Advancing Reliable Data for Cancer Control in the Central America Four Region

Abstract

The Central America Four (CA-4) region, comprising Guatemala, Honduras, El Salvador, and Nicaragua, is the largest low- and middle-income country region in the Western Hemisphere, with over 36 million inhabitants. The CA-4 nations share a common geography, history, language, and development indices, and unified with open borders in 2006. The growing CA-4 cancer burden among the noncommunicable diseases is expected to increase 73% by 2030, which argues for a regional approach to cancer control. This has driven efforts to establish population-based cancer registries as a central component of the cancer control plans. The involvement of international and academic partners in an array of initiatives to improve cancer information and control in the CA-4 has accelerated over the past several years. Existing data underscore that the infectious cancers (cervical, stomach, and liver) are a particular burden. All four countries have committed to establishing regional population-based cancer registries and have advanced significantly in pediatric cancer registration. The challenges common to each nation include the lack of national cancer control plans and departments, competing health priorities, lack of trained personnel, and sustainability strategies. General recommendations to address these challenges are outlined. The ongoing regional, international, and academic cooperation has proven helpful and is expected to continue to be a powerful instrument to contribute to the design and implementation of long-term national cancer control plans.

Helicobacter pylori antimicrobial resistance and antibiotic consumption in the low‐resource Central America setting

“…Nearly half of population in the CA‐4 resides in rural areas very similar to western Honduras, and our findings may be generalizable and helpful in the region. In addition, there is significant immigration to the United States from the CA‐4, and thus, our findings may have implications for patient care in the United States . In the treatment of H. pylori infection, resistance to clarithromycin and levofloxacin has been shown to be the central determinants of regimen efficacy.…”

“…The CA‐4 comprises four nations (Guatemala, Honduras, El Salvador, and Nicaragua), which were unified with open borders in 2006, and share a common geography, history, language, and development indices. It is the largest LMIC region in the Western Hemisphere, with over 36 million inhabitants, half of whom reside in rural areas . Surveillance is an important first step toward the implementation of policies oriented toward rational utilization of antimicrobials.…”

Health Barriers and Patterns of Gastric Cancer Care in Rural Central American Resource-Limited Settings

“…Health ministries are encouraged to develop national cancer control plans that prioritize access to cancer care and promote the establishment of cost-effective cancer prevention programs in high-risk areas. 5 …”

“…4 The nascent population-based cancer registry data were used to assess completeness for 2013 through 2015. 5 An active follow-up protocol was used in 2016 during household visits in rural and remote areas by interviewing the patient and/or relatives. Given the high mortality, most interviews were conducted with family members.…”

Patient Navigation and Access to Cancer Care in Guatemala

“…Although one hospital-based cancer registry has existed for years, recent efforts to develop a population-based cancer registry in Guatemala City for pediatric and adult cancers would make population data available for the first time. 2 Despite these limitations, in 2013 it was estimated that there were approximately 13,000 incident cases of cancer each year, the most common of which were cancers of the stomach, prostate, and cervix. 3 For the majority of the adult population without private insurance or social security, the primary cancer referral centers in Guatemala are two large public referral hospitals (Roosevelt and San Juan de Dios) and the private, not-for-profit Instituto de Cancerología (National Cancer Institute [INCAN]), all in Guatemala City.…”