Why the time is right to tackle breast and cervical cancer in low-resource settings

Tsu, Vivien; Jerónimo, José; Anderson, Benjamin O.

doi:10.2471/blt.12.116020

Cited by 67 publications

(71 citation statements)

References 35 publications

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“…3 It is the women from poor households, rural areas, and regions with low health care expenditure who are reported to have difficulty utilizing cervical cancer screening. 45, 46 Nygård et al found that nonattendance for cervical screening was associated with economic barriers. 47 Based on all these facts, VIA screening is likely to create health disparities because there are still issues regarding how poor, underserved, and hard-to-reach women access this service.…”

Section: Social Inequalitiesmentioning

confidence: 99%

Cervical cancer screening in Nepal: ethical considerations

Gyawali¹,

Keeling²,

Teijlingen³

et al. 2015

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Cervical cancer is the leading cause of cancer deaths for women worldwide. Cervical screening and early treatment can help to prevent cervical cancers. Cervical screening programs in Nepal are often associated with a number of socioeconomic, cultural, and ethical challenges. This paper discusses some central ethical challenges in providing cervical cancer screening in the Nepalese context and culture. It is necessary to address these challenges for successful implementation of such screening programs.

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Section: Social Inequalitiesmentioning

confidence: 99%

Cervical cancer screening in Nepal: ethical considerations

Gyawali¹,

Keeling²,

Teijlingen³

et al. 2015

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“…In Sub-Saharan Africa, cervical cancer is the most common cause of cancer death in women (23.2% of the total) [3]. Cancer of the breast and cervix kill more women than any other forms of cancer in all low-resource regions of the world [4]. Sixty-two percent (n = 57 318) of women in SubSaharan Africa diagnosed with cervical cancer died compared with 50% (n = 47 583) of women with breast cancer [5].…”

Section: Introductionmentioning

confidence: 99%

Cancer of the cervix: Early detection and cost‐effective solutions

Denny

Prendiville

2015

Intl J Gynecology & Obste

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a b s t r a c t a r t i c l e i n f o Keywords:Cervical cancer Cost-effectiveness HPV HPV DNA testing Secondary prevention Visual inspection with acetic acid Cervical cancer is known to be a preventable disease through the detection of cervical cancer precursors, historically using cytology of the cervix as the primary screening test. Over 85% of cervical cancer cases and deaths occur in low-resource countries. Alternatives to cytology have been investigated with the strongest possibilities being visual inspection with acetic acid (VIA) and HPV DNA testing. HPV DNA testing has been shown in randomized trials to be significantly more sensitive for the detection of cervical cancer precursors than either cytology or VIA. In this paper we argue that prevention really does cost less than cure, or that prevention and treatment of cancer costs less than no prevention, in effect just treatment, of cancer. The true cost savings of prevention will include a more difficult assessment of the socioeconomic savings associated with longer, healthier lives for women in their prime who have a major role in supporting their families.

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“…9,32,33 However, although CBE screening trials are conducted in a number of LMICs (eg. India, Peru, and Vietnam 15,28,34,35 ), these trials currently lack estimates on important screening outcomes. The estimated impact of CBE screening by our model should, therefore, be interpreted carefully.…”

Section: Discussionmentioning

confidence: 99%

Predicting the stage shift as a result of breast cancer screening in low- and middle-income countries: a proof of concept

et al. 2014

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Objective: To provide proof of concept for a simple model to estimate the stage shift as a result of breast cancer screening in low-and middle-income countries (LMICs). Stage shift is an essential early detection indicator and an important proxy for the performance and possible further impact of screening programmes. Our model could help LIMCs to choose appropriate control strategies. Methods: We assessed our model concept in three steps. First, we calculated the proportional performance rates (i.e. index number Z) based on 16 screening rounds of the Nijmegen Screening Program (384,884 screened women). Second, we used linear regression to assess the association between Z and the amount of stage shift observed in the programme. Third, we hypothesized how Z could be used to estimate the stage shift as a result of breast cancer screening in LMICs. Results: Stage shifts can be estimated by the proportional performance rates (Zs) using linear regression. Zs calculated for each screening round are highly associated with the observed stage shifts in the Nijmegen Screening Program (Pearson's R: 0.798, R square: 0.637). Conclusions: Our model can predict the stage shifts in the Nijmegen Screening Program, and could be applied to settings with different characteristics, although it should not be straightforwardly used to estimate the impact on mortality. Further research should investigate the extrapolation of our model to other settings. As stage shift is an essential screening performance indicator, our model could provide important information on the performance of breast cancer screening programmes that LMICs consider implementing.

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Why the time is right to tackle breast and cervical cancer in low-resource settings

Cited by 67 publications

References 35 publications

Cervical cancer screening in Nepal: ethical considerations

Cervical cancer screening in Nepal: ethical considerations

Cancer of the cervix: Early detection and cost‐effective solutions

Predicting the stage shift as a result of breast cancer screening in low- and middle-income countries: a proof of concept

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