tools to prevent cervical cancerCervical cancer continues to be a big problem for developing countries. More than eight out of ten cervical cancer deaths will happen in developing countries, in spite of the fact that the tools to prevent cervical cancer are available now.

How Countries are Addressing the Issue

In May 2018 in Geneva, Gavi the Vaccine Alliance “welcomed the call” issued by the World Health Organization Director-General, Dr. Tedros Adhanom Ghebreyesus, for coordinated action against cervical cancer. The first steps on the path to eliminating cervical cancer are sustainable disease control through significant investments and holistic health systems.

Currently, cervical cancer is projected to overtake childbirth as the leading cause of death among women, especially in low- and middle-income countries. Around the world, 266,000 women and girls die each year as a result of cervical cancer. By 2030, that number could increase to more than 380,000.

Eight Gavi-supported countries have launched the vaccine nationally with 30 countries implementing a demonstration program. Ethiopia and Senegal begin nationwide vaccination in 2018. These countries understand that the tools to prevent cervical cancer are available now.

Battling Cervical Cancer in Developing Countries

Cervical cancer is the third most common cancer worldwide, with 80 percent of cases happening in the developing world. It is the leading cause of death among women in developing countries, where it causes about 190,000 deaths each year. Cervical cancer risk is highest in Central America, sub-Saharan Africa and Melanesia.

A lack of effective screening programs used to detect and lead to treatment of pre-cancerous conditions is the major reason for the much higher cervical cancer occurrence in developing countries. Roughly about five percent of women in developing countries have been screened for cervical dysplasia, compared to 40 to 50 percent of women in developed countries.

Of the total number of cases of cervical cancer worldwide, 99 percent were estimated to contain HPV DNA. HPV virus infects the cells of the cervix and slowly causes pre-cancerous cellular changes (dysplasia) that progress. Women are generally at the highest risk of HPV infection in their teens, 20s or 30s. It can take as long as 20 years after the initial HPV infection for cancer to develop.

Using the Proper Tools to Prevent Cervical Cancer

In many developing countries, treatment options are limited. Cervical lesions are often treated with aggressive approaches like cone biopsies or hysterectomies (removal of the uterus) rather than with appropriate outpatient approaches.

Simple outpatient procedures should be used instead to destroy or remove pre-cancerous tissue. A common outpatient method is cryotherapy; another is a loop electrosurgical excision procedure (LEEP). LEEP does involve more equipment and supplies, but it removes diseased tissue while at the same time providing a specimen for analysis, reducing the possibility of overlooking invasive cancer.

The keys to curing cervical cancer and reducing HPV infections are education, screening and access to vaccines. What is required is the removal of barriers preventing women and girls from accessing the necessary healthcare. From vaccination campaigns to self-administered screenings, many countries are already on the right path to helping stop unnecessary deaths from cervical cancer. The tools to prevent cervical cancer are available now, and women in developing nations have a right to access those tools.

– Gustavo Lomas
Photo: Flickr

children with cancer worldwide
Every year many families are confronted with the difficult diagnosis that their child has cancer. Researchers at St. Jude Children’s Research Hospital in Memphis, Tennessee are familiar with this harsh reality and are on a mission to bring needed resources to families of impoverished children with cancer worldwide.

According to pediatric oncology researchers, 80 percent of the 160,000 children that are diagnosed with cancer worldwide have limited access to quality care and thus have a lower chance of surviving the disease. St. Jude is leading the way people understand and treat childhood cancer and have established an initiative named St. Jude Global to help spread their valuable resources overseas to reach children with cancer worldwide.

About St. Jude Global

“St. Jude Global, a major expansion of the former St. Jude International Outreach Program, is a strategic initiative led by the St. Jude Department of Global Pediatric Medicine.”

The initiative is composed of researchers and healthcare providers who have brought together resources including quality facilities, treatment protocols and research programs to address the needs of children with cancer worldwide, especially those living in developing and third-world countries.

Collaborations have been established in Central and South America, the Caribbean, Africa, the Middle East, Asia and Oceania, as well as include over 28 countries as current beneficiaries.

