Cancer Control in Low- and Middle-Income Countries: Is It Time to Consider Screening?

Abstract

The rising prevalence of noncommunicable diseases globally, with a strikingly disproportionate increase in prevalence and related mortality in low- and middle-income countries (LMICs), is a major threat to sustainable development. The epidemiologic trend of cancers in LMICs is of particular concern. Despite a lower incidence of cancer in LMICs compared with high-income countries, total cancer-related mortality is significantly higher in LMICs, especially in people younger than 65 years of age. The enormous economic impact of premature mortality and lost productive life years highlights the critical importance of galvanizing cancer prevention and management to achieve sustainable development. The rising burden of cancer in LMICs stresses an already weak health care and economic infrastructure and poses unique challenges. Although the WHO acknowledges that the effective management of cancer relies on early detection, accurate diagnosis, and access to appropriate multimodal therapy, the placement of priority on early detection cannot be assumed to be effective in LMICs, where limited downstream resources may be overwhelmed by the inevitable increases in number of diagnoses. This review discusses several factors and considerations that may compromise the success of cancer control programs in LMICs, particularly if the focus is only on early detection through screening and surveillance. It is intended to guide optimal implementation of cancer control programs by accentuating challenges common in LMICs and by emphasizing the importance of cancer prevention where relevant so that communities and stakeholders can work together to devise optimal means of combatting the growing burden of cancer.

When Is a Suboptimal Approach to Cancer Screening Better Than None?

“…Mammography in LICs For screening to be appropriate, it "must be acceptable, equitable, accessible, sustainable, and economically efficient for the target population." 9 The aim of a screening campaign for cancer thus could be different in low-and middleincome countries vs HICs. In resource-poor settings, focusing on mitigating symptomatic disease should be prioritized rather than, as in developed nations, focusing on cancer detection in asymptomatic women.…”

Seaweeds: An Extensive Review of Medicinal Values

“…In 2019, 1,762,450 new cancer cases and 606,880 cancer deaths are projected to occur in the United States [121]. Globally, cancer responsible for at least 20% of all mortality [122], 18.1 million new cancer, 9.5 million death in 2018 [123,124], 5-year prevalence 43.8 million [125], is predicted to rise by 61.4% to 27.5 million in 2040 [126]. Approximately 70% of deaths from cancer occur in LMICs [127].…”

Clinical Pharmacists in Chronic Care

“…In 2019, 1,762,450 new cancer cases and 606,880 cancer deaths are projected to occur in the United States [361]. Globally, cancer is responsible for at least 20% of all mortality [362], 18.1 million new cancer, 9.5 million death in 2018 [363,364], the 5-year prevalence of 43.8 million [365], is predicted to rise by 61.4% to 27.5 million in 2040 [366]. Approximately 70% of deaths from cancer occur in LMICs [367].…”