scholarly journals Cancer Control in Low- and Middle-Income Countries: Is It Time to Consider Screening?

2019 ◽  
pp. 1-8 ◽  
Author(s):  
Shailja C. Shah ◽  
Violet Kayamba ◽  
Richard M. Peek ◽  
Douglas Heimburger
Keyword(s):  
Sustainable Development ◽  
Early Detection ◽  
Cancer Prevention ◽  
Cancer Control ◽  
Middle Income ◽  
Control Programs ◽  
Middle Income Countries ◽  
Life Years ◽  
Related Mortality ◽  
Low And Middle Income

The rising prevalence of noncommunicable diseases globally, with a strikingly disproportionate increase in prevalence and related mortality in low- and middle-income countries (LMICs), is a major threat to sustainable development. The epidemiologic trend of cancers in LMICs is of particular concern. Despite a lower incidence of cancer in LMICs compared with high-income countries, total cancer-related mortality is significantly higher in LMICs, especially in people younger than 65 years of age. The enormous economic impact of premature mortality and lost productive life years highlights the critical importance of galvanizing cancer prevention and management to achieve sustainable development. The rising burden of cancer in LMICs stresses an already weak health care and economic infrastructure and poses unique challenges. Although the WHO acknowledges that the effective management of cancer relies on early detection, accurate diagnosis, and access to appropriate multimodal therapy, the placement of priority on early detection cannot be assumed to be effective in LMICs, where limited downstream resources may be overwhelmed by the inevitable increases in number of diagnoses. This review discusses several factors and considerations that may compromise the success of cancer control programs in LMICs, particularly if the focus is only on early detection through screening and surveillance. It is intended to guide optimal implementation of cancer control programs by accentuating challenges common in LMICs and by emphasizing the importance of cancer prevention where relevant so that communities and stakeholders can work together to devise optimal means of combatting the growing burden of cancer.

scholarly journals Adoption of Information and Communication Technologies for Early Detection of Breast and Cervical Cancers in Low- and Middle-Income Countries

2016 ◽  
Vol 2 (4) ◽  
pp. 222-234 ◽  
Author(s):  
Jessica M. DiCarlo ◽  
Sricharan Gopakumar ◽  
Preet K. Dhillon ◽  
Suneeta Krishnan
Keyword(s):  
Early Detection ◽  
Cancer Prevention ◽  
Information And Communication Technologies ◽  
Cervical Cancer Prevention ◽  
Primary Data ◽  
Middle Income ◽  
Cervical Cancers ◽  
Middle Income Countries ◽  
Information And Communication ◽  
Low And Middle Income

Purpose In response to the growing burden of breast and cervical cancers, low- and middle-income countries (LMICs) are beginning to implement national cancer prevention programs. We reviewed the literature on information and communication technology (ICT) applications in the prevention of breast and cervical cancers in LMICs to examine their potential to enhance cancer prevention efforts. Methods Ten databases of peer-reviewed and gray literature were searched using an automated strategy for English-language articles on the use of mobile health (mHealth) and telemedicine in breast and cervical cancer prevention (screening and early detection) published between 2005 and 2015. Articles that described the rationale for using these ICTs and/or implementation experiences (successes, challenges, and outcomes) were reviewed. Bibliographies of articles that matched the eligibility criteria were reviewed to identify additional relevant references. Results Of the initial 285 citations identified, eight met the inclusion criteria. Of these, four used primary data, two were overviews of ICT applications, and two were commentaries. Articles described the potential for mHealth and telemedicine to address both demand- and supply-side challenges to cancer prevention, such as awareness, access, and cost, in LMICs. However, there was a dearth of evidence to support these hypotheses. Conclusion This review indicates that there are few publications that reflect specifically on the role of mHealth and telemedicine in cancer prevention and even fewer that describe or evaluate interventions. Although articles suggest that mHealth and telemedicine can enhance the implementation and use of cancer prevention interventions, more evidence is needed.

scholarly journals An Observational Study Framework to Assess Breast Cancer Control Policy Needs in Low- and Middle-Income Countries

2018 ◽  
Vol 4 (Supplement 3) ◽  
pp. 46s-46s
Author(s):  
Ethan Thayumanavan ◽  
Catherine Duggan ◽  
Barri M. Blauvelt
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Health Outcomes ◽  
Cancer Control ◽  
Control Policy ◽  
Middle Income ◽  
Control Programs ◽  
Middle Income Countries ◽  
Breast Cancer Control ◽  
Low And Middle Income