Easing the Burden for Families

Over the years, St. Jude’s partnership with international organizations has helped reached vulnerable children in developing and third-world countries and brought progress to the sobering statistic of childhood cancer worldwide. Some of these programs include:

  • Pediatric Oncology East and Mediterranean Group: Formed in 2013, this is a collaboration between physicians, scientists and healthcare professionals from over 50 pediatric cancer centers across the Middle East and the Mediterranean. The initiative aims to “improve pediatric oncology research, training, patient care and advocacy by working in multidisciplinary teams across political and territorial boundaries.”
  • The Asociación de Hemato-Oncología Pediátrica de Centro América: Founded in 2000, “this network provides educational and training opportunities to local health care providers, as well as a framework for collaboration between participating institutions.”
  • National Childhood ALL Study Group in China: Founded in 2005, this study group established the first National Childhood ALL study group after physicians at Beijing Children’s Hospital and Shanghai Children’s Medical Center (SCMC), came together in a joint collaboration with St. Jude to “explore ways to optimize [Acute Lymphoblastic Leukemia (ALL)] treatment in China.”

Progress So Far

As a result of  St. Jude’s global partnerships with international organizations, thousands of children have benefitted from life-saving treatment.

In China, St. Jude’s collaboration with Beijing Children’s Hospital and Shanghai Children’s Medical Center increased the number of treated patients with ALL in mainland China from 10 percent before the year 2000, to over 90 percent as of 2014.

Furthermore, the Asociación de Hemato-Oncología Pediátrica de Centro América (AHOPCA) has been able to successfully fund treatment for thousands of cancer patients since the year 2000. Although there is still progress to be made with the fight against childhood cancer worldwide, St. Jude Children’s Research Hospital remains a strong force in the efforts to ensure that no child dies of cancer anywhere.

– Lois Charm

Photo: Flickr

Screening Breast Cancer in EthiopiaBreast cancer is the most common cancer found in females in both developed and developing countries. The occurrence of this cancer is soaring in developing countries due to factors such as increases in life expectancy, the expansion of urbanization and the endorsement of a more Western lifestyle. Breast cancer in Ethiopia is becoming the most prevalent disease among Ethiopian women, surpassing cervical cancer.

Many factors are known to contribute to breast cancer in women, such as the age at which women deliver children, poor diet, lack of physical exercise, uncontrolled consumption of alcohol and the lifestyle a woman lives.

Some of these factors might be reduced with lifestyle changes. However, prevention cannot eliminate the majority of breast cancer diagnosed in very late stages in low and middle-income communities. Early detection is important in order to improve breast cancer outcomes.

Pink Ribbon Red Ribbon (PRRR) is a global partnership comprised of national governments, corporations, foundations and NGOs, all working with the same intent: to reduce deaths caused by cervical and breast cancer in low- and middle-income communities.

By mobilizing resources from its cohorts, PRRR and its collaborators work on interventions ranging from prevention to medical care by educating the community about cancer, vaccinating young girls against HPV, screening women for breast cancer and cervical cancer and increasing access to treatments.

PRRR began supporting the government of Ethiopia in 2014 with the formation of a comprehensive cancer control program. With backing from PRRR and the Mathiwos Wondu Ye-Ethiopia Cancer Society, the first National Cancer-Control Plan (NCCP) was launched in October 2015 by Ethiopia’s first lady, Roman Tesfaye.

The plan is to launch five cancer treatment centers in the country, relieving the burden on the Tikur Ambessa Hospital in Addis Ababa. The government has committed $12 million to develop these centers at teaching hospitals in the areas of Mek’ele, Gondar, Jima, Hawassa and Haromaya.

The NCCP also called for cancer screenings to be offered in all of Ethiopia at locations known as “Screen-and-Treat” sites, which will be available in 118 locations. PRRR is pleased to contribute technological and monetary assistance to complement the investments of the Ethiopian government to implement this vision.

PRRR is also backing the government of Ethiopia in opening more cervical and breast cancer screening locations in the two most populated regions and Addis Ababa.

