Defining national research priorities for prostate cancer in Zambia: using the Delphi process for comprehensive cancer policy setting in sub-Saharan Africa

Locally led research on cancer is needed in sub-Saharan Africa to set feasible research priorities that inform national policy. The aim of this project was to develop a research agenda for national cancer control planning, using a nationally driven approach, focused on barriers to diagnosis and high-quality treatment for prostate cancer in Zambia.This was a Delphi process. 29 stakeholders were scored barriers on feasibility, the proportion of patients affected, the impact on patient outcomes and if there was a potential to address health systems barriers meaningfully. There were three rounds (R) to the process: (R1 and R2) by electronic survey and (R3) in-person meeting. In R1 statements scoring above 15 from over 70% of participants were prioritised immediately for R3 discussion. Those scoring below 30% were dropped and those in between were re-surveyed in R2.22 and 17 of the 29 stakeholders responded to R1 and R2. 14 stakeholders attended R3. National priority research areas for prostate cancer in Zambia were identified as prostate cancer awareness; building affordable high-quality diagnostic capacity; affordability of specialist cancer treatments; supporting better access to medicines; delivery and coordination of services across the pathway and staff training.The suggested seven priority areas allow for the development of the prostate cancer control programme to be conducted in a holistic manner. The expectation is with this guidance international partners can contribute within the frameworks of the local agenda for sustainable development to be realised.

撒哈拉以南非洲需要由当地主导的癌症研究，以确定可行的研究重点，为国家政策提供依据。本项目的目的是采用全国性驱动的方法，针对赞比亚前列腺癌诊断和高质量治疗的障碍，制定一项国家癌症控制规划的研究议程。这是一个德尔菲法流程。29名利益相关者对障碍的可行性、受影响患者的比例、对患者预后的影响以及是否有可能有效解决卫生系统障碍进行了评分。该流程有三轮：第一轮和第二轮通过电子调查进行，第三轮为面对面会议。在第一轮中，超过70%的参与者评分在15分以上的陈述立即被列为优先事项，用于第三轮讨论。得分低于30%的被淘汰，介于两者之间的在第二轮中再次接受调查。29名利益相关者中有22名和17名分别对第一轮和第二轮做出了回应。14名利益相关者参加了第三轮。赞比亚前列腺癌的国家优先研究领域被确定为前列腺癌认知；建立负担得起的高质量诊断能力；专科癌症治疗的可负担性；支持更好地获取药物；整个医疗路径的服务提供和协调以及人员培训。建议的七个优先领域允许以整体的方式开展前列腺癌控制项目。期望在这一指导下，国际合作伙伴能够在当地议程的框架内做出贡献，以实现可持续发展。