Pink October in Togo: A Vital Fight Against Breast Cancer
Pink October is much more than a simple awareness campaign; it is a global movement that highlights the fight against breast cancer and stresses the importance of early detection. Originating in 1985, this month is dedicated to informing the public about the disease, encouraging women to get screened, and raising funds for research. In high-income countries, early diagnosis allows for a five-year survival rate of over 90%.
The Stakes of Pink October in Togo
In Togo, breast cancer represents a major public health challenge. It is the most frequent cancer among women in the country, accounting for approximately 27.1% (according to hospital statistics) of female cancers, followed by cervical cancer (the second most common at 24.8% according to IARC-GLOBOCAN* and hospital statistics). Roughly 3,000 to 4,000 women die from it each year.
These alarming figures are largely explained by delayed screening: more than 80% of women are diagnosed at an advanced stage, which severely compromises the chances of recovery.
During Pink October, Togolese health authorities, in collaboration with civil society associations and organizations, arrange free or reduced-price screening and awareness campaigns in public hospitals. These actions aim to break the taboo surrounding the disease and encourage women to get examined.
* IARC-GLOBOCAN is the leading global reference source for cancer statistics. IARC stands for the International Agency for Research on Cancer, and GLOBOCAN is an IARC project that provides estimates of the incidence (new cases), mortality, and prevalence of major cancer types in 185 countries.
Obstacles to Screening and Treatment in Togo
The difficulties encountered in the fight against cancer in Togo are manifold and structural, affecting accessibility, infrastructure, and human resources.
1. Lack and Inequality in Infrastructure and Equipment
Togo suffers from a glaring lack of specialized diagnostic and treatment infrastructure, which is mainly concentrated in the capital, Lomé:
Absence of heavy treatment equipment: There are no radiotherapy services in Togo. Patients requiring this stage of treatment must travel to neighboring countries like Ghana or Côte d'Ivoire, which represents a considerable financial and logistical cost (the treatment alone can cost the equivalent of 4,600,000 FCFA).
Limitation of diagnostic equipment: The availability of diagnostic machines, such as mammography units, is very limited. A woman living in Dapaong (over 600 km from Lomé) must travel to Kara, or even Lomé, for specific examinations like screening or certain analyses.
Lack of Data: Until recently, Togo did not have population-based cancer registries, making it difficult to obtain precise data and plan an effective national strategy. Statistics are primarily based on hospital registries, which do not capture all cases.
2. Insufficient Specialized Human Resources
Oncology expertise is extremely rare in Togo, which directly affects the quality of care provided:
Scarcity of oncologists: It was reported that in 2021, Togo only had a single medical oncologist and a single surgical oncologist.
Lack of specialized staff: Adequate human resources (radiotherapists, other medical oncologists) are insufficient or non-existent.
Unequal distribution of doctors: Only 20% of health human resources are distributed in rural areas. Generally, there is 1 doctor per 18,519 inhabitants (2017 data).
3. Accessibility and Cost Issues
Patients face major challenges in accessing care:
Long distances: Women in rural areas must travel great distances, often without adequate transport, to reach the few screening and treatment centers concentrated in the cities.
High cost of care: The diagnosis and management of cancer are primarily borne by the patient. The costs are exorbitant for a population with a high poverty rate (estimated at 61% in 2017). The cost of private sector screenings can vary; for example, for cervical cancer, it can range from 10,000 FCFA in the public sector to 25,000 FCFA in the private sector.
4. The Delay in Diagnosis
All these factors contribute to the main problem: the delay in diagnosis. Women arrive at the hospital at an advanced stage of cancer after often having attempted traditional remedies. The lack of awareness, despite campaigns, and a "double silence" (that of subtle symptoms and that of the woman who doesn't dare to consult) accentuate this tragic reality.
The fight waged during Pink October in Togo is therefore essential for raising awareness and encouraging early detection—the only guarantee of better survival—while awaiting significant improvement in national health infrastructure.