Breast and Cervical Cancer Screening and Treatment in Low and Middle-Income Countries
Abstract
Cancer is a leading cause of death worldwide, with approximately 14 million new cases and over 8 million deaths occurring in 2012. The majority of cases occur in low and middle-income countries (LMICs), where over 70 percent of all cancer related deaths take place. Breast and cervical cancers are the leading causes of cancer-related mortality among females globally. In 2012, there were approximately 1.7 million cases of breast cancer and over 500,000 deaths due to the disease. While mortality rates have been decreasing in high-income countries, the opposite is true for LMICs due to limited access to adequate detection and treatment methods. Cervical cancer is the third leading cause of cancer-related mortality and the single biggest cause of years of life lost to cancer in LMICs. In 2012, there were approximately 528,000 cases of cervical cancer and 266,000 cervical cancer-related deaths worldwide. It is estimated that greater than 80 percent of all cervical cancers occur in LMICs, where high-coverage screening has yet to be successfully implemented. In light of increasing population growth and aging in the coming decades, developing sustainable national cancer programs is crucial. Cancer management is multifaceted, with prevention, early detection, education and engagement, and adequate treatment at the forefront of care. In LMICs, weak healthcare systems with low resources make establishing sustainable cancer care models difficult. We review the components of a comprehensive breast and cervical cancer program and describe the experiences of others in building cancer capacity in LMICs. We also reflect on our own experiences in Haiti targeting breast and cervical cancer through prevention, early detection, diagnostic pathology, treatment and cancer awareness and engagement.
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Stewart BW. World Cancer Report 2014. Lyon, France, 2014.
Torre LA, Siegel RL, Ward EM, Jemal A. Global Cancer Incidence and Mortality Rates and Trends--An Update. Cancer Epidemiol Biomarkers Prev 2016; 25(1): 16-27.
Bray F, McCarron P, Parkin DM. The changing global patterns of female breast cancer incidence and mortality. Breast Cancer Res 2004; 6(6): 229-39.
Gomez A, DeGennaro Jr. V, George S, et al. Abstract C55: Presentation, treatment, and outcomes of Haitian women with breast cancer in Miami and Haiti: Disparities in breast cancer. A retrospective cohort study. Cancer Epidemiology, Biomarkers & Prevention 2016; 25.
Agosti JM, Goldie SJ. Introducing HPV vaccine in developing countries--key challenges and issues. N Engl J Med 2007; 356(19): 1908-10.
Kitchener HC, Castle PE, Cox JT. Chapter 7: Achievements and limitations of cervical cytology screening. Vaccine 2006; 24 Suppl 3: S3/63-70.
Goldie SJ, O'Shea M, Campos NG, Diaz M, Sweet S, Kim SY. Health and economic outcomes of HPV 16,18 vaccination in 72 GAVI-eligible countries. Vaccine 2008; 26(32): 4080-93.
Rijkaart DC, Berkhof J, Rozendaal L, et al. Human papillomavirus testing for the detection of high-grade cervical intraepithelial neoplasia and cancer: final results of the POBASCAM randomised controlled trial. Lancet Oncol 2012; 13(1): 78-88.
Castle PE, Glass AG, Rush BB, et al. Clinical human papillomavirus detection forecasts cervical cancer risk in women over 18 years of follow-up. J Clin Oncol 2012; 30(25): 3044-50.
Dillner J, Rebolj M, Birembaut P, et al. Long term predictive values of cytology and human papillomavirus testing in cervical cancer screening: joint European cohort study. BMJ 2008; 337: a1754.
Katki HA, Kinney WK, Fetterman B, et al. Cervical cancer risk for women undergoing concurrent testing for human papillomavirus and cervical cytology: a population-based study in routine clinical practice. Lancet Oncol 2011; 12(7): 663-72.
Ronco G, Dillner J, Elfström KM, et al. Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomised controlled trials. Lancet 2014; 383(9916): 524-32.
Sankaranarayanan R, Nene BM, Shastri SS, et al. HPV screening for cervical cancer in rural India. N Engl J Med 2009; 360(14): 1385-94.
Bansil P, Wittet S, Lim JL, Winkler JL, Paul P, Jeronimo J. Acceptability of self-collection sampling for HPV-DNA testing in low-resource settings: a mixed methods approach. BMC Public Health 2014; 14: 596.
Arbyn M, Verdoodt F, Snijders PJ, et al. Accuracy of human papillomavirus testing on self-collected versus clinician-collected samples: a meta-analysis. Lancet Oncol 2014; 15(2): 172-83.
Arbyn M, Castle PE. Offering Self-Sampling Kits for HPV Testing to Reach Women Who Do Not Attend in the Regular Cervical Cancer Screening Program. Cancer Epidemiol Biomarkers Prev 2015; 24(5): 769-72.
Organization WH. Guidelines for screening and treatment of precancerous lesions for cervical cancer prevention, 2013.
Denny L, Kuhn L, Hu CC, Tsai WY, Wright TC. Human papillomavirus-based cervical cancer prevention: long-term results of a randomized screening trial. J Natl Cancer Inst 2010; 102(20): 1557-67.
Yip CH, Smith RA, Anderson BO, et al. Guideline implementation for breast healthcare in low- and middle-income countries: early detection resource allocation. Cancer 2008; 113(8 Suppl): 2244-56.
