Cancer In High-income Countries Research Articles

International Women's Day 2014: women's health equity is progress for all.

International Women's Day 2014: women's health equity is progress for all.

Breast transillumination a viable option for breast cancer screening in limited resource settings

Background : Mammography is an established screening tool for breast cancer in high-income countries but may not be feasible for most resource poor nations. Alternative modalities are needed to mitigate the impact of the increasing incidence and mortality due to breast cancer. This may require the development of new technologies or reevaluation of old technologies applicable to resource limited settings. Objective : To determine the sensitivity and specificity of breast transillumination as compared to mammography and to describe features of benign and malignant breast lesions as seen with breast transillumination. Methods : A single group descriptive analytical study was conducted over a six month period (2011) in the breast unit of Mulago National hospital. Eligible participants were consecutively sampled. Participants underwent Clinical Breast Examination (CBE), breast transillumination (BT), mammography (MG) and histopathological analysis of identified breast lumps. Sensitivity, specificity and predictive values were calculated. Features of the masses detected by transillumination were then described. Results : The number of participants recruited was 201 (mean age 42 years, range 30-80 years). The average palpable lump size was 3.8 cm (range 0.5 to 10 cm). BT had a sensitivity of 63.2% (PPV 86.8%) and a specificity of 89.5% (NPV 61.2%) with mammography as the reference standard. Also, 73.3% of breast lumps with irregular margins and 88.5% with dense opacity at transillumination turn out to be malignant at histopathology examination. Conclusion : The Breast transillumination technique had a moderate sensitivity of 63.2%. This warrants a large scale population-based evaluation of BT as a screening tool. This technique may not substitute mammography but to be considered an option where mammography access is limited.

Global cancer research initiative

Cancer is an increasing problem for low- and middle-income countries undergoing an epidemiologic transition from dominantly acute communicable disease to more frequent chronic disease with increased public health successes in the former domain. Progress against cancer in high-income countries has been modest and has come at enormous expense. There are several well-conceived global policy and planning initiatives which, with adequate political will, can favorably impact the growing global cancer challenges. Most financial resources for cancer, however, are spent on diagnosis and management of patients with disease in circumstances where specific knowledge about effective approaches is significantly limited, and the majority of interventions, other than surgery, are not cost-effective in resource-limited countries by global standards. In summary, how to intervene effectively on a global scale for the majority of citizens who develop cancer is poorly defined. In contrast to technology-transfer approaches, markedly increased clinical research activities are more likely to benefit cancer sufferers. In these contexts, a global cancer research initiative is proposed, and mechanisms for realizing such an effort are suggested.

Global cancer research initiative

Global cancer research initiative Richard R LoveThe Ohio State University Comprehensive Cancer Center, Columbus, OH, USAAbstract: Cancer is an increasing problem for low- and middle-income countries undergoing an epidemiologic transition from dominantly acute communicable disease to more frequent chronic disease with increased public health successes in the former domain. Progress against cancer in high-income countries has been modest and has come at enormous expense. There are several well-conceived global policy and planning initiatives which, with adequate political will, can favorably impact the growing global cancer challenges. Most financial resources for cancer, however, are spent on diagnosis and management of patients with disease in circumstances where specific knowledge about effective approaches is significantly limited, and the majority of interventions, other than surgery, are not cost-effective in resource-limited countries by global standards. In summary, how to intervene effectively on a global scale for the majority of citizens who develop cancer is poorly defined. In contrast to technology-transfer approaches, markedly increased clinical research activities are more likely to benefit cancer sufferers. In these contexts, a global cancer research initiative is proposed, and mechanisms for realizing such an effort are suggested.Keywords: breast cancer, research, global, international, low-income, middle-income