This interview marks the first in a series dedicated to exploring women’s cancers in the Eastern Mediterranean Region, with a focus on breast and cervical cancer—significant public health challenges in the region. In this inaugural discussion, Dr. Wala Mahgoub, Head of the Cancer Prevention and Control Program in Sudan, shares insights into the current state of women’s cancer care in Sudan, the major challenges faced, and the future directions for enhancing cancer prevention and control efforts in the country.
Dr. Walaa Mahgoub Abd Elrahim Younis, a public health consultant with 10 years of experience in Sudan’s health system, has expertise in clinical care and disease epidemiology. She currently leads the National Cancer Control Program at Sudan Federal Ministry of Health. In 2020, Dr. Walaa was appointed Sudan’s national focal point for cancer screening initiatives. She oversees screening, early detection, and treatment pathways, including mapping program coverage, aligning national policies with global cancer plans, and strengthening the capacity of the primary healthcare system.
Can you provide an overview of the current status of breast and cervical cancer in Sudan, particularly in terms of prevalence, mortality, and public awareness?
“Breast cancer is the most common cancer among women in Sudan,” Dr. Younis said, “and cervical cancer remains one of the leading causes of cancer-related deaths.” While the exact burden of cancer hasn’t been fully assessed since 2020 due to the absence of national cancer registry reports, Sudan relies on estimates from international agencies like the International Agency for Research on Cancer (IARC). According to IARC, as of 2022, breast and cervical cancer are ranked as the first and second most diagnosed cancers in women, representing 45.5% of all cancers diagnosed in women in Sudan, with a total of 7,865 cases.
“The prevalence of these cancers is exacerbated by limited screening services and the absence of a national early detection program,” Dr. Younis explained. “These issues are now worsened by the ongoing conflict, which has significantly rolled back previous efforts.”
What are the major challenges faced in the prevention and control of breast and cervical cancer in Sudan? How are you addressing these challenges?
Sudan faces many obstacles in its efforts to control breast and cervical cancer. “Our healthcare system is strained by several factors,” Dr. Younis elaborated. “Conflict, economic challenges, and resource limitations have crippled the system’s ability to provide adequate services.”
The conflict in Sudan has severely impacted healthcare facilities, many of which have been damaged or destroyed, further limiting access to essential cancer screening and treatment services. Displacement and the destruction of infrastructure have disrupted the continuity of care for cancer patients, making early detection efforts extremely difficult.
Despite these challenges, Dr. Younis highlighted that international organizations and NGOs are playing a critical role in sustaining healthcare services. “We have support from various international partners, but we still face significant limitations, particularly in screening and early detection for women’s cancers.”
How important is early detection in managing breast and cervical cancer? Are there any specific programs or campaigns currently in place to promote early detection?
Dr. Younis stressed the importance of early detection in managing breast and cervical cancer in Sudan. “Early detection is crucial in reducing the burden of cancer,” she said. “It decreases the financing load on the national healthcare system, increases survival rates, and empowers us to tackle community misconceptions.”
She also shared that the Federal Ministry of Health (FMOH) recently identified clinical pathways for breast and cervical cancer and designated screening points in five states. Additionally, NGOs are actively working at the community level to raise awareness about the importance of early detection and provide community education.
“These are positive steps,” Dr. Younis said, “but we need to expand these efforts to reach more women across the country, especially in underserved areas.”
From your experience, what strategies have been most effective in scaling up women’s cancer care in Sudan, including screening, early diagnosis, and management? Are there any successful case studies you can share?
Reflecting on strategies that have been effective in scaling up women’s cancer care, Dr. Younis pointed to the pilot project for breast and cervical cancer pathways in Red Sea State, initiated by AISPO, an international NGO. “This project, which began in 2020, led to an increase in the detection of new cancer cases, which is encouraging,” she explained. “It shows
that when we provide clear clinical pathways and access to screening, we can better identify high-risk groups and initiate treatment earlier.”
She emphasized that the continuum of cancer services—from screening to treatment—is crucial for improving patient outcomes and managing the overall burden of cancer.
How does the government approach policy-making for cancer prevention and control? Are there any new policies or initiatives that we can expect in the near future?
Sudan’s current health policies provide a framework for tackling cancer, but much more needs to be done. Dr. Younis highlighted the National Health Sector Recovery and Reform Strategic Plan (2022-2024) and the Sudan National Cancer Prevention and Control Strategy (2023-2030), as key policy documents that guide efforts in cancer prevention and control.
However, the implementation of these policies has been hindered by the ongoing conflict and resource constraints. ” We need adherence to the already established policies targeting cancer care and a fully functional national cancer registry” Dr. Younis emphasized. “Without accurate data, it’s difficult to make informed decisions about where to allocate resources.”
Looking to the future, Dr. Younis believes there is potential for progress through:
- Expanding early detection services to underserved regions.
- Strengthening healthcare infrastructure to improve the quality and safety of cancer care.
- Building human resource capacity, particularly in training more healthcare professionals.
- Securing sustainable financing for cancer services through both national and international partnerships.
How are you engaging communities and healthcare providers to raise awareness and educate them about breast and cervical cancer prevention and control?
A key component of improving cancer care in Sudan is community and healthcare provider engagement. Dr. Younis highlighted several strategies aimed at raising awareness, including community workshops, partnerships with local organizations, and training healthcare providers to enhance their cancer care capabilities. Additional efforts, such as health fairs, social media campaigns, and peer support groups, educate women on the importance of early detection and encourage regular screenings.
While these initiatives are small in scale, they play a crucial role in shifting community perceptions and increasing the uptake of cancer screening services. ‘There is still much work to be done in changing cultural attitudes and ensuring women understand the importance of early detection,’ Dr. Younis emphasized.”
Are there any notable collaborations or partnerships with local or international organizations that have significantly contributed to cancer prevention and control efforts in Sudan?
International collaborations have played a significant role in supporting Sudan’s cancer prevention efforts. Organizations like AISPO have contributed technical expertise, training, and financial support, helping to build capacity and improve healthcare infrastructure.
Dr. Younis expressed hope that further partnerships would help Sudan expand its cancer care services and better address the growing burden of women’s cancers.
What are your recommendations for improving the current state of women’s cancer care in Sudan? What future directions do you see for the Cancer Prevention and Control Department in this regard?
The road ahead for women’s cancer care in Sudan is long and fraught with challenges. However, as Dr. Younis concluded, “We have seen what can be achieved with the right resources and support. If we can expand early detection services, strengthen our healthcare system, and secure sustainable financing, we can make a real impact on the lives of women across Sudan.”
The future of women’s cancer care in Sudan hinges on comprehensive strategies, international collaboration, and continued advocacy for the importance of early detection. Despite the current obstacles, there is hope that through coordinated efforts, Sudan can begin to reverse the rising trend of cancer cases and provide better care for its women.