Excerpt

The National Cancer Institute and the American Cancer Society—two organizations that have recognized the need to raise awareness about and take action against cancer in low- and middle-income countries (LMCs)—asked the Institute of Medicine to conduct this study and provided the funding for it. The report calls for governments, health professionals, nongovernmental organizations (NGOs), and others in LMCs, with the help of the global health community, to achieve a better understanding of the current and future burden of cancer in LMCs and to take appropriate and feasible next steps in cancer control. Steps taken now—particularly in prevention—will be rewarded by curbing the growth in cancer rates. Steps taken toward establishing effective cancer diagnosis and treatment (i.e., cancer management), even if modest, can act as a nucleus from which development can grow.

Contents

• The National Academies
• Committee on Cancer Control in Low- and Middle-Income Countries
• Board on Global Health
• Reviewers
• Preface
• Project Consultants and Commissioned Authors
• Summary
  • CANCER IN LOW- AND MIDDLE-INCOME COUNTRIES
  • NEXT STEPS IN CANCER CONTROL
  • OPPORTUNITIES FOR CANCER CONTROL IN LMCs
• 1. Introduction
  • REASONS FOR OPTIMISM
  • CANCER AND OTHER CHRONIC DISEASES
  • LOW- AND MIDDLE-INCOME COUNTRIES DEFINED
  • INTENT OF THIS REPORT
  • FRAMEWORK OF THE REPORT
  • REFERENCES
• 2. Cancer Causes and Risk Factors and the Elements of Cancer Control
  • CAUSES OF AND RISK FACTORS FOR CANCER IN LMCS
  • BASIC ELEMENTS OF CANCER CONTROL
  • SUMMARY AND RECOMMENDATION
  • REFERENCES
• 3. The Cancer Burden in Low- and Middle-Income Countries and How It Is Measured
  • WORLDWIDE CHANGES IN MORTALITY PATTERNS
  • BASIC CANCER STATISTICS
  • CANCER TRENDS AND CURRENT STATUS OF COMMON CANCERS
  • HOW THE CANCER BURDEN IN LMCS IS ESTIMATED
  • SUMMARY AND RECOMMENDATIONS
  • REFERENCES
• 4. Defining Resource-Level-Appropriate Cancer Control
  • CONSIDERATIONS FOR RESOURCE-LEVEL APPROPRIATENESS
  • THE BREAST HEALTH GLOBAL INITIATIVE: A BLUEPRINT FOR DEVELOPING RESOURCE-LEVEL-APPROPRIATE INTERVENTIONS
  • GUIDELINE DEVELOPMENT FOR LIMITED-RESOURCE SETTINGS: SPECIAL CONSIDERATIONS REGARDING BREAST CANCER
  • THE GLOBAL PARTNERSHIP UNDERLYING THE BHGI
  • LESSONS FROM THE BHGI MODEL FOR OTHER CANCERS
  • APPLYING THE BHGI MODEL TO OTHER CANCERS
  • PRIORITIZING CANCERS FOR GUIDELINE DEVELOPMENT IN LIMITED-RESOURCE COUNTRIES
  • DISCUSSION AND RECOMMENDATION
  • REFERENCES
• 5. Preventing Cancers (and Other Diseases) by Reducing Tobacco Use
  • PREVALENCE AND EFFECTS OF SMOKING
  • THE FRAMEWORK CONVENTION ON TOBACCO CONTROL
  • INTERVENTIONS TO PREVENT SMOKING
  • SUMMARY AND RECOMMENDATIONS
  • REFERENCES
• 6. Compelling Opportunities in Global Cancer Control
  • REDOUBLED EFFORTS TO INCREASE THE UPTAKE OF HEPATITIS B VACCINATION
  • REDUCING THE TOLL OF CERVICAL CANCER IN LMCS
  • HPV VACCINES
  • SAVING CHILDREN WITH CANCER
  • SUMMARY AND RECOMMENDATIONS
  • REFERENCES
• 7. Palliative Care
  • STATUS OF PALLIATIVE CARE IN AFRICA
  • PAIN AND PALLIATIVE CARE
  • INTERVENTIONS FOR PAIN RELIEF
  • ADEQUACY OF AND BARRIERS TO PAIN CONTROL IN LMCS
  • IMPROVING PALLIATIVE CARE IN LMCS
  • PROGRESS IN PAIN CONTROL IN ROMANIA: A CASE EXAMPLE
  • DISCUSSION AND RECOMMENDATIONS
  • REFERENCES
• 8. Cancer Centers in Low- and Middle-Income Countries
  • DEFINITION OF A CANCER CENTER
  • CANCER CENTERS IN LMCS
  • DISCUSSION
  • SUMMARY AND RECOMMENDATIONS
  • REFERENCES
• 9. Advocacy for Cancer Control
  • AN UMBRELLA FOR ADVOCACY: THE INTERNATIONAL UNION AGAINST CANCER
  • THE AMERICAN CANCER SOCIETY
  • CURRENT STATUS OF CANCER ADVOCACY IN LMCS
  • ROLE OF THE GLOBAL ADVOCACY COMMUNITY IN PROMOTING CANCER ADVOCACY IN LMCS
  • SUMMARY AND RECOMMENDATION
  • REFERENCES
• 10. Expanding the Role of the Global Community in Cancer Control
  • THE “GLOBAL COMMUNITY” IN GLOBAL CANCER CONTROL
  • UN AGENCIES: WHO, IARC, AND IAEA
  • OTHER SOURCES OF GLOBAL SUPPORT FOR CANCER CONTROL
  • DEVELOPMENT ASSISTANCE FOR NONCOMMUNICABLE DISEASES, 1995–2002
  • THE UNTAPPED POTENTIAL OF THE ACADEMIC COMMUNITY
  • SUMMARY AND RECOMMENDATIONS
  • REFERENCES
• Appendixes
  • APPENDIX A Cancer Control in Malaysia and Tanzania
  • APPENDIX B Acronyms and Abbreviations

This study was supported by Contract No. NO1-OD-4-2139 between the National Academy of Sciences and the National Cancer Institute and Grant No. 71685 between the National Academy of Sciences and the American Cancer Society.

Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.