Purpose Women with breast cancer in low- and middle-income countries (LMICs) have worse health outcomes than their counterparts in high-income countries (HICs). Improved outcomes in HICs are attributable to more rigorous breast cancer control policies, implementation of evidence-based guidelines, and greater national investment in health care. In resource-limited settings, identifying the most effective resource-appropriate policies can be a challenge. The proposed study will provide a framework to identify unmet breast cancer policy and infrastructure needs in LMICs and will aid in the prioritization of key elements of successful breast cancer control programs. Building on previous work, we will develop a framework for policy analysis and conduct a breast cancer policy needs assessment through a comparative analysis of attitudes and preferences for breast cancer control elements in 30 countries. Methods The proposed observational survey-based study will measure and compare attitudes and preferences for breast cancer control across 24 LMICs and six reference HICs from across the six WHO regions, stratifying countries by health care spending and mortality-to-incidence ratios. This study will be a cross-sectional survey of medical, policy, and advocacy experts in breast cancer from each of the selected countries. Research will be conducted in three phases. First, we will conduct key informant interviews of international breast cancer experts. Then we will develop and pilot a survey tool. Finally, we will conduct the full survey in countries. The study will use analysis of variance, conjoint analysis, and best-worst scaling to analyze survey results. Results This study will assess current breast cancer control needs, prioritize elements of a comprehensive breast cancer control plan, and determine attitudes about the potential of emerging technologies to improve breast cancer control. Conclusion This study will facilitate the improvement of health outcomes for women with breast cancer by assessing the specific unmet breast cancer policy and infrastructure needs in LMICs and prioritizing elements to improve breast cancer control programs. The study thus provides a resource-appropriate framework to improve breast cancer control policy, reform, and implementation. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Barri M. Blauvelt Stock or Other Ownership: AstraZeneca, Biogen, Celgene, Ecolab, Elite Pharmaceuticals Consulting or Advisory Role: Boehringer Ingelheim, Novartis

scholarly journals Cancer Control in Low- and Middle-Income Countries

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 153s-153s
Author(s):  
F. Humura
Keyword(s):  
Sustainable Development ◽  
Developing Countries ◽  
Health Services ◽  
Sustainable Development Goals ◽  
Cancer Control ◽  
High Quality ◽  
Middle Income ◽  
Middle Income Countries ◽  
Development Goals ◽  
Low And Middle Income

Background: Cancer is also referred to as malignant tumor or neoplasm. It is one of the leading causes of death on the global scale. The knowledge and tools to manage and even cure cancer patients exist in developed countries but are unavailable to many who live in the developing world, resulting in unnecessary loss of life. Strategies are needed to close the gap between developed and developing countries in cancer survival and the effects of the disease on human suffering. It is also pertinent to bridge the gap to ensure universal health coverage which is very important to achieve the sustainable development goals. Aim: The aim of this abstract is to review the barrier to cancer control in developing world especially the low-and middle-income countries. Method: Selected papers amounting to 79 papers in PubMed from 2007 to 2017 were used from peer-reviewed literature and relevant publicly available documents with the appropriate keywords searched. Results: In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries and also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. Cancer is low or absent on the health agendas of low- and middle-income countries (LMCs) despite the fact that more people die of cancer in these countries than from AIDS and malaria combined. International health organizations, bilateral aid agencies, and major foundations which are instrumental in setting health priorities also have largely ignored cancer in these countries. Conclusion: and recommendations: There is an urgent need to improve health services for cancer control in developing countries to ensure health equity which is one of the key areas to be addressed in other to achieve sustainable development goals. Current resources and much-needed investments must be optimally managed. To achieve this, recommended investment should be focused in the following key priorities: capacity building in oncology health services research, policy and planning relevant to developing countries, development of high-quality health data sources, more oncology-related economic evaluations in developing countries, exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international collaboration as well as political leadership. Horizontal integration with programs for other diseases will be important.

scholarly journals The Programme of Action for Cancer Therapy of the International Atomic Energy Agency, the Islamic Development Bank, and the Organization of Islamic Cooperation

