Published in PLOS One on 2026-03-25, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Sarah Day, Jane Harries, Bukeka Sawula, Alec Payne, Shameem Bray, Denis Okova, Lauren Pretorius, Jennifer Moodley
Source: PLOS One • DOI 10.1371/journal.pone.0327113
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Cancer is an increasing public health problem in South Africa, with breast cancer being the most diagnosed cancer and cervical cancer the leading cause of cancer deaths among women. Despite the complexity of breast and cervical cancer patients’ journeys through the healthcare system, patients’ voices are still predominantly missing from the body of literature. Patient journey mapping, as a qualitative research method, offers an opportunity for centring patients in their care journeys and reimagine healthcare provision for the potential improvement of health systems and patient outcomes.
The aim of this study was to map journeys of breast and cervical cancer patients across the cancer care continuum.
Using patient journey mapping, we conducted six focus group discussions with patients with breast and cervical cancer who had completed treatment in Gauteng, KwaZulu Natal and the Western Cape, South Africa. The process involved three steps: 1.) development of individual maps; 2.) narrative sharing; and 3.) development of a collective map. Results of the study were shared in feedback sessions.
A total of 31 people participated in the focus groups: 23 with breast cancer, 7 cervical cancer and one had both cancers during her lifetime. The participants’ ages ranged between 30 and 69 years old. A patient journey map was developed drawing on the individual and collective maps and participant narratives. The findings of the paper constellate around three themes. The first theme, (de)personalised care, offers an examination of how relational, institutional and structural factors shape and are reshaped through participants lived experiences across the cancer care continuum. The second theme, self-advocacy, explores how participants advocate for their healthcare needs throughout the cancer care continuum. The third theme, intersecting vulnerabilities, explores how intersecting social identities, such as socioeconomic factors, gender, comorbidities and mental health, shape their cancer care journeys.
By centring patient with breast and cervical cancer voices, patient journey mapping not only showed where services and systems fall short but also provided guidance for redesigning a more patient responsive health system.
Introduction
Low-and-middle income countries (LMICs) face a disproportionate burden of cancer-related death [1]. Increasing cancer incidence and poorer prognosis in LMICs can be attributed to ageing societies, health disparities, poor access to quality healthcare, inequalities in timely care-seeking and high prevalence of risk factors [1]. Of the 13 million cancer deaths estimated in 2030, 75% will occur in LMICs. Most cancer patients in Southern Africa present with advance stage disease, which is associated with a poorer prognosis [2–4]. Cancer is an increasing public health problem in South Africa (SA), with breast cancer being the most commonly diagnosed cancer and cervical cancer the leading cause of cancer deaths among women [5]. In 2017, SA adopted Breast [6] and Cervical [7] Cancer Prevention and Control Policies. Both policies offer comprehensive guidelines for promoting community awareness, screening, primary and secondary prevention, early detection, diagnosis, treatment, post-treatment care, palliation and end of life care. These policies are supported by the National Cancer Strategic Framework 2017–2022 [8] and the National Policy Framework and Strategy on Palliative Care 2017–2022 [9].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Sarah Day, Jane Harries, Bukeka Sawula, Alec Payne, Shameem Bray, Denis Okova, Lauren Pretorius, Jennifer Moodley. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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- Evidence brief: Unmet needs and quality of life of adult patients while receiving cancer treatment in Uganda: A cross-sectional study
