Non-communicable diseases (NCDs)
The cancer burden and cancer control in developing countries
Interventions to reduce the cancer burden in developing countries
Authors:
P. Pisani
Publisher:
Envirnomental Health, 2011
Means to monitor the occurrence of cancer in developing countries are still very limited, and prevention planning relies largely on estimates. The present paper summarises some of the priorities in cancer prevention in developing countries and the underlying evidence base, and addresses some of the challenges.
The author draws these conclusions:
- cancer control encompasses a package of diverse interventions aiming at reducing morbidity and mortality from the disease, with wide variations in costs and potential impact.
- any intervention should be kept logistically simple and incorporated into a general plan aiming at building gradually the infrastructure that is necessary to bring care to the population at large.
- under serious budgetary constrains, cancer control programmes need to make wise choices to maximise the efficacy of their investments.
The paper shows the following options for preventions:
- of all possible interventions to reduce the cancer burden, comprehensive programmes to prevent tobacco smoking are the most cost-effective; tobacco prevention should be a priority for all countries.
- immunisation of infants against hepatitis B virus (HBV) is probably the second most cost-effective option in regions where the infection is still endemic.
- prevention of invasive cervix cancer by early detection and timely treatment is to remain an important component of cancer control policies.
- screening for Human Papilloma Virus (HPV) combined with the see-and-treat strategy is an effective intervention requiring limited expenditure.
- concerning breast cancer, improving access to timely treatment of early palpable tumours is likely to result in a greater benefit to the population.
- the uncontrolled use of carcinogens in industrial processes needs to be addressed in any cancer control programme of actions to prevent occupational exposure and environmental contamination.
