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6.8.3: 3. Motivation and Methodology

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  • The AfHNS Clinical Practice Guidelines for Oral Cancers in Developing Countries and Limited Resource Settings tailor management of oral cancers according to diagnostic and therapeutic resources available to physicians and to their patients.

    International guidelines for oral cancers assume availability of cytology, ultrasound, CT, MRI, high levels of surgical expertise, reconstructive surgery, frozen section, and postoperative (chemo)radiation therapy. Frequently, not all these interventions are available, and follow-up may be unreliable.

    Without resource appropriate guidelines for oral cancers, both resident and volunteer surgeons from developed countries have little to guide them about best practice when working in resource limited settings. This might lead to inappropriate investigations, inappropriate treatment, and may compromise patients.


    The AfHNS convened a task force to enumerate resource appropriate guidelines for management of oral cancers in poorly resourced settings. This collaboration between physicians from African and developed countries included members of the AfHNS and American colleagues. International guidelines were referenced and adapted for limited resources. Due to paucity of literature about management of oral cancers in low resource settings, much of the recommendations represents expert opinion.

    Contributors to AfHNS Clinical Practice Guidelines for Oral Cancers  in Developing Countries and Limited Resource Settings were: Johan Fagan (South Africa), Julie Wetter (South Africa), Paul Onakoya (Nigeria), Anna Konney (Ghana), Innocent Kundiona (Zimbabwe), Melesse Biadgelign (Ethiopia), Kenneth Baidoo (Ghana), Khaled Twier (Libya), Joyce Aswani (Kenya), Rajab Mugabo (Rwanda), Victor Mashamba (Tanzania), Marco Faniriko (Madagascar), Evelyne Diom (Senegal), Mark Zafereo (USA), and Wayne Koch (USA).