Screening for Cancer in Low- and Middle-Income Countries

Background: Screening programs involve testing asymptomatic individuals with an accurate screening test to identify those likely to have the disease of interest and to further investigate them to confirm or exclude the disease. The aim of <a title="Learn more about Cancer screening" hre...

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Autor principal:	R. Sankaranarayanan
Formato:	article
Lenguaje:	EN
Publicado:	Ubiquity Press 2014
Materias:	breast cancer cervical cancer colorectal cancer cytology early detection fecal occult blood test HPV testing oral cancer screening visual screen Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/4adc94a2d4964d03ab57e3782963d3ea
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id	oai:doaj.org-article:4adc94a2d4964d03ab57e3782963d3ea
record_format	dspace
institution	DOAJ
collection	DOAJ
language	EN
topic	breast cancer cervical cancer colorectal cancer cytology early detection fecal occult blood test HPV testing oral cancer screening visual screen Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
spellingShingle	breast cancer cervical cancer colorectal cancer cytology early detection fecal occult blood test HPV testing oral cancer screening visual screen Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270 R. Sankaranarayanan Screening for Cancer in Low- and Middle-Income Countries
description	Background: Screening programs involve testing asymptomatic individuals with an accurate screening test to identify those likely to have the disease of interest and to further investigate them to confirm or exclude the disease. The aim of <a title="Learn more about Cancer screening" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/cancer-screening">cancer screening</a> is to prevent cancer deaths and improve quality of life by finding cancers early and by effectively treating them. A decision to introduce a screening program in public health services depends on the evidence that the benefits outweigh the harms of screening, disease burden, availability of suitable screening test, effective treatment, adequate resources, and efficient health services. Screening programs should achieve high participation for testing, diagnosis, and treatment to be effective and efficient. Objective: To describe the current status of cancer screening programs in low- and middle-income countries (LMICs). Method: A review of literature and on-going cancer screening initiatives in LMICs was made to discuss cancer screening in these countries. Findings: Although population-based programs offering Papanicolaou testing every 3 to 5 years have reduced cervical cancer incidence and mortality in high-income countries, such programs have been less successful in reducing cervical cancer burden in LMICs due to poor organization, lack of coverage, and lack of quality assurance. The challenges in introducing high-quality cytology screening in LMICs have led to evaluation of alternative screening approaches such as visual inspection with acetic acid (VIA), <a title="Learn more about Human Papillomavirus" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/human-papillomavirus">human papillomavirus</a> (HPV) testing-based screening, and novel paradigms such as a “single-visit screen and treat” in which treatment with <a title="Learn more about Cryotherapy" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/cryotherapy">cryotherapy</a> or cold <a title="Learn more about Coagulation" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/coagulation">coagulation</a> is provided to screen-positive women without clinical evidence of cancer. Both HPV testing and VIA have been found to prevent cervical neoplasia and cervical cancer deaths in clinical trials. Although <a title="Learn more about Breast cancer screening" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/breast-cancer-screening">mammography screening</a> reduces <a title="Learn more about Breast Cancer" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/breast-cancer">breast cancer</a> mortality, associated overdiagnosis and overtreatment and the balance between benefits and harms have received much attention in recent years. Although introduction of clinical breast examination screening in LMICs should wait for evidence from ongoing trials, improving breast awareness and access to <a title="Learn more about Early Diagnosis" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/early-diagnosis">early diagnosis</a> and treatment in health services is a valuable breast cancer control option in LMICs. Organized colorectal cancer screening programs are still evolving and are in early stages of development in many high-income countries. To date, there is insufficient evidence to support the introduction of population-based stomach, lung, ovarian, and prostate cancer screening in public health services. Conclusions: Implementation of VIA screening in several LMICs is conducive to future HPV screening programs when affordable HPV tests become widely available. Both HPV <a title="Learn more about Vaccination" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/vaccination">vaccination</a> and HPV screening have a huge potential to eliminate cervical cancer in LMICs. A mammography screening program is a complex undertaking involving substantial resources and infrastructure that may not be feasible in many LMICs.
format	article
author	R. Sankaranarayanan
