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Friday 29 July 2011

Research on cancer prevention, detection and management in low- and medium-income countries

Research on cancer prevention, detection and management in low- and medium-income countries

Cancer site Cancer control intervention Research priority
Prevention Early detection Treatment
Head and neck +++; tobacco control; reduced alcohol consumption; increased consumption of vegetables and fruits +++; awareness, early clinical diagnosis; screening by visual inspection +++; surgery; radiotherapy Implementation and evaluation of tobacco and alcohol control measures and population-based visual screening for oral cancer; evaluation of clinical downstaging; formulation of locally feasible cost-effective management protocols and evaluating their adherence and effectiveness
Esophagus +++; tobacco control; reduced alcohol use; healthy diet + + Evaluation of the effectiveness of tobacco/alcohol control measures and promotion of healthy eating practices; evaluation of chemoprevention
Stomach +++; prevention and eradication of H. pylori infection; healthy diet; tobacco control; improved living conditions +; early clinical diagnosis ++; surgery Evaluation of the efficacy and cost-effectiveness of screening individuals for infection with Helicobacter pylori and then eradicating H. pylori with antibiotic therapy; vaccination to prevent H. pylori infection
Colon, rectum ++; control of overweight/obesity; promotion of healthy diet and physical activity +++; awareness; early clinical diagnosis; screening by fecal occult blood test; endoscopy +++; surgery; chemotherapy Evaluation of efficacy and cost-effectiveness of colorectal cancer screening; evaluation of clinical downstaging; formulation of locally feasible cost-effective management protocols and evaluating their adherence and effectiveness
Liver +++; HBV vaccination in infancy; prevention of exposure to liver flukes; reduced fungal contamination of stored grains; blood supply and injection safety measures to prevent exposure to HCV; reduced alcohol use; tobacco control + + Evaluation of long-term protection from HBV vaccination, need for booster doses; evaluation of methods to cure chronic HBV and HCV infection
Lung +++; tobacco control; regulation of occupational exposures; ventilation and improved low-technology heating and cooking + + Implementation and evaluation of primary prevention measures, in particular tobacco control
Breast ++; control of obesity; promotion of physical activity; reduced alcohol use +++; breast awareness; early clinical diagnosis +++; surgery; chemotherapy; hormone therapy; radiotherapy Evaluation of chemoprevention; evaluation of breast awareness and physical examination; evaluation of clinical downstaging; formulation of locally feasible cost-effective management protocols and evaluating their adherence and effectiveness
Uterine cervix +++; HPV vaccination; tobacco control +++; awareness; early clinical diagnosis; screening with cytology, VIA or HPV testing +++; surgery; radiotherapy; chemotherapy Implementation and evaluation of HPV vaccination and alternative methods of screening; integration of HPV vaccine and screening programs; effectiveness of screening with fast HPV testing followed by VIA triage and treatment in preventing cervical cancer; evaluation of clinical downstaging; formulation of locally feasible cost-effective management protocols and evaluating their adherence and effectiveness
Lymphohematopoietic (lymphoma, multiple myeloma, leukemia) + + +++; chemotherapy; radiotherapy Evaluation of affordable forms of chemotherapy regimens in low-resource settings; formulation of locally feasible cost-effective management protocols and evaluating their adherence and effectiveness
  • LMIC, low- and medium-income countries; HBV, hepatitis B virus; HCV, hepatitis C virus; HPV, human papillomavirus; VIA, visual inspection with acetic acid; +, limited role; ++, moderate role; +++, substantial role.