Acciones gubernamentales para la detección temprana del cáncer de mama en América Latina: Retos a futuro

González-Robledo, Luz María; González-Robledo, María Cecilia; Nígenda, Gustavo; López‐Carrillo, Lizbeth

doi:10.1590/s0036-36342010000600009

Cited by 22 publications

(25 citation statements)

References 23 publications

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“…Cancer incidence and mortality rates are rising across Central America [9], [10]. In Costa Rica and Mexico breast cancer ranks among the top-five causes of death for women over 25 years old [11].…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness of Breast Cancer Control Strategies in Central America: The Cases of Costa Rica and Mexico

et al. 2014

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This paper reports the most cost-effective policy options to support and improve breast cancer control in Costa Rica and Mexico. Total costs and effects of breast cancer interventions were estimated using the health care perspective and WHO-CHOICE methodology. Effects were measured in disability-adjusted life years (DALYs) averted. Costs were assessed in 2009 United States Dollars (US$). To the extent available, analyses were based on locally obtained data. In Costa Rica, the current strategy of treating breast cancer in stages I to IV at a 80% coverage level seems to be the most cost-effective with an incremental cost-effectiveness ratio (ICER) of US$4,739 per DALY averted. At a coverage level of 95%, biennial clinical breast examination (CBE) screening could improve Costa Rica's population health twofold, and can still be considered very cost-effective (ICER US$5,964/DALY). For Mexico, our results indicate that at 95% coverage a mass-media awareness raising program (MAR) could be the most cost-effective (ICER US$5,021/DALY). If more resources are available in Mexico, biennial mammography screening for women 50–70 yrs (ICER US$12,718/DALY), adding trastuzumab (ICER US$13,994/DALY) or screening women 40–70 yrs biennially plus trastuzumab (ICER US$17,115/DALY) are less cost-effective options. We recommend both Costa Rica and Mexico to engage in MAR, CBE or mammography screening programs, depending on their budget. The results of this study should be interpreted with caution however, as the evidence on the intervention effectiveness is uncertain. Also, these programs require several organizational, budgetary and human resources, and the accessibility of breast cancer diagnostic, referral, treatment and palliative care facilities should be improved simultaneously. A gradual implementation of early detection programs should give the respective Ministries of Health the time to negotiate the required budget, train the required human resources and understand possible socioeconomic barriers.

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Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness of Breast Cancer Control Strategies in Central America: The Cases of Costa Rica and Mexico

et al. 2014

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“…This has been stated previously by other researchers who mentioned the need to ease the access of women to quality care by integrating and coordinating systematic actions at all levels of health provision 36 . Our findings add to the evidence that the resources required to adequately screen and diagnose women with breast cancer are still scant in terms of infrastructure and personnel -and possibly also insufficiently trained -, and point to the need to redesign the current screening program.…”

Section: Discussionmentioning

confidence: 67%

“…Results also revealed various delay mechanisms to establish the definitive breast cancer diagnosis that in part explain the high frequency of advanced stages reported at the time of diagnosis 36 . In some cases diagnostic delays were associated with ignorance and lack of information about the risks and consequences of breast cancer.…”

Section: Discussionmentioning

confidence: 96%

Medical therapeutic itineraries of women with breast cancer diagnosis affiliated to the People's Health Insurance in San Luis Potosí, central Mexico

2015

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This study aims to describe the medical itineraries followed by breast cancer women affiliated to the People's Health Insurance in San Luis Potosí, central Mexico. We used an ethnographic approach based on oral histories of 12 women diagnosed with breast cancer in the year prior to the first meeting. Two face-to-face sessions per participant lasting 60 minutes each were conducted followed by a telephone interview. Content and diachronic analyses were used. Three main itineraries were identified: (1) diagnostic process, (2) final diagnosis to treatment, and (3) cancer control and relapse. Findings suggested that infrastructure and human resources to adequately screen and timely diagnose breast cancer were scant and insufficiently trained, respectively. Deferral of medical assessment was related with lack of information about breast cancer consequences, with women being afraid of a positive result, and with economic constraints. The current screening program needs to be redesigned to prevent diagnostic delays, as these seem to explain the high frequency of advanced stages reported at the time of diagnosis.

