Global Response to the Burden of Cancer: The WHO Approach

Author(s):  
Andreas Ullrich ◽  
Anthony Miller

As the burden of many cancer types of major public health relevance worldwide are in part determined by behavioral risks, much of the success of cancer control depends on the up take of prevention strategies at the population level. Over the last decade, the World Health Organization (WHO) has developed global prevention strategies of major relevance for cancer prevention and the prevention of other non-communicable diseases (NCDs), such as the 2003 WHO Framework Convention on Tobacco Control and others. The implementation of these core strategies gained momentum in 2011, when heads of states at the United Nation's (UN) High Level Meeting (HLM) on NCDs declared that NCDs are a global health threat that menaces social and economic development globally and requires urgent action. They asked for a paradigm change of the global health agenda by including NCD prevention and control into the group of priorities set by the Millennium Development Goals. WHO's translation of this call for action by the UN into practice has been consolidated into one clearly defined the WHO Global NCD Action Plan 2013–2020, including the pre-existing prevention strategies. Although cancer risk reduction will profit from the WHO Global NCD Action Plan, comprehensive cancer prevention and control will require other supplementary strategies not included in the plan because they are not shared with other NCDs. Causality of the over 200 cancer types is complex. A myriad of non-behavioral factors such as environmental and infectious risks, require specific attention when planning comprehensive cancer prevention. In reducing the cancer burden globally much will depend on how prevention strategies are implemented and how progress in cancer treatment can be translated into the reality of health systems in less affluent countries.

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 93s-93s
Author(s):  
A. Karagu ◽  
M. Cira ◽  
M. Akhavan ◽  
K. Duncan

Background: Coordination of stakeholders in cancer prevention and control ensures prudent use of available resources toward a common goal while limiting overlaps and redundancies. The National Cancer Institute of Kenya (NCI-K) is a statutory body with an overall mandate to coordinate and centralize all activities related to cancer prevention and control in Kenya. To identify baseline status of cancer control stakeholder activity to guide implementation of the National Cancer Control Strategy, NCI-K collaborated with US National Cancer Institute (NCI-US) to map stakeholders involved in cancer control in Kenya. Aim: The survey set out to determine the geographical distribution, scope of cancer prevention and control activities, and sources of financing for identified stakeholders involved in cancer prevention and control in Kenya. Methods: Between October 2017 and March 2018, we conducted an online survey among stakeholders involved in cancer prevention, research and control in Kenya adapted from similar stakeholder mapping activities coordinated by NCI-US in other settings. Using attendance lists to past multisectoral forums organized by NCI-K, Kenyan Ministry of Health, and NCI-US, a Google link to a standard pretested questionnaire was circulated. Descriptive analysis was conducted using Microsoft Excel. Results: A total of 52 responses were received with 38 respondents reporting Kenya as their institution country. Twenty (38%) had ongoing activities in all the counties in Kenya. Nairobi County had the highest reported number of active institutions (19) followed by Kisumu (16) and Uasin Gishu (10). The three program focus areas most reported were training 28 (54%), clinic-based screening 27 (52%) and advocacy/information and educational 26 (50%), while the least reported was financing 12 (23%). For organizations involved in cancer screening, 22 (81%) focused on breast cancer while 18 (67%) prioritized cervical cancer. Among the programs that identified cancer prevention as one of their focus areas, a large majority (91%) were involved in health education, while only 1 organization focused on environmental control activities. The most reported source of funding for the cancer programs was grant funding 17 (33%). Conclusion: This stakeholder mapping activity has identified a strong stakeholder presence in most parts of the country while also highlighting gaps in the focus of cancer prevention and control programs. This baseline information on stakeholder activity will help shape future collaborations in cancer prevention and control and will guide NCI-K in developing appropriate policies and ensuring effective coordination.


With current situation of increasing burden of cancer in Pakistan, this report reviews studies related to cancer burden and cancer prevention and control in Pakistan. Electronic databases used were PubMed, Medline, EMBASE, the University of Adelaide library & AKU library database, to search for relevant articles on the topic of cancer prevalence in Pakistan published in English. We conducted a literature search of published epidemiological and clinical studies relating to this topic up to March 1st, 2020. There is a dearth of epidemiological studies in cancer risk factors, prevention and control. Most studies are hospital based with small sample sizes and underpowered. Epidemiological integrated transdisciplinary research in collaboration with hospitals is needed to find the actual burden, etiology and feasible prevention strategies of cancer unique to our population with focus on low cost screening methods for early detection of cancers and premalignant lesions in our population. There is an urgent need for a centralized national cancer registry to have combined results of cancer registry from Pakistan Atomic Energy Commission, Karachi Caner Registry, Punjab Cancer Registry and cancer registries from the rest of Pakistan. There is a need to make cancer incidence as notifiable disease mandatory to have the data of cancer incidence in Pakistan. Collaboration is also needed to work with diverse groups like the National Cancer Society of Pakistan (NCSP), National Cancer Control Plan, and Society of Medical Oncology Pakistan to draft and implement plans and strategies for national cancer control programs. It will help mobilize Ministry of Health and policy makers to address the alarming high incidence of different types of cancers in Pakistan.


