Cancer In Low- And Middle-income Countries Research Articles

Preventing breast cancer in LMICs via screening and/or early detection: The real and the surreal.

To review the present status of breast cancer (BC) screening/early detection in low- and middle-income countries (LMICs) and identify the way forward, an open focused search for articles was undertaken in PubMed, Google Scholar and Google, and using a snowball technique, further articles were obtained from the reference list of initial search results. In addition, a query was put up on ResearchGate to obtain more references and find out the general opinion of experts on the topic. Experts were also personally contacted for their opinion. Breast cancer (BC) is the most common cancer in women in the world. The rise in incidence is highest in LMICs where the incidence has often been much lower than high-income countries. In spite of more women dying of cancer than pregnancy or childbirth related causes in LMICs, most of the focus and resources are devoted to maternal health. Also, the majority of women in LMICs present at late stages to a hospital to initiate treatment. A number of trials have been conducted in various LMICs regarding the use of clinical breast examination and mammography in various combinations to understand the best ways of implementing a population level screening/early detection of BC; nevertheless, more research in this area is badly needed for different LMIC specific contexts. Notably, very few LMICs have national level programs for BC prevention via screening/early detection and even stage reduction is not on the public health agenda. This is in addition to other barriers such as lack of awareness among women regarding BC and the presence of stigma, inappropriate attitudes and lack of following proper screening behavior, such as conducting breast self-examinations. The above is mixed with the apathy and lack of awareness of policy makers regarding the fact that BC prevention is much more cost-effective and humane than BC treatment. Implementation of population level programs for screening/early detection of BC, along with use of ways to improve awareness of women regarding BC, can prove critical in stemming the increasing burden of BC in LMICs. Use of newer modalities such as ultrasonography which is more suited to LMIC populations and use of mHealth for awareness creation and increasing screening compliance are much needed extra additions to the overall agenda of LMICs in preventing BC.

Essential medicines for pediatric oncology in developing countries

The burden of cancer in children in low and middle income countries (LMICs) is substantial, comprising at least 80% of incident cases globally, and an even higher proportion of cancer-related deaths. With survival rates exceeding 80% in high income countries, it is imperative to transfer these successes to LMICs. A major challenge is the poor availability of safe, cost-effective chemotherapy. A list of 51 drugs-chemotherapeutics, infectious disease agents, and supportive care medications-is proposed as essential to improving the survival of children with cancer in LMICs with an additional 13 drugs identified as being of further value.

Prostate Cancer Prevention in the Developing World - What are we Waiting for?

The field of personalized medicine is currently broadening in scope in at least three crucial dimensions. First, while genetics/genomics individual variability is an important aspect of personalized medicine, it is clear that environmental, nutritional, lifestyle and social risk factors play a crucial role for suboptimal therapeutics or disease susceptibility. Second, personalized medicine can inform not only drug therapy but also preventative medicine such that public health interventions that mitigate or prevent disease risks are also customized at an individual and subpopulation level. Third, personalized medicine is now truly global in scope demanding scholarship and innovation analysis beyond the developed countries. In this paper, we critically bring together these three emerging and broader strands of personalized medicine by focusing on prevention of prostate cancer in the developing world. Although prostate cancer prevalence used to be lower in developing countries in the past, this situation is beginning to change rapidly as people living in the developing world transition to a lifestyle more similar to that found in affluent countries. This transition to decreased physical activity, burgeoning overweight/obesity levels, changing nutritional habits, and greater consumption of tobacco, leads to an increased prevalence of non-communicable diseases. There are indications that these changes may also lead to an increase in prostate cancer in low and middle income countries (LMICs). We outline the risk factors associated with prostate cancer, some of the changes that are taking place in LMICs, the reasons behind these changes and the need for personalized or rationally targeted preventative interventions against prostate cancer in LMICs and globally. Keywords: Developing countries, global personalized medicine, lifestyle risks, low and middle income countries (LMICs), nutrigenomics, personalizing preventive medicine, prostate cancer, risk assessment

Global Breast Cancer: The Lessons to Bring Home

Breast cancer is the most common cancer affecting women globally. This paper discusses the current progress in breast cancer in Western countries and focuses on important differences of this disease in low- and middle-income countries (LMCs). It introduces several arguments for applying caution before globalizing some of the US-adopted practices in the screening and management of the disease. Finally, it suggests that studies of breast cancer in LMCs might offer important insights for a more effective management of the problem both in developing as well as developed countries.