Kristen Rat Sarcoma Viral Oncogene Mutations in Colorectal Carcinomas at the University Teaching Hospital in Lusaka, Zambia

ackground: The second leading cause of cancerrelated deaths worldwide iscolorectal cancer. With an incidence rate of 4.8 per 100,000, this is Zambia's sixth most prevalent cancer; Methods: This laboratory-based, cross-sectional study examined the frequency of Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation and its association with prognostic factors in colorectal carcinoma cases from the University Teaching Hospital-Adult Hospital (UTHs), Lusaka, Zambia; Results: Thirty (30) formalin-fixed paraffinembedded (FFPE) samples collected between June 2017 and June 2018 were sent to the Lancet laboratories and analyzed for KRAS mutations (codons 12 and 13). One FFPE block did not meet the inclusion criteria and was excluded. The demographic and clinicopathological data were analyzed using STATA 12. Males outnumber females by 20 to nine. The average age of the patient was 45 ± 16 years. The rectum was the location of 44.8% of the tumors, with the majority being conventional adenocarcinoma (CAC) (65.6 %). All cases (100%) had advanced-stage (stages 3 and 4) disease;however, only 27.6% of patient tumors exhibited lymphovascular invasion. KRAS mutation was detected in 11 (37.9%) cases and mainly in left-sided tumors (62.5%). KRAS mutations were only detected in CAC and serrated adenocarcinoma subtypes. No significant associations were observed between the KRAS mutation status and tumor or patient's clinical and sociodemographic factors; Conclusion: We advocate for incorporating KRAS mutation testing into the standard of care for treating colorectal cancer.

Radiation Sciences Education in Africa: An Assessment of Current Training Practices and Evaluation of a High-Yield Course in Radiation Biology and Radiation Physics.

PURPOSE: Formal education in the radiation sciences is critical for the safe and effective delivery of radiotherapy. Practices and patterns of radiation sciences education and trainee performance in the radiation sciences are poorly described. This study assesses the current state of radiation sciences education in Africa and evaluates a high-yield, on-site educational program in radiation biology and radiation physics for oncology and radiation therapy trainees in Africa. METHODS: An anonymous survey was distributed to members of the African Organization for Research and Treatment in Cancer Training Interest Group to assess current attitudes and practices toward radiation sciences education. A 2-week, on-site educational course in radiation biology and radiation physics was conducted at the Cancer Diseases Hospital in Lusaka, Zambia. Pre- and postcourse assessments in both disciplines were administered to gauge the effectiveness of an intensive high-yield course in the radiation sciences. RESULTS: Significant deficiencies were identified in radiation sciences education, especially in radiation biology. Lack of expert instructors in radiation biology was reported by half of all respondents and was the major contributing factor to deficient education in the radiation sciences. The educational course resulted in marked improvements in radiation biology assessment scores (median pre- and posttest scores, 27% and 55%, respectively; P < .0001) and radiation physics assessment scores (median pre- and posttest scores, 30% and 57.5%, respectively; P < .0001). CONCLUSION: Radiation sciences education in African oncology training programs is inadequate. International collaboration between expert radiation biology and radiation physics instructors can address this educational deficiency and improve trainee competence in the foundational radiation sciences that is critical for the safe and effective delivery of radiotherapy.

Zambia's National Cancer Centre response to the COVID-19 pandemic-an opportunity for improved care.

The COVID-19 pandemic has overwhelmed health systems around the globe even in countries with strong economies. This is of particular concern for nations with weaker health systems. This article reports the response of a comprehensive cancer centre in a lower-middle income country to prevent COVID-19 transmission and how the implementation of pragmatic strategies have served as a springboard to improve cancer services beyond the COVID-19 pandemic. The strategies included establishment of a local taskforce, increased education and facilitation of good hygiene practices, staff training, patient triaging, improved patient scheduling, remote review of patients and establishing a virtual platform for meetings.