2019 ◽  
Vol 47 (2) ◽  
pp. 249-257 ◽  
Author(s):  
Kelly D. Blake ◽  
Chan Thai ◽  
Angela Falisi ◽  
Wen-Ying Sylvia Chou ◽  
April Oh ◽  
...  

Background. The use of videos for patient and public health education has been widely adopted and well documented in the literature. Aims. To conduct a systematic review of empirical studies that used video-based interventions for cancer prevention and control to document study designs, settings, approaches, targeted cancer sites and behaviors, and outcomes and to identify gaps in research and practice. Method. PubMed, PsychINFO, CINAHL, SCOPUS, and Web of Science were searched for studies published in the 30-year period from 1984 to 2014. Of 1,521 articles identified, duplicates were removed, and titles and abstracts of 779 were examined for eligibility. In all, 315 articles met the inclusion criteria and were coded by three independent coders. Interrater reliability was assessed. Descriptive frequencies and proportions were calculated. Results. Studies evaluating video interventions for cancer prevention and control have increased over time. The majority used randomized controlled trial designs (54%), followed by single-group pre–posttest designs (18%). Most were delivered in health care settings (39%). Detection (30%) and treatment (16%) were the cancer control continuum stages most frequently addressed, with breast cancer (29%) being the most frequently targeted cancer site. The behavior most commonly targeted was screening/early detection (39%). Topics such as caregiving, coping, palliative care, and end of life were rarely addressed. The majority (69%) reported being successful at achieving their stated objectives, though outcomes varied across studies. Conclusions. Video interventions have been widely utilized for cancer prevention and control, with demonstrated successes. Future research should test innovative designs and new delivery platforms and should include underrepresented topics and cancer sites.


2019 ◽  
pp. 1-6
Author(s):  
Mishka Kohli Cira ◽  
Jo Anne Zujewski ◽  
Allison Dvaladze ◽  
Nathan R. Brand ◽  
Amanda L. Vogel

PURPOSE Comprehensive breast cancer control programs are needed to decrease breast cancer mortality, but few tools exist to assist stakeholders in limited-resource settings. The Knowledge Summaries for Comprehensive Breast Cancer Control (KSBCs) are a series of evidence-based publications intended to support cancer control planning at various resource levels. The goals of this evaluation research study were to learn about the extent to which the KSBCs could be useful to policymakers, health care providers, and breast cancer advocates in Kenya, and whether introducing the KSBCs led to their uptake, and if so, how they were used. METHODS This study used one-on-one interviews, focus groups, and self-administered online surveys. Policymakers were recruited from the Ministry of Health. Providers were recruited from four hospitals in two cities, Nairobi and Eldoret, and one rural municipality, Kijabe. Advocates were recruited from cancer advocacy organizations. RESULTS Twenty individuals participated in the research. They found the KSBCs to be educational reference tools that create a shared planning-related knowledge base among diverse stakeholders. The KSBCs were seen to be applicable to a variety of contexts and stakeholders. CONCLUSION This study found that the KSBCs can be useful as both an educational tool and a convening tool for multistakeholder engagement in breast cancer prevention and control in a variety of settings. Additional engagement with users of the KSBCs can provide more knowledge about how the KSBCs are used and how they contribute to building collaborations across stakeholder groups to strengthen breast cancer prevention and control in low-resource settings.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Taha Nasiri ◽  
Shahram Yazdani ◽  
Lida Shams ◽  
Amirhossein Takian

PurposeNoncommunicable diseases (NCDs) count for over 80% of premature death worldwide. More than 76% of the total burden of diseases in Iran is devoted to NCDs. In line with the World Health Organization action plan, Iran has developed its national action plan that led to establishment of the National Committee for Prevention and Control of NCDs (INCDC), whose aim is 30% mortality reduction attributed to NCDs by 2030. The stewardship of health system is the cornerstone of performing and sustaining meaningful actions toward prevention and control of NCDs. The literature is tiny on how to materialize the stewardship and governance of health system. The purpose of this article is to report the findings of a national study that aimed to identity functions and subfunctions of stewardship of NCDs and its related risk factors in Iran.Design/methodology/approachThis is a qualitative study. The authors conducted interviews with 18 purposefully selected interviewees until the authors reached saturation. Thematic content analysis was used for analysis and MAXQDA 10 was employed for data management. The difficulty of coordinating with interviewers and health policymakers in the field slowed the process of research progress.FindingsThe authors identified seven themes and categorized them as main functions for appropriate stewardship of NCDs in Iran, including intelligence generation; strategic framework; evidence-based policies/decisions; system design; resource allocation/development; capacity-building and enforcement/alignment; and categorized them as important.Practical implicationsThe seven themes presented as stewardship functions include concepts and practical examples of the experiences and performance of leading countries in the field of NCDs control that can help policymakers and health managers for better descion-making.Originality/valueIran adopted its national action plan in 2015 and WHO selected Iran as a fast-track country in 2017. The study confirmed that to achieve the global targets, appropriate and contextual stewardship for any specific setting is fundamental. Iran needs to improve its stewardship for prevention and control of NCDs and implement its national action plan. Therefore, the functions and policies outlined in this article for the proper performance of NCDs can improve more meaningful practices in this area in Iran and many other countries.