Anderson BO, Cazap E, El Saghir NS, et al. Optimisation of breast cancer management in low-resource and middle-resource countries: executive summary of the Breast Health Global Initiative consensus, 2010. Lancet Oncol 2011; 12(4): 387-98.
Koroltchouk V, Stanley K, Stjernswärd J. The control of breast cancer. A World Health Organization perspective. Cancer 1990; 65(12): 2803-10.
Glanz K, Rimer B, Viswanath K. Health Behavior and Health Education: Theory, Research, and Practice. 4 ed. San Francisco, CA: Jossey-Bass; 2008. p. 46-61.
Jerome G, Ivers LC. Community health workers in health systems strengthening: a qualitative evaluation from rural Haiti. AIDS 2010; 24 Suppl 1: S67-72.
Kok MC, Namakhoma I, Nyirenda L, et al. Health surveillance assistants as intermediates between the community and health sector in Malawi: exploring how relationships influence performance. BMC Health Serv Res 2016; 16(1): 164.
Meyers DJ, Ozonoff A, Baruwal A, et al. Combining Healthcare-Based and Participatory Approaches to Surveillance: Trends in Diarrheal and Respiratory Conditions Collected by a Mobile Phone System by Community Health Workers in Rural Nepal. PLoS One 2016; 11(4): e0152738.
Rachlis B, Naanyu V, Wachira J, et al. Community Perceptions of Community Health Workers (CHWs) and Their Roles in Management for HIV, Tuberculosis and Hypertension in Western Kenya. PLoS One 2016; 11(2): e0149412.
O'Neil DS, Lam WC, Nyirangirimana P, et al. Evaluation of care access and hypertension control in a community health worker driven non-communicable disease programme in rural Uganda: the chronic disease in the community project. Health Policy Plan 2016.
Global Education and Training Initiative (GETI). 2015.
(UICC) UfICC. UWOCASO- SPARC MBC Challenge Grant Awardee. YouTube; 2016.
(UICC) UfICC, Pfizer. IECAS- SPARC MBC Challenge Grant Awardee. YouTube; 2016.
Canada GC. HOPE- Human Papillomavirus screening to improve women's life. 2014.
http://www.grandchallenges.ca/grantee-stars/0686-01-10/.
DeGennaro Jr V, Majid S. Innovating Health International; 2013.
DeGennaro Jr V, Libby R, Patberg E, et al. Development of a breast cancer treatment program in Port-au-Prince, Haiti: Experiences from the field. Journal of Global Oncology 2015; 2(1): 9-14.
Adesunkanmi AR, Lawal OO, Adelusola KA, Durosimi MA. The severity, outcome and challenges of breast cancer in Nigeria. Breast 2006; 15(3): 399-409.
Coughlin SS, Ekwueme DU. Breast cancer as a global health concern. Cancer Epidemiol 2009; 33(5): 315-8.
Pace LE, Mpunga T, Hategekimana V, et al. Delays in Breast Cancer Presentation and Diagnosis at Two Rural Cancer Referral Centers in Rwanda. Oncologist 2015; 20(7): 780-8.
Control UfIC, Pfizer. Project Medishare for Haiti-SPARC MBC Challenge Grant Awardee. YouTube; 2015.
Tillyard G, Surena G, Cornely J, Alcindort M, DeGennaro Jr V. Building a community-based awareness and engagement network around breast cancer in Haiti. 2016.
Gopal S, Krysiak R, Liomba G. Building a pathology laboratory in Malawi. Lancet Oncol 2013; 14(4): 291-2.
Mpunga T, Tapela N, Hedt-Gauthier BL, et al. Diagnosis of cancer in rural Rwanda: early outcomes of a phased approach to implement anatomic pathology services in resource-limited settings. Am J Clin Pathol 2014; 142(4): 541-5.
Gopal S, Krysiak R, Liomba NG, et al. Early experience after developing a pathology laboratory in Malawi, with emphasis on cancer diagnoses. PLoS One 2013; 8(8): e70361.
Farmer P, Frenk J, Knaul FM, et al. Expansion of cancer care and control in countries of low and middle income: a call to action. Lancet 2010; 376(9747): 1186-93.
Hoyler M, Finlayson SR, McClain CD, Meara JG, Hagander L. Shortage of doctors, shortage of data: a review of the global surgery, obstetrics, and anesthesia workforce literature. World J Surg 2014; 38(2): 269-80.
DeGennaro V, DeGennaro VA, Bitar M, Bitar J, Thaller S. Building Advanced Surgical Capacity at a Hospital in Port-au-Prince, Haiti. J Craniofac Surg 2015; 26(4): 1042-7.
Atun R, Jaffray DA, Barton MB, et al. Expanding global access to radiotherapy. Lancet Oncol 2015; 16(10): 1153-86.
Uganda's radiotherapy machine for cancer treatment breaks. BBC, 2016. (accessed.
De Lima L, Pastrana T, Radbruch L, Wenk R. Cross-sectional pilot study to monitor the availability, dispensed prices, and affordability of opioids around the globe. J Pain Symptom Manage 2014; 48(4): 649-59.e1.
Downing J, Leng M, Grant L. Implementing a Palliative Care Nurse Leadership Fellowship Program in Uganda. Oncol Nurs Forum 2016; 43(3): 395-8.
DOI: http://dx.doi.org/10.18103/imr.v2i9.128
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