Guidelines for cancer treatment in low-income countries.
Article Type: Brief article
Subject: Developing countries (Health aspects)
Tamoxifen (Usage)
Cancer (Care and treatment)
Cancer (Standards)
Pub Date: 11/01/2010
Publication: Name: Reproductive Health Matters Publisher: Elsevier Science Publishers Audience: General Format: Magazine/Journal Subject: Family and marriage; Health; Women's issues/gender studies Copyright: COPYRIGHT 2010 Reproductive Health Matters ISSN: 0968-8080
Issue: Date: Nov, 2010 Source Volume: 18 Source Issue: 36
Topic: Event Code: 350 Product standards, safety, & recalls
Product: Product Code: 8000432 Cancer Therapy NAICS Code: 621 Ambulatory Health Care Services
Organization: Organization: World Health Organization
Geographic: Geographic Scope: Ghana Geographic Code: 0DEVE Developing Countries; 6GHAN Ghana
Accession Number: 247520215
Full Text: The WHO has estimated that the global cancer burden will increase from 10 million new cases per year in 2000 to 16 million by 2020, of which 70% will be in the developing world. In high-income countries, there is public debate surrounding the licensing of expensive new anti-cancer agents, many of which are associated with marginal clinical benefits. Yet in low-income countries the simplest generic treatment is not available. Very little has been done to develop evidence-based guidelines for cost-effective cancer treatment or recommended therapeutic algorithms for use in poorly funded health systems. An interdisciplinary task force is needed to develop such guidelines, including oncologists, health economists, and clinical pharmacologists. Where data are lacking, this group could recommend clinical trials and studies needed to fill gaps. Specific problems could still be solved through "lateral thinking": for instance, the Africa Oxford Cancer Foundation is planning a trial of nurse-dispensed tamoxifen for Ghanaian women over 50 who, at informal breast-examination clinics held in village churches, have breast lumps that are clinically adjudged to be cancer. This will lead to over-treatment of some women, who may not have cancer, but tamoxifen is a safe drug with some chance of palliative benefit to women who cannot afford formal health care. More could also be made of innovative open-access projects to help refine treatment regimens for people in developing countries with cancer. (1)

(1.) Kerr DJ, Midgley R. Can we treat cancer for a dollar a day? Guidelines for low-income countries. New England Journal of Medicine 2010;363(9): 801-03.
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