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 186s-186s
Author(s):  
B. Akinwande ◽  
A. Nitzsche
Keyword(s):  
Cancer Control ◽  
Comprehensive Cancer Control ◽  
Development Bank ◽  
Energy Agency ◽  
Member States ◽  
Middle Income ◽  
Control Programs ◽  
Middle Income Countries ◽  
National Governments ◽  
Low And Middle Income

Amount raised: Background and context: International financial institutions (IFIs), including the Islamic Development Bank (IDB), the World Bank Group, multilateral and regional development banks, have played a major role in the social and economic development of low- and middle-income countries. In addition to policy expertise, economic analysis and knowledge products, IFIs provide considerable financial resources to national governments to tackle a wide range of health challenges. Intergovernmental organizations like the Organization of Islamic Cooperation (OIC) are providing critical support to advance the socioeconomic development of its member states as well. While there have been some collaborative initiatives to work with national governments to address the growing cancer crisis, more could still be done. With the aim of building a coalition of global partners committed to addressing the growing cancer crisis in low- and middle-income member states, the International Atomic Energy Agency (IAEA) approached Islamic Development Bank (IDB) and OIC to highlight the lack of access to effective and sustainable radiotherapy in these member states and to explore potential opportunities to jointly assist member states in their efforts to improve cancer control and expand their radiation medicine services. In 2016, the IAEA, the IDB and the OIC formalized their collaboration through the signing of practical arrangements which encompass technical support, resource mobilization and the implementation of joint activities in comprehensive cancer control in common member states. As the international community acknowledges the increasing global cancer burden and includes an NCD-related target in the sustainable development goals, it is imperative for national governments, multilateral and intergovernmental organizations, including IFIs, to work together if the target is to be met. Aim: To share the experiences of the IAEA-IDB-OIC collaboration and its results so far to provide national decision makers and cancer specialists with a framework to engage a variety of critical international players in their fight against cancer. Strategy/Tactics: IAEA-OIC-IDB practical arrangements on cooperation in the area of comprehensive cancer control in common member states. Program process: Bringing IFIs and low- and middle-income member states together to review their financing needs for the implementation of priority interventions in national cancer control programs and to identify resource mobilization opportunities. Costs and returns: Member states cancer control programs funded by the Islamic Development Bank, and potentially, by other IFIs. What was learned: As the international community acknowledges the rising global cancer burden IFIs have increased their interest in working with governments in low- and middle-income countries to fight cancer. It is important for these countries to seize the opportunities provided by this new development.

scholarly journals Toward Model-Generated Household Listing in Low- and Middle-Income Countries Using Deep Learning

2018 ◽  
Vol 7 (11) ◽  
pp. 448 ◽  
Author(s):  
Robert Chew ◽  
Kasey Jones ◽  
Jennifer Unangst ◽  
James Cajka ◽  
Justine Allpress ◽  
...  
Keyword(s):  
Sustainable Development ◽  
Object Detection ◽  
Household Surveys ◽  
Building Structures ◽  
Middle Income ◽  
The Sustainable Development ◽  
Detection Model ◽  
Middle Income Countries ◽  
Development Goals ◽  
Low And Middle Income

While governments, researchers, and NGOs are exploring ways to leverage big data sources for sustainable development, household surveys are still a critical source of information for dozens of the 232 indicators for the Sustainable Development Goals (SDGs) in low- and middle-income countries (LMICs). Though some countries’ statistical agencies maintain databases of persons or households for sampling, conducting household surveys in LMICs is complicated due to incomplete, outdated, or inaccurate sampling frames. As a means to develop or update household listings in LMICs, this paper explores the use of machine learning models to detect and enumerate building structures directly from satellite imagery in the Kaduna state of Nigeria. Specifically, an object detection model was used to identify and locate buildings in satellite images. In the test set, the model attained a mean average precision (mAP) of 0.48 for detecting structures, with relatively higher values in areas with lower building density (mAP = 0.65). Furthermore, when model predictions were compared against recent household listings from fieldwork in Nigeria, the predictions showed high correlation with household coverage (Pearson = 0.70; Spearman = 0.81). With the need to produce comparable, scalable SDG indicators, this case study explores the feasibility and challenges of using object detection models to help develop timely enumerated household lists in LMICs.

