tailieunhanh - Controlling Cancer in Developing Countries - Prevention and Treatment Strategies Merit Further Study

Monitoring for coverage, effectiveness, impact, usage (loss and wastage), and safety of vaccines should be planned and use existing systems as much as possible. Collection of coverage data can be challenging, and should include disaggregated data by dose and age at delivery site. Nominal registries may be useful for collecting coverage information and ensuring proper follow-up, but may require unique national identifiers. With appropriate technical support, vaccine impact evaluations may be done using HPV prevalence studies in certain settings. WHO recommends that all countries establish or enhance cancer registries to be able to evaluate the impact of cervical cancer prevention. | Disease Control Priorities Project April 2007 Controlling Cancer in Developing Countries Prevention and Treatment Strategies Merit Further Study Cancer imposes a major disease burden worldwide with considerable variation among countries and regions. Cancers associated with bacterial or viral infections such as cervical liver and stomach cancer make up a larger share of total cases in developing than in developed countries. Lung colorectal breast and prostate cancers on the other hand appear at higher rates in developed countries because they are related to tobacco use diet and carcinogens in the workplace. These cancers are becoming more common in developing countries as people increasingly adopt the living habits of wealthier nations especially smoking. Unless screening and prevention can reduce the incidence of cancer the number of new cases is projected to increase from 10 million in 2000 to 15 million in 2020 9 million would be in developing countries. Much of what is known about cancer prevention and treatment comes from studies conducted in developed countries. Controlling cancer in developing countries is still relatively new making it difficult to estimate the costs and cost-effectiveness of various prevention and treatment strategies. Further study of health care technologies and health service strategies along with cost evaluations will shed more light on which strategies are likely to be feasible and affordable. Pilot programs are an ideal way to begin controlling cancer in developing countries. Burden of Cancer in Developing Countries Although data on cancer cases and deaths in developing countries are more limited and less accurate than in developed countries researchers do know that patterns and types of cancer differ considerably between the world s richer and poorer nations. In developing countries the top cancers among women in order of incidence are breast cervical stomach lung and colorectal cancer see Figure 1 . Cervical cancer accounts for the