Audit of the Care Pathway for Gynaecological and Breast Cancer Patients Monitored at the Jeanne Ebori Foundation Mother-Child University Hospital (Gabon) in 2025

Introduction: Given their prevalence, often late diagnosis, lack of organised screening and poor treatment, gynaecological and breast cancers are therefore real public health problems in Africa. Method: An audit was conducted from 1 to 7 March 2025 in the Gynaecology Department at the Mother-Child University Hospital, Jeanne éBORI Foundation, comparing the information collected in medical records with the department’s planned standards. The audit focused on patients followed for gynaecological or breast cancer in 2024. The Fleiss kappa coefficient was used to measure agreement between participants’ responses, setting a probability threshold of less than 5% and a 95% confidence interval. Results: A high level of agreement was noted between the responses, reflecting substantial agreement among the doctors interviewed (K = 0.69; 95% CI (0.59 - 0.79); p < 0.001) regarding the standardisation of care. Analysis of 60 files (i.e. 64.5% of all patients followed for gynaecological or breast cancer, N = 93) after reaching saturation revealed imprecise risk factors in 83.3% (50/60), the non-recording of biopsy results in 8.3% (5/60) and an absence of clinical and anatomopathological staging in 26.8% (15/56) and 33.3% (20/60), respectively. Conclusion: To ensure quality of care and guarantee good information management, the department must implement patient data management software, including a standardised clinical record. Alternatively, a standard medical record template for cancer could be developed and made available to users.