Global, regional, and national cancer incidence and death for 29 cancer groups in 2019 and trends analysis of the global cancer burden, 1990–2019

Background and aims Cancer will soon become the leading cause of death in every country in the twenty-first century. This study aimed to analyze the mortality and morbidity of 29 types of cancer in 204 countries or regions from 1990 to 2019 to guide global cancer prevention and control. Methods Detailed information for 29 cancer groups was collected from the Global Burden of Disease Study in 2019. The age-standardized incidence rate (ASIR) and age-standardized death rate (ASDR) of the 29 cancer groups were calculated based on sex, age, region, and country. In addition, separate analyses were performed for major cancer types. Results In 2019, more than 10 million people died from cancer, which was approximately twice the number in 1990. Tracheal, bronchus, and lung (TBL) cancers collectively showed the highest death rate, and the ASDR of pancreatic cancer increased by 24%, which was cancer with the highest case fatality rate (CFR). The global cancer ASIR showed an increasing trend, with testicular cancer, thyroid cancer, and malignant skin melanoma showing a significant increase. The ASDR and ASIR of cancer in males were about 1.5 times higher than that in females. Individuals over 50 years had the highest risk of developing cancer, with incidences and deaths in this age group accounting for more than 85% of cancers in all age groups. Asia has the heaviest cancer burden due to its high population density, with esophageal cancer in this region accounting for 53% of the total fatalities related to this type of cancer in the world. In addition, the mortality and morbidity of most cancers increased with the increase in the development or socio-demographic index (SDI) in the SDI regions based on the World Bank's Human Development Index (HDI), with cancer characteristics varying in the different countries globally. Conclusions The global cancer burden continues to increase, with substantial mortality and morbidity differences among the different regions, ages, countries, gender, and cancer types. Effective and locally tailored cancer prevention and control measures are essential in reducing the global cancer burden in the future.

Moving from Offline to Online: Addressing the Cancer Spectrum Through the National Strategic Plan on Cancer Prevention and Control, Sri Lank - 2020-2024

Introduction: Sri Lanka is committed to achieving the global targets at the end of 2025 by a 25% reduction in premature mortality from cancer by intervening from prevention, early detection, treatment palliative care, and surveillance. Current Sri Lankan evidence shows a gradual increase of cancers where many are preventable by risk factor reduction. According to the data of the National Cancer Registry, Sri Lanka in 2019, there were 14,845 (47%) males and 16,989 (53%) females diagnosed with cancer with a total of 31844. One of the recommendations of the imPACT review 2019 was to develop the NSP to achieve quality of life by preventing and control of cancer in Sri Lanka. National Cancer Control Programme, Ministry of Health, Sri Lanka gave the leadership to develop the National Strategic Plan (2020-2024) that provided a direction for the country for cancer prevention and control. Methods: Based on the local and international evidence initial draft was prepared by the NCCP. Feedback was obtained via emails and virtual meetings from all the stakeholders (medical professional colleges, UN organizations, non-government organizations, community-based organizations) due to COVID 19 physical meeting restrictions. This was followed by a series of virtual meetings with the same stakeholders and finalizing the document. Results: The NSP was developed for the year 2020-2024 as a guiding document for Sri Lanka’s response to cancer control and prevention with a vision and a goal to be achieved in cancer prevention and control in the country. This document has laid down seven strategic objectives and seven strategic directions to serve as pillars for the cancer spectrum with a detailed activity plan under each strategic direction. Conclusion and recommendations: The NSP was developed to reduce cancer incidence and mortality via evidence-based strategic objectives of prevention, early detection, diagnosis, treatment and palliation, surveillance, and research with an activity plan. It was recommended to have close monitoring, mid-term and end of five-year reviews to assess its progress.

