Recent advances in breast, cervix and oral cancer early detection and prevention in low and middle income countries


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Rengaswamy Sankaranarayanan
International Agency for Research on Cancer, World Health Organization, Lyon, France

Abstract

Early detection linked to appropriate treatment is a major strategy for breast, cervix and oral cancer control. Diagnosing and treating breast cancer cases when they are small (<2 cm) without spread to regional lymph nodes are key preventing breast cancer deaths. mammography screening is not feasible in lmics and alternative early detection approaches include 1) programs using clinical examination (cbe) of asymptomatic women 2) increased awareness among health care providers. two large randomised controlled cbe trials show significant cancers although mortality outcomes yet emerge from these studies. merits further evaluation as a cost-effective option. there several challenges implementing successful cytology developing countries. strategy involving hpv vaccination single year cohorts the age range 9-13 years aged 35 will have far reaching impact cervical low-resource settings. current research indicates that testing most effective tool negative for at baseline very low risk cancer. eventual availability simple, affordable, faster accurate tests (e.g., careHPV test) will facilitate wider HPV screening. It is prudent to implement a complimentary approach involving HPV vaccination and cervical screening in developing countries. Early oral cancers can be readily detected by trained clinicians, nurses and auxiliary health workers, by systematic visual oral inspection and by palpation. In a randomized screening trial in India, three rounds of oral visual screening at 3-year intervals were followed by 33% reduction in oral cancer mortality among tobacco and/or alcohol users. It is prudent to invest in a health care infrastructure that supports early detection and treatment of these major cancers.

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