Question ID: WS-59
Submitted by: Sudha Sivaram
February 11, 2011
How can global cancer prevention and control efforts be integrated into existing primary health care services? Background. Cancer is an emerging public health concern in resource poor countries. In 1970, 15% of incident cancers worldwide were reported from developing countries. This number is projected to rise to 70% by 2030 (World Cancer Report, 2008; International Agency for Research on Cancer, 2010). Compared to the developed world, there is evidence that peak prevalence of cancer in developing countries occur at a younger age (Joshi et al. 2006; Int J Epid). Health systems of many resource poor countries, mandated to oversee a broad public health agenda, are often burdened by poor resources and programs are infrequently based on evidence from research (Murray, 2000). Primary health care services designed to provide basic health services to all residents are an integral component of these health systems, and have been critical in the success of programs for other disease outcomes. These lessons can inform global cancer control. Feasibility. Lessons from HIV prevention, tuberculosis control and treatment, and childhood immunization programs suggest that education, treatment and care services might be efficiently delivered through the primary health care system. While these existing systems do have their challenges, this approach holds promise as a way to reach a wider section of the population who do not live in urban and semi-urban areas (where cancer care centers and clinics are typically located). Training community-based health workers in prevention education, symptom identification and referral, education for reducing stigma are some strategies that have been effective in other disease control programs and can be evaluated for cancer control . Implications for public health. Research to understand health systems' features, their interaction with other service delivery systems of the local government, patterns of utilization and public's concerns with quality might help plan, implement and evaluate locally relevant cancer prevention and control programs.
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