radiotherapy","score":0.2328999936580658,"subfield":{"id":"https://openalex.org/subfields/2741","display_name":"Radiology, Nuclear Medicine and Imaging"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11731","display_name":"Global Health and Surgery","score":0.11249999701976776,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/breast-cancer","display_name":"breast cancer","score":0.8939999938011169},{"id":"https://openalex.org/keywords/breast-cancer-diagnosis","display_name":"breast cancer diagnosis","score":0.6600000262260437},{"id":"https://openalex.org/keywords/diagnostic-devices","display_name":"diagnostic systems","score":0.6150000095367432},{"id":"https://openalex.org/keywords/core-needle-biopsy","display_name":"core needle biopsy","score":0.746999979019165},{"id":"https://openalex.org/keywords/medical-equipment-procurement","display_name":"medical equipment procurement","score":0.843999981880188},{"id":"https://openalex.org/keywords/device-reuse","display_name":"device reuse","score":0.6830000281333923},{"id":"https://openalex.org/keywords/east-african-community","display_name":"East African Community","score":0.5690000057220459},{"id":"https://openalex.org/keywords/low-income-countries","display_name":"low-income countries","score":0.8859999775886536},{"id":"https://openalex.org/keywords/health-professions-education","display_name":"health professions education","score":0.5550000071525574},{"id":"https://openalex.org/keywords/access-to-diagnostic-services","display_name":"access to diagnostic services","score":0.4729999899864197}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7158033847808838},{"id":"https://openalex.org/C23131810","wikidata":"https://www.wikidata.org/wiki/Q818574","display_name":"Observational study","level":2,"score":0.46518296003341675},{"id":"https://openalex.org/C530470458","wikidata":"https://www.wikidata.org/wiki/Q128581","display_name":"Breast cancer","level":3,"score":0.4572271406650543},{"id":"https://openalex.org/C2779357621","wikidata":"https://www.wikidata.org/wiki/Q655495","display_name":"Tanzania","level":2,"score":0.4390881657600403},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.428399920463562},{"id":"https://openalex.org/C121608353","wikidata":"https://www.wikidata.org/wiki/Q12078","display_name":"Cancer","level":2,"score":0.30189642310142517},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.16709944605827332},{"id":"https://openalex.org/C45355965","wikidata":"https://www.wikidata.org/wiki/Q1643441","display_name":"Socioeconomics","level":1,"score":0.15626388788223267},{"id":"https://openalex.org/C144024400","wikidata":"https://www.wikidata.org/wiki/Q21201","display_name":"Sociology","level":0,"score":0.0},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.0}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1200/go.20.11000","doi":"https://doi.org/10.1200/go.20.11000","is_oa":true,"landing_page_url":"https://doi.org/10.1200/go.20.11000","pdf_url":null,"source":{"id":"https://openalex.org/S4210209558","display_name":"JCO Global Oncology","issn_l":"2687-8941","issn":["2687-8941"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","jufo-1","ki-jl-1","medline","norway-1","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"JCO Global Oncology","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.1200/go.20.11000","doi":"https://doi.org/10.1200/go.20.11000","is_oa":true,"landing_page_url":"https://doi.org/10.1200/go.20.11000","pdf_url":null,"source":{"id":"https://openalex.org/S4210209558","display_name":"JCO Global Oncology","issn_l":"2687-8941","issn":["2687-8941"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","jufo-1","ki-jl-1","medline","norway-1","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"JCO Global Oncology","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.98580002784729,"display_name":"Good health and well-being"},{"id":"https://metadata.un.org/sdg/10","score":0.7578999996185303,"display_name":"Reduced