Low cost health interventions to curb female cancer deaths

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vaccinationwebHealth interventions costing as little as $1.72 per person could prevent hundreds of thousands of deaths from breast and cervical cancer in developing countries, found an international study led by the University of Cape Town.

Nearly 800,000 women die of cervical and breast cancer every year, with two thirds of breast cancer deaths and 9 out of 10 cervical cancer deaths in developing countries, they said in a study. While some diagnostic and treatment options such as mammography and radiotherapy are often not available in poor countries, several low-cost interventions have a potential to save lives, the scientists said.

“There is a widespread misconception that breast and cervical cancers are too difficult and expensive to prevent and treat, particularly in resource-poor countries where the burden of these diseases is highest,” Ophira Ginsburg from the University of Toronto is quoted in the report as saying. “But nothing could be further from the truth. Recent estimates suggest that a basic cancer control package could be introduced in low- and middle-income countries for as little as $1.72 per person – equivalent to just 3% of current health spending in these countries.”

Breast and cervical cancer kill nearly three times as many women each year than complications from pregnancy and childbirth, the scientists from University of Toronto, University of Cape Town and King’s College London and led by Professor Lynette Denny, department of obstetrics and gynaecology, University of Cape Town and Groote Schuur Hospital, said. With the number of women diagnosed with breast cancer expected to almost double to 3.2m in 2030 and the number of women diagnosed with cervical cancer projected to rise by at least a quarter to over 700,000, the scientists warned the cost of inaction will be “huge”.

They said human papilloma virus (HPV) vaccination of girls in the world’s poorest countries over a period of four years could prevent 600,000 deaths from cervical cancer.

Low- and middle- income countries receive just 5% of global funding for cancer and persistent under-investment has exacerbated the problem.

Reducing inequalities and improving cancer survival for women should be seen as a part of international commitments to achieve universal health coverage, they added. They recommended immunising 70% of girls against HPV by 2030 and enabling access to early diagnosis and treatment to all women with breast cancer.

Summary
Breast and cervical cancers are the commonest cancers diagnosed in women living in low-income and middle-income countries (LMICs), where opportunities for prevention, early detection, or both, are few. Yet several cost-effective interventions could be used to reduce the burden of these two cancers in resource-limited environments. Population- wide vaccination against human papillomavirus (HPV) linked to cervical screening, at least once, for adult women has the potential to reduce the incidence of cervical cancer substantially. Strategies such as visual inspection with acetic acid and testing for oncogenic HPV types could make prevention of cervical cancer programmatically feasible. These two cancers need not be viewed as inevitably fatal, and can be cured, particularly if detected and treated at an early stage. Investing in the health of girls and women is an investment in the development of nations and their futures. Here we explore ways to lessen the divide between LMICs and high-income countries for breast and cervical cancers.

Authors
Lynette Denny, Silvia de Sanjose, Mirian Mutebi, Benjamin O Anderson, Jane Kim, Jose Jeronimo, Rolando Herrero, Karen Yeates, Ophira Ginsburg, Rengaswamy Sankaranarayanan

Reuters Health report
The Lancet article summary
The Lancet series


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