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“…Un dato relevante es el hecho de que en ese país, más del 75 % de los casos son diagnosticados en etapas localmente avanzadas de la enfermedad (II, III y IV), de acuerdo con datos del Registro Histopatológico de Neoplasias Malignas (RHNM). 6 El padecimiento puede ocurrir en mujeres de cualquier nivel social, económico y étnico, aunque son las mujeres con mayores desventajas sociales y menores recursos las más vulnerables, 7 puesto que las acciones de salud están basadas en la capacidad de pago y no en las necesidades de salud de las personas.…”

Section: Introductionunclassified

Enfoque bioético en los cuidados paliativos en pacientes con cáncer de mama avanzado

Vázquez¹,

Hernández²,

Luis³

et al. 2012

Rev. cub. salud pública

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RESUMENObjetivo: contribuir a elevar el nivel de información en profesionales de la atención primaria de salud acerca del enfoque bioético en los cuidados paliativos en pacientes con cáncer de mama avanzado. Métodos: se examinaron los artículos publicados en las revistas nacionales entre 2008 y 2011 y bases de datos nacionales y regionales. Las palabras clave para la búsqueda fueron: cáncer de mama avanzado, atención primaria de salud, bioética, cuidados paliativos, estadio terminal; en títulos, resúmenes o texto. Síntesis de los datos: los cuidados paliativos es uno de los cuatro componentes de control de cáncer que recomienda la OMS para reducir la morbilidad, mortalidad y mejorar la calidad de vida de los pacientes afectados. El médico y la enfermera de la familia, tienen la posibilidad de detectar en personas de la comunidad la aparición de una lesión tumoral en sus comienzos y llegar hasta la conducción de cuidados continuos que se prestan desde el momento del diagnóstico hasta la muerte. En Cuba, los cuidados paliativos vienen a llenar el espacio que faltaba en el Programa Integral para el Control del Cáncer, como una necesidad de la oncología en el sistema de salud. La atención integral al paciente con cáncer avanzado involucra el control de los síntomas, alivio del sufrimiento, reflexión ética sobre el final de la vida, atención adecuada al proceso de la muerte, y al duelo de los familiares. Conclusiones: existen insuficiencias en la información para el desarrollo del pensamiento bioético valorativo en los profesionales en la atención primaria de salud con la inclusión del enfoque bioético en los cuidados paliativos en pacientes con cáncer de mama avanzado. Revista Cubana de Salud Pública 2012; 38(4): 591-601http://scielo.sld.cu 592Palabras clave: cuidados paliativos, cáncer de mama avanzado, enfoque bioético, atención primaria de salud, Cuba. ABSTRACTObjective: to contribute raising the level of information on the inclusion of bioethical approach in the palliative care for advanced breast cancer patients at the primary health care. Methods: the articles published in domestic journals from 2008 to 2011 as well as the national and regional databases were reviewed. The key words for the search in titles, abstracts and full texts were advanced breast cancer, primary health care, bioethics, palliative care and terminally-ill. Results: palliative care is among the four cancer control components which are recommended by the WHO to reduce morbidity, mortality and to improve the quality of life of patients. The family physician and nurse can detect the occurrence of tumoral lesions at onset in persons living in the community, in addition to providing continuous care from the time of diagnosis to death if it happens. The palliative care fills the gap existing in the Comprehensive Program for the Cancer Control, as a requirement of the oncological service of the Cuban health care system. The comprehensive care to the advanced cancer patient involves the control of symptoms, the alleviation of pain, the ethical ref...

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Acciones gubernamentales para la detección temprana del cáncer de mama en América Latina: Retos a futuro

Cited by 22 publications

References 23 publications

Cost-Effectiveness of Breast Cancer Control Strategies in Central America: The Cases of Costa Rica and Mexico

Cost-Effectiveness of Breast Cancer Control Strategies in Central America: The Cases of Costa Rica and Mexico

Medical therapeutic itineraries of women with breast cancer diagnosis affiliated to the People's Health Insurance in San Luis Potosí, central Mexico

Enfoque bioético en los cuidados paliativos en pacientes con cáncer de mama avanzado

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