2019 ◽  
Vol 45 (3) ◽  
pp. 131-132
Author(s):  
Shah Md Mahfuzur Rahman ◽  
Shah Monir Hossain ◽  
Mahmood Uz Jahan

Noncommunicable diseases (NCDs) are the leading cause of mortality and morbidity, and posing significant challenges both in developed and developing countries including Bangladesh. In 2016, of the total 56.9 million global deaths, 71.0%, were due to NCDs. Some 85.0% of premature deaths from NCDs, are in low and middle income countries, where greater burden of undernutrition and infectious diseases exist.1-3 Evidence suggests a higher age specific mortality for NCDs among Bangladeshi population compared to Western populations, which putting burden on healthcare systems. 4 Bangladesh NCD Risk Factors Survey, 2018 showed that among the adult population, the mean salt intake was 16.5 gram per day and the prevalence of dislipidaemia was 28.4 %.5 Sugar consumption also continues to rise, driven by increased intake of beverages, biscuits, sweets and confectionary items. Industrially produced transfat in some food items is also an important issue in the country. Malnutrition is a key risk factor for NCDs. Globally, nearly one in three people has at least one form of malnutrition, and this will reach one in two by 2025, based on current trends.6-8 All forms of malnutrition are caused by unhealthy, poor quality diets. Unhealthy diets that include high sugar, salt and fat intake, malnutrition, and NCDs are closely linked. Not only on the health, malnutrition and diet related NCDs pose a substantial burden on the economy and development. Food systems worldwide face major challenges, such as population growth, globalisation, urbanisation, and climate change. Today’s food systems are broken and do not deliver nutritious, safe, affordable, and sustainable diets; they undermine nutrition in several ways, particularly for vulnerable and marginalised populations. Billions of dollars are spent annually marketing foods high in calories, fats, sugars, and salt, and intake has increased globally, including in low income countries.8 United Nations (UN) is well committed to prevent and control noncommunicable diseases through adopting series of resolutions in its General Assembly.  In 2013, Member States of the World Health Organization (WHO) resolved to develop and implement national action plans, in line with the Global Action Plan for the Prevention and Control of Noncommunicable Diseases (2013–2020).9 NCDs are also embedded in sustainable development goal (SDG) target 3.4, that is, to reduce by one-third the premature mortality from noncommunicable diseases by 2030. NCDs are also linked to other SDGs, notably SDG 1 to end poverty. In 2017, the WHO Global Conference on Noncommunicable Diseases reaffirmed noncommunicable diseases as a sustainable development priority in the Montevideo roadmap 2018–2030.10 Bangladesh has also developed the Multisectoral Action Plan for Prevention and Control                             of Noncommunicable Diseases 2018-2025, with a three-year operational plan.11 Earlier the country has developed National Nutrition Policy, 2015, Second National Plan of Action for Nutrition, 2016-2025, Dietary Guidelines and other policies, strategies and action plan. The country is putting efforts for the prevention and control of malnutrition and NCDs. Furthermore,  to prevent and control the diet related noncommunicable diseases across the life cycle nutrition labelling, re-formulation of food standards with limiting high sugar, salt and fat, and banning industrial transfats; restriction of food advertising particularly marketing of unhealthy foods to children, imposing tax on sugar sweetened drinks, junk food etc. Aimed at behavior change communication, mass-media campaigns, nutritional advice and nutrition education on NCDs in general and diet related NCDs in particular are thus recommended.


2018 ◽  
pp. 1-9
Author(s):  
Virginia Senkomago ◽  
Rachael Joseph ◽  
Monica Sierra ◽  
Elizabeth Van Dyne ◽  
Meheret Endeshaw ◽  
...  

Cancer is one of the leading causes of morbidity and mortality worldwide. In 2012, there were > 14 million new cancer cases and > 8 million cancer deaths, with 70% of these deaths occurring in low- and middle-income countries (LMICs). Part of the success of cancer prevention and control efforts requires the development and strengthening of the public health workforce, particularly in LMICs where the cancer burden is the greatest. The US Centers for Disease Control and Prevention (CDC) supports workforce capacity development globally through Field Epidemiology Training Programs (FETPs) established in ministries of health in > 70 countries. To enhance training in cancer prevention and control in FETPs, the CDC has developed an open-access curriculum in applied cancer epidemiology and supports FETP trainees who conduct cancer-related planned projects. The curriculum contains modules on cancer registration, screening, and comprehensive cancer control that are particularly relevant to current cancer control efforts in many LMICs. Pilot testing of the curriculum showed an increase in trainees’ cancer knowledge and covered content trainees found to be relevant to their field epidemiology training and projects and future work in cancer prevention and control. Since 2013, the CDC has supported 13 trainees with cancer-related projects; two have published articles, two have presented their results at international conferences, and others are writing manuscripts on their project outcomes. Through the development of an open-access applied cancer epidemiology curriculum and by supporting cancer-related projects for FETP trainees, the CDC provided technical assistance for LMICs to build capacity for cancer prevention and control efforts.


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