Breast Cancer Initiative 2.5 (BCI2.5): A Global Campaign to Reduce Disparities in Breast Cancer Outcomes

20 Aim: Breast Cancer Initiative 2.5 (BCI2.5) is a global campaign to reduce disparities in breast cancer outcomes for 2.5 million women by 2025. About BCI2.5: BCI2.5 represents a new commitment to unite the global breast cancer community behind a common goal to make breast health a global priority and reduce disparities in breast cancer outcomes worldwide. The initiative began as a call for action in 2014, supported by the American Cancer Society, Susan G. Komen and UICC. Since that initial pledge, BCI2.5 has been engaging partners around the world, assessing need, identifying priorities and defining a strategy to meet this goal. Its consensus-based approach empowers regional champions to bring about change with the aid of BCI2.5 analytic, assessment and planning tools, educational materials and implementation science research methodology. BCI2.5 delivers evidence-based technical expertise and a resource-stratified approach to improving breast health services and care at any resource level. The initiative is inclusive and encourages organizations, institutions and countries to connect and join the effort. Why BCI2.5: Breast cancer is the most prevalent cancer in women worldwide. Estimates suggest that 5.8 million women will die from breast cancer by 2025, with a disproportionate number of these deaths occurring in low-resource settings. Higher breast cancer case fatality rates in low-resource settings have been attributed to a lack of awareness regarding the benefits of early detection and treatment, late stage diagnosis and limited access to appropriate care. To reduce this global disparity in breast cancer outcomes for 2.5 million women by 2025, BCI2.5 is exploring innovative ways to implement affordable, appropriate, acceptable and feasible evidence-based strategies. A key element of this initiative is identifying, documenting and fostering dissemination of new and innovative approaches to the delivery of breast health care developed in low-resource settings. This demands a collaborative effort that draws on the collective expertise and resources of individuals and institutions engaged in breast cancer care. The BCI2.5 Strategy: The BCI2.5 strategy consists of the following: Outreach. BCI2.5 engages regional alliances, organizations, experts and advocates to assess specific needs and to determine how BCI2.5 technical expertise can be leveraged most effectively. Tools, innovation and information. Tools. BCI2.5 is developing situation analyses tools to aid countries in assessing need and identifying bottlenecks in breast health care delivery. BCI2.5 is also developing models to estimate the impact of providing early diagnosis and treatment interventions in different resource settings. These models will assist in determining the most effective and appropriate interventions given available resources. Innovation. BCI2.5 seeks to support innovative approaches to addressing breast health care in low-resource settings by linking partners and developing a library of case studies featuring innovative evidence-based approaches to breast health care in different resource settings and facilitating their dissemination. Information. BCI2.5 is building an online library featuring Knowledge Summaries, Case Studies and other educational resources. Global Breast Health Analytics Map (GloBAM). GloBAM is an interactive data visualization tool for analyzing the determinants of the global breast cancer burden. GloBAM provides a means for linking data on breast cancer incidence and mortality, health spending, cancer policies and practices, determinants of health and more by country. It is vital to mapping health system resource levels, identifying gaps in breast health care and shaping resource-appropriate solutions. Situation Analyses. BCI2.5 is supporting baseline assessments and situation analyses utilizing the BCI2.5 self-assessment tools, Global Breast Health Analytics Map (GloBAM), stakeholder mapping, focus groups and other methods as appropriate. Breast Cancer Action Plans (BCAP). Through a collaborative process BCI2.5 supports partners and multidisciplinary teams in developing resource-appropriate action plans to assist countries in the decision-making process and outline next steps in implementing improvements in breast health care. BCI2.5 Master Courses. BCI2.5 is developing modular online curriculum units using the above mentioned tools and resources for advocates, policy makers and clinicians. Technical Assistance and Implementation Research. BCI2.5 works collaboratively with partner organizations and countries to facilitate implementation of evidence-based breast health care programs for scale-up, and develop metrics and implementation science methodology to evaluate plan implementation, and to assess systems-based outcomes. BCI2.5 Master Courses. BCI2.5 is developing modular curriculum units using the above mentioned tools and resources. Courses will target advocates, policy makers and clinicians. Materials will be available online via the BCI2.5 website. Technical Assistance and Implementation Research. BCI2.5 works collaboratively with partner organizations and countries to facilitate implementation of evidence-based breast health care programs for scale-up, and develop metrics and implementation science methodology to evaluate, to plan implementation, and to assess systems-based outcomes. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: Allison Dvaladze Travel, Accommodations, Expenses: Roche Catherine Duggan No relationship to disclose Julie R. Gralow Consulting or Advisory Role: Novartis, Roche, Pfizer Benjamin O. Anderson Research Funding: Pfizer, Roche