Vol. 1 No. 1 (2026): Inaugural Issue: Cancer Research Across Africa

Opening letter. Front-matter contribution reproduced from the AJCR Welcome page for the synthetic inaugural issue fixture.

Opening letter. Front-matter contribution reproduced from the AJCR Welcome page for the synthetic inaugural issue fixture.

Background: Triple-negative breast cancer is biologically heterogeneous, yet molecular characterization from African populations remains underrepresented in the literature. Methods: Synthetic retrospective molecular cohort included 318 synthetic tumor profiles across 4 simulated referral sites in University-linked oncology and pathology services in Cape Town. Results: Actionable alteration yield changed from 31% to 46%. The four-period secondary series was 68, 74, 81, 89. Conclusion: The modeled molecular workflow increased the proportion of evaluable profiles and produced clinically interpretable genomic subgroups suitable for multidisciplinary review.

Background: Circulating tumor DNA offers a minimally invasive way to track molecular response, but feasibility depends on reliable serial sampling and laboratory workflows. Methods: Synthetic prospective biomarker feasibility study included 196 synthetic serial-sample profiles across 3 simulated oncology laboratories in Colorectal cancer services linked to MUHAS in Dar es Salaam. Results: Evaluable serial ctDNA pairs changed from 58% to 88%. The four-period secondary series was 63, 71, 82, 90. Conclusion: Serial ctDNA assessment was feasible in the modeled workflow and generated interpretable molecular-response patterns alongside routine treatment assessment.

Background: Travel burden and treatment interruptions can make completion of multi-fraction radiotherapy difficult for patients referred across large geographic areas. Methods: Synthetic multicentre cohort analysis included 911 synthetic treatment courses across 7 simulated referral sites in Radiotherapy referral networks centered in Nairobi. Results: Radiotherapy courses completed as planned changed from 64% to 82%. The four-period secondary series was 41, 35, 28, 21. Conclusion: The modeled referral intervention reduced treatment interruptions and improved radiotherapy completion across travel-distance strata.

Background: Treatment abandonment remains a major threat to childhood-cancer outcomes when financial, social, geographic, and health-system barriers accumulate during prolonged therapy. Methods: Synthetic multicentre prediction study included 426 synthetic treatment episodes across 4 simulated pediatric oncology sites in Pediatric oncology referral pathways in Kigali. Results: Patients remaining in treatment at 6 months changed from 69% to 86%. The four-period secondary series was 61, 70, 79, 87. Conclusion: A simple risk-stratification pathway identified children needing additional support and improved modeled retention through the first six months of treatment.

Background: Localized prostate cancer often presents several reasonable management options, making patient preferences and shared decision-making central to treatment selection. Methods: Synthetic mixed-methods service evaluation included 356 synthetic consultations across 4 simulated clinics in Urology and oncology services linked to the University of Botswana. Results: Documented shared decision-making changed from 33% to 76%. The four-period secondary series was 48, 59, 68, 77. Conclusion: A structured consultation approach increased documented shared decision-making and improved modeled decision-quality measures.

Background: Delays between a suspicious breast finding and diagnostic confirmation can postpone treatment and increase uncertainty for patients navigating fragmented referral pathways. Methods: Synthetic stepped implementation study included 642 synthetic referrals across 6 simulated diagnostic sites in Breast assessment pathways linked to the University of Ghana in Accra. Results: Completed diagnosis within 30 days changed from 44% to 73%. The four-period secondary series was 62, 51, 42, 34. Conclusion: A structured navigation pathway shortened the modeled diagnostic interval and increased timely completion of breast-cancer diagnostic work-up.

Background: HPV self-sampling may extend cervical-screening reach when clinic-based participation is limited by access, time, privacy, or competing demands. Methods: Synthetic cluster implementation study included 1,204 synthetic screening encounters across 12 simulated screening clusters in Community screening pathways linked to the University of Ibadan. Results: Screening participation changed from 36% to 71%. The four-period secondary series was 49, 58, 67, 75. Conclusion: Community self-sampling increased modeled screening participation while preserving a clear pathway from molecular testing to triage.

Background: Head and neck cancer outcomes are shaped by both exposure patterns and the sequence of contacts that occurs before diagnostic confirmation and treatment referral. Methods: Synthetic population-based pathway study included 735 synthetic incident cases across 8 simulated reporting sites in Diagnostic and treatment pathways in Harare. Results: Cases documented at stage I–III changed from 41% to 59%. The four-period secondary series was 55, 64, 72, 81. Conclusion: The modeled pathway study linked presentation stage with referral timing and exposure documentation, illustrating how registry and service data can be analyzed together.

Background: Hepatocellular carcinoma surveillance can identify disease earlier only when abnormal screening findings are linked reliably to diagnostic imaging and specialist care. Methods: Synthetic health-system cohort study included 588 synthetic surveillance episodes across 6 simulated surveillance clinics in Liver cancer surveillance pathways linked to UCAD in Dakar. Results: Positive screens linked to diagnostic imaging changed from 47% to 78%. The four-period secondary series was 57, 65, 73, 80. Conclusion: A strengthened surveillance-to-imaging pathway improved modeled diagnostic linkage after positive liver-cancer screening results.

Background: Cancer-registry completeness depends on reconciling records from multiple clinical, pathology, treatment, and mortality sources without creating duplicate cases. Methods: Synthetic before-and-after informatics study included 1,842 synthetic incident records across 9 simulated reporting facilities in Cancer registration pathways linked to Addis Ababa University. Results: Registry records meeting completeness criteria changed from 61% to 91%. The four-period secondary series was 54, 68, 82, 93. Conclusion: Digital source linkage substantially improved modeled registry completeness while retaining a human quality-assurance step for uncertain matches.

Background: People living with advanced cancer frequently carry substantial symptom burden, while specialist palliative care remains concentrated in referral facilities. Methods: Synthetic prospective cohort included 284 synthetic participants across 5 simulated community teams in Community and oncology referral pathways in Kampala. Results: Participants with meaningful symptom improvement changed from 38% to 67%. The four-period secondary series was 71, 58, 46, 39. Conclusion: Home-based multidisciplinary follow-up was associated with lower modeled symptom burden and more consistent review of supportive-care needs.

Background: Introducing palliative care early in the oncology pathway may improve symptom control, communication, and care planning before crisis needs emerge. Methods: Synthetic pragmatic randomized service trial included 512 synthetic participants across 5 simulated oncology clinics in Oncology clinics linked to the University of Zambia in Lusaka. Results: Patients receiving palliative review within 14 days changed from 28% to 79%. The four-period secondary series was 52, 61, 68, 74. Conclusion: Embedding early palliative review within oncology clinics increased timely supportive-care contact and improved modeled quality-of-life measures.