author_facet	R. Sankaranarayanan
author_sort	R. Sankaranarayanan
title	Screening for Cancer in Low- and Middle-Income Countries
title_short	Screening for Cancer in Low- and Middle-Income Countries
title_full	Screening for Cancer in Low- and Middle-Income Countries
title_fullStr	Screening for Cancer in Low- and Middle-Income Countries
title_full_unstemmed	Screening for Cancer in Low- and Middle-Income Countries
title_sort	screening for cancer in low- and middle-income countries
publisher	Ubiquity Press
publishDate	2014
url	https://doaj.org/article/4adc94a2d4964d03ab57e3782963d3ea
work_keys_str_mv	AT rsankaranarayanan screeningforcancerinlowandmiddleincomecountries
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spelling	oai:doaj.org-article:4adc94a2d4964d03ab57e3782963d3ea2021-12-02T02:40:22ZScreening for Cancer in Low- and Middle-Income Countries2214-999610.1016/j.aogh.2014.09.014https://doaj.org/article/4adc94a2d4964d03ab57e3782963d3ea2014-12-01T00:00:00Zhttps://annalsofglobalhealth.org/articles/2074https://doaj.org/toc/2214-9996Background: Screening programs involve testing asymptomatic individuals with an accurate screening test to identify those likely to have the disease of interest and to further investigate them to confirm or exclude the disease. The aim of <a title="Learn more about Cancer screening" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/cancer-screening">cancer screening</a> is to prevent cancer deaths and improve quality of life by finding cancers early and by effectively treating them. A decision to introduce a screening program in public health services depends on the evidence that the benefits outweigh the harms of screening, disease burden, availability of suitable screening test, effective treatment, adequate resources, and efficient health services. Screening programs should achieve high participation for testing, diagnosis, and treatment to be effective and efficient. Objective: To describe the current status of cancer screening programs in low- and middle-income countries (LMICs). Method: A review of literature and on-going cancer screening initiatives in LMICs was made to discuss cancer screening in these countries. Findings: Although population-based programs offering Papanicolaou testing every 3 to 5 years have reduced cervical cancer incidence and mortality in high-income countries, such programs have been less successful in reducing cervical cancer burden in LMICs due to poor organization, lack of coverage, and lack of quality assurance. The challenges in introducing high-quality cytology screening in LMICs have led to evaluation of alternative screening approaches such as visual inspection with acetic acid (VIA), <a title="Learn more about Human Papillomavirus" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/human-papillomavirus">human papillomavirus</a> (HPV) testing-based screening, and novel paradigms such as a “single-visit screen and treat” in which treatment with <a title="Learn more about Cryotherapy" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/cryotherapy">cryotherapy</a> or cold <a title="Learn more about Coagulation" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/coagulation">coagulation</a> is provided to screen-positive women without clinical evidence of cancer. Both HPV testing and VIA have been found to prevent cervical neoplasia and cervical cancer deaths in clinical trials. Although <a title="Learn more about Breast cancer screening" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/breast-cancer-screening">mammography screening</a> reduces <a title="Learn more about Breast Cancer" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/breast-cancer">breast cancer</a> mortality, associated overdiagnosis and overtreatment and the balance between benefits and harms have received much attention in recent years. Although introduction of clinical breast examination screening in LMICs should wait for evidence from ongoing trials, improving breast awareness and access to <a title="Learn more about Early Diagnosis" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/early-diagnosis">early diagnosis</a> and treatment in health services is a valuable breast cancer control option in LMICs. Organized colorectal cancer screening programs are still evolving and are in early stages of development in many high-income countries. To date, there is insufficient evidence to support the introduction of population-based stomach, lung, ovarian, and prostate cancer screening in public health services. Conclusions: Implementation of VIA screening in several LMICs is conducive to future HPV screening programs when affordable HPV tests become widely available. Both HPV <a title="Learn more about Vaccination" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/vaccination">vaccination</a> and HPV screening have a huge potential to eliminate cervical cancer in LMICs. A mammography screening program is a complex undertaking involving substantial resources and infrastructure that may not be feasible in many LMICs.R. SankaranarayananUbiquity Pressarticlebreast cancercervical cancercolorectal cancercytologyearly detectionfecal occult blood testHPV testingoral cancerscreeningvisual screenInfectious and parasitic diseasesRC109-216Public aspects of medicineRA1-1270ENAnnals of Global Health, Vol 80, Iss 5, Pp 412-417 (2014)

Screening for Cancer in Low- and Middle-Income Countries

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