Accurate anatomo-pathological and biological diagnosis is the essential prerequisite for the proper management of a cancer patient.

The morphology, "gold standard" of any initial analysis: cytological by microscopic analysis of cells and histological by tissue analysis is now completed by a multidisciplinary approach: biological and genetic according to WHO criteria. These expensive technologies are not yet fully accessible to low- and middle-income countries, exacerbating inequalities in access to health care in these countries.

Several approaches are being implemented within AMCC to improve the diagnostic process within these countries, particularly in Africa.

The improvement of standard cytology and pathological anatomy techniques and access to tele-pathology.

The latter is currently carried out by the transmission via the Internet of microscopic images of digitized interest (j-Peg images), these images are selected by local cytologists or pathologists using a microscope with a digital camera connected to a computer and an exchange platform, the "i-Path" platform in connection with the INCTR network (International Network for Cancer Treatment and Research). This platform includes several scientific exchange groups composed of identified physicians (hematologists, anatomo-pathologists, clinicians) linked to a group of international experts in the different fields of cancer. They comment on the images that help local stakeholders to make a diagnosis. http://www.ipath-network.com/inctr/

This is an already functional network involving several centres in the following countries:

Senegal, Ivory Coast, Democratic Republic of Congo, Cameroon, Benin, Madagascar, Burkina Faso, Mali, Morocco, Tunisia.

The implementation of techniques to characterize the cells

Immunohistochemistry on cut

Flow cytometry

Chromosome analysis.

The implementation of the complementary techniques necessary for diagnosis is carried out in coordination with cancer therapeutic management projects.

Martine RAPHAEL - Aurore COULOMB - Elisabeth AUBERGER