Cancer Control in Low-And Middle-Income Countries: Is It Time To Consider Screening? - Summary

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Ava Welty

2/17/2022

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

While not the face of disease for low-income countries, non-commutable disease has a

large impact on low-income countries. Non-commutable diseases have been on the rise globally

but have a larger prevalence and death rate for low-income countries. Over 50% of deaths in less

developed counties are considered premature. This impact substantially impacts the life span and

development of these countries. Countries with people dying prematurely have a difficult

creating and maintaining development. This is a global equity problem, and impacts women and

children more than any other demographic. This article from Heimburer et. Al describes the

devastating nature of cancers in less developed countries, details reasons for disparities, explains

the current system of treatment, and lists possible solutions.

The burden of cancers in less developed countries is steep. In 2018, there were 18.1

million new cancer diagnoses and 9.6 million deaths. These values are expected to only grow

higher. Despite having a lower incidence rate in comparison to high income countries, the high

mortality rate proves these commutable diseases to be dangerous. Within developed countries,

cancer rates appear to be stabilizing or decreasing, while in less developed countries cancer rates

are only increasing. This is for a few reasons, notably decreasing levels of smoking and

preventative measures in developed countries, and increased smoking and obesity within less

developed countries. Infection associated cancers are also much more prevalent in less developed

countries. These cancers are a very small percentage of cases in developed countries, while they

have a large impact in less developed countries. These high numbers and high death tolls might

not even be accurate. Diagnosing and detecting cancer is much less advanced in less developed
countries than in their developed counterparts. These trends are only expected to worsen as time

goes on.

Within the current healthcare systems that exist in less developed countries, they are not

designed to deal with non-commutable diseases. They have historically been built around

addressing nutrition, maternal heath, and commutable diseases, as these issues have been and

still are the biggest causes of mortality. The rise of non-commutable diseases poses a problem for

this system. This is complicated to fix and takes a variety of changes, including specific research

for the individual country, better systems of tracking cases, and screening. Comprehensive

changes in this health care system are a necessary step, but the high expenditure can be a

dissuading factor.

A huge way to change this trend of high mortality and minimal treatment in less

developed countries is with increased screening. According to the article, screening must be

“acceptable, sustainable, and economically efficient for the target population, and the health care

infrastructure must be equipped to manage the increased case finding with respect to treatment,

support, and follow up.” Improving health services, including increased cancer screenings is a

big step towards better cancer treatment and prevention. Screening has many different aspects to

consider. The reasoning behind screening is to detect cancers at a time when they can be treated

in ways possible in less developed countries. However, within less developed countries there are

unique risks. Cultural norms towards treatments and willingness towards treatment are both

obstacles. However, education on those of these topics can greatly help both issues.

Treating cancers in less developed countries is complicated. Treating cancer generally

uses three approaches- surgical resection, chemotherapy, and radiotherapy. All these treatments

are largely unavailable in less developed countries, despite a simple surgery sometimes being
enough to cure a deadly cancer. While these treatments have proven helpful for cancer treatment,

they are unavailable for the large part. Providing greater access to this care could have enormous

impacts on cancer treatment, but large-scale changes in healthcare need to be in place before

these changes can be made. Outside of these treatments, a different kind of treatment is

important. This is palliative care and pain control. As a result of many cancers being diagnosed

late and treatment being limited, pain control is an important treatment in improving quality of

life. Increasing pain treatment where it doesn’t exist currently can help people with cancer live a

better life for their time left. While this is not a life extending treatment, it is still an important

treatment for those struggling.

Investing in cancer screening, prevention, and control is a necessary step to fight against

increasing incidence and mortality of cancer in less developed countries. This can be seen in a

few ways, from prevention by eradicating bad behaviors such as smoking and obesity, to testing

and screening to higher technology treatments such as radiology. The treatment option available

might depend on the individual country and needs of that country. Cancer is very complex and

has several outcomes and treatments, and countries should create their own individual pathways

to provide adequate prevention and treatment.

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