CANCER CONTROL PLANNING
36 CANCER CONTROL 2015
More technical and financial support for those child
immunization programmes must be provided; leveraging
existing United States and international maternal and child
health platforms to do so would help. This strategy may also
yield compound benefits for controlling communicable
diseases. Working with suppliers to package HBV vaccine in
prefilled, auto-disable syringes appropriate for use in lowincome
countries would enable community-based health
providers to deliver immunizations after home births,
reducing the demand for health-care infrastructure in the
poorest settings (25).
Cervical cancer
Approximately 300,000 women die from cervical cancer
each year, mostly young women in low- and middle-income
countries. Cervical cancer is now the leading cause of death
from cancer among women in sub-Saharan Africa and is a
persistent, rising health challenge in developing countries
(Fig. 5) (1).
The Task Force identifies two interventions that could
transform cervical cancer control in developing countries:
increased access to the effective vaccines that exist for
preventing HPV infection; and implementation of screening
methods that are more compatible with the available
resources and infrastructure in developing countries than
Pap smear programmes. The international community
should increase assistance to low- and middle-income
countries seeking to lower HPV vaccine delivery costs and
investment in improving and integrating low-technology
screen-and-treat programmes for cervical cancer into
PEPFAR platforms (16).
Breast cancer
Between 1990 and 2013, premature deaths in low-income
countries from breast cancer grew 90%. The burden
continues to increase globally (Fig. 6). People in poor
countries have little access to the diagnostic and curative
care that is widely available for breast cancer in wealthier
countries.
The Task Force identifies four ways that the United States
government and its international partners may assist lowand
lower-middle-income countries in addressing breast
cancer and other treatable or curable cancers: (i) support
registries in developing countries to define the incidence,
mortality, and survival rates of different types of cancers; (ii)
mobilize more aid for the development of resource-levelappropriate
guidelines for the management of treatable and
curable cancers; (iii) boost the resources dedicated to NGOs
that are working to adapt and develop lower-cost, less
infrastructure-intensive breast cancer screening and
diagnosis; and (iv) explore avenues for increasing
"telepathology" programmes between developed-country
public hospitals and developing countries.
With engaged United States and international leadership,
more population and implementation research, and
collaboration with private-sector and philanthropic
Figure 5: Percentage change in breast cancer DALYs, 1990-2010