Cancer Prevention in Low-Resource Countries: An Overview of the Opportunity

Abstract

Rising trends in the incidence of cancer in low- and middle-income countries (LMICs) add to the existing challenges with communicable and noncommunicable diseases. While breast and colorectal cancer incidence rates are increasing in LMICs, the incidence of cervical cancer shows a mixed trend, with rising incidence rates in China and sub-Saharan Africa and declining trends in the Indian subcontinent and South America. The increasing frequencies of unhealthy lifestyles, notably less physical activity, obesity, tobacco use, and alcohol consumption are causing a threat to health care in LMICs. Also, poorly developed health systems tend to have inadequate resources to implement early detection and adequate basic treatment. Inequalities in social determinants of health, lack of awareness of cancer and preventive care, lack of efficient referral pathways and patient navigation, and nonexistent or inadequate health care funding can lead to advanced disease presentation at diagnosis. This article provides an overview of opportunities to address cancer control in LMICs, with a focus on tobacco control, vaccination for cervical cancer, novel tools to assist with early detection, and screening for breast and other cancers.

The Prevalence and Associated Factors of Cancer Screening Uptake Among a National Population-Based Sample of Adults in Marshall Islands

“…Unadjusted and adjusted (including variables significant p < 0.05 at univariate analysis) logistic regression analyses were used to predict the prevalence of mammography, CBE, Pap smear or VIA, FOBT and colonoscopy. Covariates, based on literature review, 5 , 7 , 12 - 17 , 21 , 22 , 24 , 25 , 28 , 30 included sociodemographic factors, health care utilization, health risk behaviors, cardiovascular disorder, body mass index, and use of traditional medicine for all outcome variables. Explanatory variables are statistically significant at p < 0.05 and are free from multicollinearity as measured by the variance inflation factor (VIF < 1.8).…”

“…Factors associated with cancer screening may include sociodemographic factors, health system factors, health status, and lifestyle factors. 5 , 12 Sociodemographic factors associated with cancer screening uptake include higher socioeconomic position, 7 , 13 - 15 older age, 16 younger age, 17 and urban living. 18 , 19 Health system issues associated with cancer screening uptake include increased access to health care, 20 had health insurance, 18 , 21 having had blood cholesterol test, 22 general health care utilization, 13 , 16 , 17 , 21 and complementary medicine use.…”

Strengthening tobacco control must remain a global health priority

“…Since the full health consequences of smoking are usually delayed by decades, 6 it is likely that the tobacco-associated disease burden will increase in the years to come in such countries, including many MICs and LICs whose health systems might not cope well with this challenge. 7,8 Hence, there is an urgent need to strengthen tobacco control globally. The WHO global report 9 on trends in prevalence of tobacco use in 2000-25 describes the remarkable achievements, but also the shortcomings, in curbing the smoking epidemic following the adoption of the WHO Framework Convention on Tobacco Control in 2003, hence further strengthening the implementation of the convention must remain a global health priority.…”

Cancer Prevention Strategies for Nepal

“…Graphic warning labels on tobacco products have been consistently demonstrated to be effective in promoting quitting smoking, and in reducing initiation, especially with younger people, which situation is very relevant in Nepal (vide supra). [24][25][26] Internationally, we have learned again some key lessons about public health messaging from the Covid pandemic: messages need to be consistent, repeated, and sensitive to equity issues. There are some areas for anti-tobacco messaging which have proven particularly effective (Table 3).…”

“…Four strategies have been significantly successful in reducing tobacco smoking globally: 24 1. Increases in excise taxes on tobacco.…”