Maternal morbidity

2018 ◽  
pp. 112-116
Author(s):  
Mary McCauley ◽  
Nynke van den Broek
Keyword(s):  
Sustainable Development ◽  
Maternal Health ◽  
Maternal Mortality ◽  
Maternal Morbidity ◽  
Reproductive Age ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health And Wellbeing ◽  
Development Goals ◽  
Low And Middle Income

Maternal morbidity describes complications that have a significant effect on women during and after pregnancy, and are a leading cause of ill-health among women of reproductive age, especially in low- and middle-income countries. With the introduction of the new Sustainable Development Goals, the scope of global maternal health targets has been expanded, moving from a focus on preventing maternal mortality to formulating targets and emphasising the importance of maternal health and wellbeing. This chapter introduces the new concept of maternal morbidity, suggests how this relates to maternal mortality, and summarises what is known about the burden of maternal morbidity globally and what interventions and research are needed to improve maternal health during and after pregnancy, with an emphasis on the context of low- and middle-income countries.

Cancer control-planning and monitoring population-based systems

2009 ◽  
Vol 95 (5) ◽  
pp. 568-578 ◽  
Author(s):  
Joe B Harford ◽  
Brenda K Edwards ◽  
Ambakumar Nandakumar ◽  
Paul Ndom ◽  
Riccardo Capocaccia ◽  
...  
Keyword(s):  
Cancer Control ◽  
Population Based ◽  
Middle Income ◽  
Cancer Risk Factors ◽  
Middle Income Countries ◽  
Care Services ◽  
Aging Populations ◽  
Global Health Issue ◽  
Palliative Care Services ◽  
Low And Middle Income

Cancer is a growing global health issue, and many countries are ill-prepared to deal with their current cancer burden let alone the increased burden looming on the horizon. Growing and aging populations are projected to result in dramatic increases in cancer cases and cancer deaths particularly in low- and middle-income countries. It is imperative that planning begin now to deal not only with those cancers already occurring but also with the larger numbers expected in the future. Unfortunately, such planning is hampered, because the magnitude of the burden of cancer in many countries is poorly understood owing to lack of surveillance and monitoring systems for cancer risk factors and for the documentation of cancer incidence, survival and mortality. Moreover, the human resources needed to fight cancer effectively are often limited or lacking. Cancer diagnosis and cancer care services are also inadequate in low-and middle-income countries. Late-stage presentation of cancers is very common in these settings resulting in less potential for cure and more need for symptom management. Palliative care services are grossly inadequate in low- and middle-income countries, and many cancer patients die unnecessarily painful deaths. Many of the challenges faced by low- and middle-income countries have been at least partially addressed by higher income countries. Experiences from around the world are reviewed to highlight the issues and showcase some possible solutions.

scholarly journals Early Detection of CKD: Implications for Low-Income, Middle-Income, and High-Income Countries

2020 ◽  
Vol 31 (9) ◽  
pp. 1931-1940 ◽  
Author(s):  
Marcello Tonelli ◽  
James A. Dickinson
Keyword(s):  
Early Detection ◽  
Low Income ◽  
Population Based ◽  
Case Finding ◽  
High Income ◽  
Opportunity Costs ◽  
Middle Income ◽  
Middle Income Countries ◽  
Use Of Resources ◽  
Low And Middle Income

CKD is common, costly, and associated with adverse health outcomes. Because inexpensive treatments can slow the rate of kidney function loss, and because CKD is asymptomatic until its later stages, the idea of early detection of CKD to improve outcomes ignites enthusiasm, especially in low- and middle-income countries where renal replacement is often unavailable or unaffordable. Available data and prior experience suggest that the benefits of population-based screening for CKD are uncertain; that there is potential for harms; that screening is not a wise use of resources, even in high-income countries; and that screening has substantial opportunity costs in low- and middle-income countries that offset its hypothesized benefits. In contrast, some of the factors that diminish the value of population-based screening (such as markedly higher prevalence of CKD in people with diabetes, hypertension, and cardiovascular disease, as well as high preexisting use of kidney testing in such patients) substantially increase the appeal of searching for CKD in people with known kidney risk factors (case finding) in high-income countries as well as in low- and middle-income countries. For both screening and case finding, detection of new cases is the easiest component; the real challenge is ensuring appropriate management for a chronic disease, usually for years or even decades. This review compares and contrasts the benefits, harms, and opportunity costs associated with these two approaches to early detection of CKD. We also suggest criteria (discussed separately for high-income countries and for low- and middle-income countries) to use in assessing when countries should consider case finding versus when they should consider foregoing systematic attempts at early detection and focus on management of known cases.

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