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Addressing the Global Burden of Breast Cancer

, by Laura Wagstaff

While there has been a longstanding perception that cancer is an illness of developed nations, cancer incidence within developing regions has been increasing steadily for decades. Globally, more than half of breast cancer cases now occur in low- and middle-income countries (LMICs). The devastation of a cancer diagnosis is compounded when health systems are under-resourced.  While breast cancer survival rates are over 80% in North America, they can fall below 40% in some low-income countries. This disparity between nations can be largely attributed to lack of early detection programs in LMICs, as well as to challenges implementing appropriate diagnostic and treatment approaches.

The U.S. National Cancer Institute’s Center for Global Health (CGH) is a key partner in a multi-institutional expert team that has developed a set of publications to address foundational concerns in breast cancer outcomes across the cancer care continuum and within limited resource settings.  These brief publications, called the Knowledge Summaries for Comprehensive Breast Cancer Control, provide evidence-based, resource-stratified guidelines on planning, prevention, early detection, diagnosis, treatment, palliation, and survivor care.  The resources are available in both English and Spanish.  The multi-institutional expert team was led by Union for International Cancer Control (UICC), and includes the U.S. National Cancer Institute (NCI), the Breast Cancer Initiative 2.5 (BCI2.5), Breast Health Global Initiative (BHGI), the Pan American Health Organization (PAHO), Fred Hutchinson Cancer Research Center (FHCRC), and the University of Washington (UW).

CGH, as the lead of a trans-NCI working group, is also supporting late stage development and translational research for technologies that have the potential to increase early detection, diagnosis, and non-invasive or minimally invasive treatment of cancer in low-resource settings. Earlier this year, CGH announced that the first of three cohorts from the Affordable Cancer Technologies Program transitioned from the validation phase to build phase.  This group includes a research team from the Dr. Susan Love Research Foundation who are developing low-cost, portable computer-aided detection and diagnostic (CADD) tools for non-invasive triage of patients with palpable breast masses in remote locations in low- and middle-income countries.

Breast cancer poses a major threat to public health worldwide, but increasingly so in developing countries where the majority of cases are diagnosed in late stages. By providing resource-appropriate guidelines and technologies to advance breast cancer control, CGH continues to support the reduction of breast cancer cases and improved outcomes for breast cancer patients around the world.

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