One view of the next decade of research on behavioral and biobehavioral approaches to cancer prevention and control: intervention optimization

As a new decade begins, we propose that the time is right to reexamine current methods and procedures and look for opportunities to accelerate progress in cancer prevention and control. In this article we offer our view of the next decade of research on behavioral and biobehavioral interventions for cancer prevention and control. We begin by discussing and questioning several implicit conventions. We then briefly introduce an alternative research framework: the multiphase optimization strategy (MOST). MOST, a principled framework for intervention development, optimization, and evaluation, stresses not only intervention effectiveness, but also intervention affordability, scalability, and efficiency. We review some current limitations of MOST along with future directions for methodological work in this area, and suggest some changes in the scientific environment we believe would permit wider adoption of intervention optimization. We propose that wider adoption of intervention optimization would have a positive impact on development and successful implementation of interventions for cancer prevention and control and on intervention science more broadly, including accumulation of a coherent base of knowledge about what works and what does not; establishment of an empirical basis for adaptation of interventions to different settings with different levels and types of resources; and, in the long run, acceleration of progress from Stage 0 to Stage V in the National Institutes of Health Model of Stages of Intervention Development.

Cervical Cancer Prevention and Control

Cervical cancer is caused by HPV (human papilloma virus). It is the second most common cancer in women living low developed countries. The components of cervical cancer prevention and control comprises primary prevention, secondary prevention and tertiary prevention. Primary prevention of cervical cancer encompasses prevention of infection with HPV. Giving HPV vaccine for girls aged 9–14 years before they initiate sexual activity is one of the interventions of primary prevention of cervical cancer. Screening and treatment is needed in secondary prevention of cervical cancer. Screening of cervical cancer encompasses testing a target group (women) who are at risk for a cervical pre-cancer. Tertiary prevention of cervical cancer comprises treatment of cervical cancer and palliative care. The components of tertiary care comprise surgery, radiotherapy, chemotherapy and palliative care. Community mobilization, health education and counseling on cervical cancer prevention and control is vital to make ownership on cervical prevention. Monitoring and evaluation of cervical cancer prevention and control on key program indicators should be done regularly.

Community-Engaged Approaches to Cervical Cancer Prevention and Control in Sub-Saharan Africa: A Scoping Review

Background: Cervical cancer remains one of the top causes of cancer mortality among African women. Cervical cancer screening and early detection and treatment of precancer is one of the evidence-based interventions to reduce incidence and mortality. The application of community-based participatory research (CBPR) has been used in the United States to improve participation in screening and reduce cervical cancer disparities. However, it is unclear whether these engaged approaches have been used in sub-Saharan African to address disparities related to cervical cancer mortality.Objectives: Highlight community engagement in cervical cancer prevention and control in Sub-Saharan Africa (SSA), describe the community engagement efforts that are currently being used, and to describe the best practices for community engagement toward the end-goal of cervical cancer prevention and control.Methods: We searched PubMed, Embase, CINHAL, African Journals Online (AJOL), and African Index Medicus-WHO from inception until June 8, 2020. After screening 620 titles and abstracts, and reviewing 56 full-text articles according to inclusion and exclusion criteria, 9 articles met the selection criteria and were included. Relevant data variables were extracted from the included articles and a narrative synthesis was performed.Results: Between 2005 and 2019, 9 articles describing research in Ghana, Kenya, Zambia, Senegal, South Africa, and Nigeria were included. These articles described work that largely took place in rural settings predominantly among women age 15–65 years. Leveraging community networks such as community health workers, religious organizations, traditional leaders, and educational institutions increased awareness of cervical cancer. Working within existing social structures and training community members through the research effort were promising methods for addressing the disparities in cervical cancer incidence and mortality among communities.Discussion: The findings of this scoping review have contributed to the understanding of which novel approaches to community-based practices can be used to address cervical cancer disparities among SSA communities that carry a disproportionate disease burden. Community engagement in the research process, while effortful, has shown to be beneficial to researchers and to the communities that they serve, and provides valuable next steps in the effort to address cervical cancer disparities in SSA.