inequalities"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2947393313","https://openalex.org/W3134472310","https://openalex.org/W3157332764","https://openalex.org/W6889562525","https://openalex.org/W4410810820","https://openalex.org/W2794942366","https://openalex.org/W4396755678","https://openalex.org/W4230027118","https://openalex.org/W2565886458","https://openalex.org/W4405514678"],"abstract_inverted_index":{"PURPOSE":[0],"Globally,":[1],"two":[2],"million":[3],"women":[4],"develop":[5],"breast":[6,48,276],"cancer":[7,49,64,277],"each":[8],"year.":[9],"Low-income":[10],"countries":[11],"bear":[12],"a":[13,17,34],"disproportionate":[14],"burden":[15],"as":[16,33],"result":[18],"of":[19,36,56,156,215,240],"systems":[20],"strapped":[21],"by":[22,208],"limited":[23],"resources.":[24],"Inadequate":[25],"access":[26,62],"to":[27,60,63,77,92,257,270,284,309],"diagnostic":[28,50],"services":[29],"is":[30,268,307],"widely":[31],"recognized":[32],"driver":[35],"unfavorable":[37],"outcomes,":[38],"yet":[39],"baseline":[40],"data":[41,95],"on":[42],"supply,":[43],"use,":[44,203],"and":[45,74,76,82,107,111,121,166,173,196,204,228,265,293,298,316],"pricing":[46,294],"for":[47,273,312,320],"devices":[51,66,200],"are":[52],"scant.":[53],"The":[54],"purpose":[55],"this":[57],"study":[58],"was":[59,116,152,253,295],"assess":[61],"biopsy":[65],"in":[67,202,278],"Burundi,":[68],"Kenya,":[69],"Rwanda,":[70],"South":[71],"Sudan,":[72],"Tanzania,":[73],"Uganda,":[75],"ascertain":[78],"related":[79,283],"pricing,":[80,108],"procurement,":[81],"payment":[83],"models.":[84],"METHODS":[85],"We":[86,126],"conducted":[87],"an":[88],"observational":[89],"online":[90],"survey":[91,129],"capture":[93],"institution-based":[94],"that":[96,244],"address":[97],"demographics,":[98],"facility":[99],"capacity,":[100],"human":[101,160,286],"capital,":[102],"pathology":[103],"systems,":[104],"device":[105],"sourcing":[106],"supply":[109],"chains,":[110],"workarounds.":[112],"Additional":[113,305],"manufacturer":[114],"information":[115],"obtained":[117],"through":[118],"public":[119,141],"sources":[120],"communication":[122],"with":[123,275],"industry.":[124],"RESULTS":[125],"received":[127,232,248],"58":[128],"responses":[130],"from":[131],"the":[132,300],"6":[133],"East":[134,301],"African":[135,302],"Community":[136,303],"countries,":[137],"most":[138,186,209],"representing":[139],"urban":[140],"hospitals":[142],"(68%).":[143],"Pathology":[144],"laboratory":[145],"capacity":[146],"varied":[147,177],"drastically:":[148],"Although":[149],"basic":[150],"histopathology":[151],"consistently":[153],"performed":[154],"(92%":[155],"respondents),":[157],"hormone":[158],"receptor,":[159],"epidermal":[161],"growth":[162],"factor":[163],"receptor":[164],"2,":[165],"genetic":[167],"studies":[168],"were":[169,201,206],"not":[170,189],"(63%,":[171],"53%,":[172],"11%,":[174],"respectively).":[175],"Training":[176],"among":[178],"practitioners":[179,187],"performing":[180],"biopsies\u2014for":[181],"example,":[182],"surgeons":[183],"or":[184,223,260],"nurses\u2014and":[185],"did":[188],"have":[190],"ultrasound":[191],"guidance":[192],"(80%).":[193],"Both":[194],"disposable":[195,216],"reusable":[197],"core":[198],"needle":[199],"stockouts":[205],"reported":[207,243],"respondents":[210,242],"(69%).":[211],"Workarounds":[212],"included":[213],"reuse":[214],"devices,":[217],"alternative":[218],"procedures":[219],"(eg,":[220],"surgical":[221],"excision":[222],"fine-needle":[224],"aspiration),":[225],"patient":[226],"rescheduling,":[227],"referral.":[229],"Most":[230],"patients":[231,246,274],"results":[233],"at":[234],"follow":[235],"up,":[236],"but":[237],"one":[238],"fifth":[239],"all":[241],"some":[245],"never":[247],"results.":[249],"Of":[250],"importance,":[251],"there":[252],"no":[254],"observable":[255],"pattern":[256],"procurement":[258,291],"channels":[259],"pricing.":[261],"CONCLUSION":[262],"Reliable,":[263],"accurate,":[264],"timely":[266],"diagnosis":[267],"vital":[269],"improving":[271],"outcomes":[272],"low-income":[279],"countries.":[280,304],"Significant":[281],"variation":[282],"operations,":[285],"capital":[287],"management,":[288],"product":[289],"mix,":[290],"methods,":[292],"observed":[296],"between":[297],"within":[299],"investigation":[306],"needed":[308],"identify":[310],"opportunities":[311],"applying":[313],"best":[314],"practices":[315],"leveraging":[317],"regional":[318],"synergies":[319],"impact.":[321]},"counts_by_year":[{"year":2025,"cited_by_count":1}],"updated_date":"2026-10-16T09:59:22.235173","created_date":"2020-08-03T00:00:00"}