GLOBAL CANCER POLICY-MAKING
provides a detailed summary of BHGI methodology, which the include oncoplastic breast surgery, which simultaneously
editors identify as a model approach for developing resource- improves oncologic and cosmetic outcome with complex cancer
sensitive guidelines that could be applied to other cancers or resections. He holds joint faculty positions in the Fred
chronic diseases for which effective treatments are available.25 Hutchinson Cancer Research Center Division of Public Health
BHGI analyses suggested that to better assess breast cancer Sciences and the UW Department of Global Health and directs
burden in poorly studied populations, countries require the Breast Health Clinic at the Seattle Cancer Care Alliance
accurate statistics regarding cancer incidence and mortality so (SCCA). From 2005–2007, Dr Anderson served as President of
that chronic diseases taking the greatest toll can be identified the American Society of Breast Disease (ASBD).
and targeted . To better identify health care system strengths Dr Anderson created and chairs the Breast Health Global
and weaknesses, countries require reasonable indicators of Initiative (BHGI), which developed and studies implementation
true health system quality and capacity. Using qualitative and of resource-sensitive, culturally appropriate guidelines for
quantitative research methods, countries should formulate breast cancer early detection, diagnosis and treatment in low-
cancer control strategies to identify both system inefficiencies and middle-income countries (LMIC). As private sector advisor
and patient barriers. Patient navigation programmes linked to on the US delegation to the 58th World Health Assembly in
public advocacy efforts feed and strengthen functional early Geneva, Dr Anderson contributed to the first WHO Cancer
detection and treatment programmes. Cost-effectiveness Prevention and Control Resolution passed in 2005, which
research and implementation science are tools that can guide reinforces comprehensive cancer policies and strategies for
and expand successful pilot programmes. l LMICs. Honouring his commitment to women’s health
throughout the world and his dedicated efforts to improve their
Benjamin O Anderson is Professor of Surgery and Global Health quality of care, Dr Anderson was awarded the 2011 Partners in
Medicine at the University of Washington (UW) in Seattle where Progress Award by the American Society of Clinical Oncology
his clinical practice is devoted to caring for patients with breast (ASCO). Most recently, Dr Anderson was elected to the Board of
health issues and cancers. Dr Anderson’s clinical interests Directors of the Union for International Cancer Control (UICC).
Carlson RW, Anderson BO, Bensinger W, et al. NCCN Practice Guidelines for Breast overview of the Breast Health Global Initiative 2005 guidelines. Breast J. Jan-Feb
Cancer. Oncology (Williston Park). Nov 2000;14(11A):33-49. 2006;12 Suppl 1:S3-15.
Morrow M, Strom EA, Bassett LW, et al. Standard for breast conservation therapy in Anderson BO, Yip CH, Smith RA, et al. Guideline implementation for breast healthcare
the management of invasive breast carcinoma. CA Cancer J Clin. Sep-Oct in low-income and middle-income countries: overview of the Breast Health Global
2002;52(5):277-300. Initiative Global Summit 2007. Cancer. Oct 15 2008;113(8 Suppl):2221-2243.
Smith RA. Breast cancer screening among women younger than age 50: a current Anderson BO, Cazap E, El Saghir NS, et al. Optimisation of breast cancer management
assessment of the issues. CA Cancer J Clin. Sep-Oct 2000;50(5):312-336. in low-resource and middle-resource countries: executive summary of the Breast
Executive summary of the national cancer control programmes: policies and Health Global Initiative consensus, 2010. Lancet Oncol. Apr 2011;12(4):387-398.
managerial guidelines. Geneva: World Health Organization;2002. Yip CH, Smith RA, Anderson BO, et al. Guideline implementation for breast healthcare
IARC. Breast Cancer Screening. In: Vainio H, Bianchini F, eds. International Agency for in low- and middle-income countries: early detection resource allocation. Cancer. Oct
Research on Cancer (IARC) Handbooks of Cancer Prevention. Vol Volume 7. Lyon, 15 2008;113(8 Suppl):2244-2256.
France: IARC Press; 2002:87-117. Shyyan R, Sener SF, Anderson BO, et al. Guideline implementation for breast
Parkin DM, Fernandez LM. Use of statistics to assess the global burden of breast healthcare in low- and middle-income countries: diagnosis resource allocation. Cancer.
cancer. Breast J. Jan-Feb 2006;12 Suppl 1:S70-80. Oct 15 2008;113(8 Suppl):2257-2268.
Forouzanfar MH, Foreman KJ, Delossantos AM, et al. Breast and cervical cancer in Eniu A, Carlson RW, El Saghir NS, et al. Guideline implementation for breast
187 countries between 1980 and 2010: a systematic analysis. Lancet. Oct 22 healthcare in low- and middle-income countries: treatment resource allocation.
2011;378(9801):1461-1484. Cancer. Oct 15 2008;113(8 Suppl):2269-2281.
Jemal A, Thomas A, Murray T, Thun M. Cancer statistics, 2002. CA Cancer J Clin. Jan- Harford J, Azavedo E, Fischietto M. Guideline implementation for breast healthcare in
Feb 2002;52(1):23-47. low- and middle-income countries: breast healthcare program resource allocation.
Cancer. Oct 15 2008;113(8 Suppl):2282-2296.
Carlson RW, Allred DC, Anderson BO, et al. Invasive breast cancer. J Natl Compr Canc
Netw. Feb 2011;9(2):136-222. Anderson BO, Braun S, Lim S, Smith RA, Taplin S, Thomas DB. Early detection of breast
cancer in countries with limited resources. Breast J. May-Jun 2003;9 Suppl 2:S51-59.
Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial
comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the El Saghir NS, Adebamowo CA, Anderson BO, et al. Breast cancer management in low
treatment of invasive breast cancer. N Engl J Med. Oct 17 2002;347(16):1233-1241. resource countries (LRCs): consensus statement from the Breast Health Global
Initiative. Breast. Apr 2011;20 Suppl 2:S3-11.
Veronesi U, Cascinelli N, Mariani L, et al. Twenty-year follow-up of a randomized study
comparing breast-conserving surgery with radical mastectomy for early breast cancer. Yip CH, Cazap E, Anderson BO, et al. Breast cancer management in middle-resource
N Engl J Med. Oct 17 2002;347(16):1227-1232. countries (MRCs): consensus statement from the Breast Health Global Initiative.
Breast. Apr 2011;20 Suppl 2:S12-19.
Nadkarni MS, Gupta PB, Parmar VV, Badwe RA. Breast conservation surgery without
pre-operative mammography – a definite feasibility. Breast. Oct 2006;15(5):595-600. Harford JB, Otero IV, Anderson BO, et al. Problem solving for breast health care
delivery in low and middle resource countries (LMCs): consensus statement from the
Anderson BO, Braun S, Carlson RW, et al. Overview of breast health care guidelines
Breast Health Global Initiative. Breast. Apr 2011;20 Suppl 2:S20-29.
for countries with limited resources. Breast J. May -Jun 2003;9 Suppl 2:S42-50.
In: Sloan FA, Gelband H, eds. Cancer Control Opportunities in Low- and Middle-
Anderson BO, Shyyan R, Eniu A, et al. Breast cancer in limited-resource countries: an
Income Countries (summary). Washington, D.C.: The National Academies Press; 2007
40 CANCER CONTROL 2013