With foundations like Pink Ribbon Red Ribbon breaking ground in Ethiopia where there are not many resources available to most women, the awareness of breast cancer in Ethiopia is becoming much greater. With continued work, more progress will be made in the prevention and early detection of the disease.

– Zainab Adebayo

Photo: Google

In the African country of Senegal — population 15.41 million — cervical cancer is the leading cause of cancer deaths among women, and the nation ranks at number 15 in global cervical cancer prevalence.  Considering the cancer is completely treatable through early detection, the number of deaths from cervical cancer in Senegal is startling.

Cervical cancer is the third most commonly diagnosed and the second most common cause of cancer deaths among women. However, in the U.S. and other developed countries, cervical cancer does not even rank among the top three cancer killers. Why the discrepancy between nations like the U.S. and developing nations like Senegal?

The answer is simple: access to screenings and vaccines.

Screening for a Treatable Cancer

While cervical cancer was the leading cancer killer of women in the U.S. until the 1950s, development of the Papanicolaou (Pap) smear allowed for detection of cell abnormalities.  In the following decades, scientists and doctors learned that cervical cancer is the most preventable and treatable type of cancer because it develops very slowly.

“There are 5 to fifteen years from the first cellular changes to the actual cancer development,” says Dr. Andrew Dykens, professor of family medicine at the University of Illinois at Chicago (UIC).  “So you’ve got time during that phase to do something about it.”

Dykens is director of the Global Community Health Track at the Center for Global Health at UIC.  He is also a former Peace Corps volunteer and current member of Rotary International (Rotary Club of Chicago).  He also started the nonprofit Peace Care, which provides resources by bringing together the local expertise of Peace Corps workers and the communities who need them.

Dykens worked with each of these organizations and Senegal’s Ministry of Health and Social Action to bring low-cost screening to the women of the nation.  A method even simpler than a Pap smear, a vinegar solution is used to detect abnormal cells.  The cells can be killed off immediately with a cryotherapy gun and a CO2 tank — another simple method that involves no electricity.

The Cancer Vaccine

In 2013, the global vaccine alliance Gavi selected ten African countries for a pilot human papillomavirus (HPV) vaccination program, with Senegal being among them.

Certain strains of HPV are the cause of cervical cancer.  While the HPV vaccine has been used in the U.S. and other developed countries since 2006, it was finally introduced to Africa in 2016.  Along with Rwanda and Uganda, Senegal is one among the first three countries to adopt the vaccine as part of its national vaccination program.

Professor Ousseynou Badiane, head of Immunization Division for the Ministry of Health in Senegal, states that through subsidization by Gavi and the Senegalese state, the vaccine will be accessed by all at no cost.  The vaccine is being implemented in two phases – first, a mass vaccination for girls between age 9 and fifteen by May 2018; after that, it will become part of routine immunizations for all girls at age 9.

In the U.S., women are commonly screened for cervical cancer every three years.  For cervical cancer in Senegal, many women are being screened for the first time.  Dykens and other health practitioners understand the challenges they face in terms of a traditionally conservative environment concerning women’s health issues. But with Peace Care, local Rotary clubs, Gavi, and others working together with the nation’s government, promotion of awareness and education will reduce the number of deaths caused by cervical cancer in Senegal.

– Jaymie Greenway

Photo: Flickr

Common Diseases in Portugal

Portugal has a population of 10.5 million as of 2016, and a mortality rate of 548.6 deaths per 100,000 people. The top ten most common diseases in Portugal in 2016 were ischemic heart disease, cerebrovascular disease, Alzheimer’s disease, lower respiratory infections, COPD, colorectal cancer, lung cancer, diabetes, chronic kidney disease and stomach cancer.

The rates of ischemic heart disease, cerebrovascular disease, diabetes and stomach cancer have all gone down in recent years, though they still rank in the top ten. The top ten causes of disability in 2016 were low back and neck pain, sense organ diseases, depressive disorders, migraines, skin diseases, anxiety disorders, oral disorders, diabetes, falls and other musculoskeletal issues.

Broadly speaking, the deadliest diseases are cardiovascular diseases, cancer and neurological disorders.

Addiction: A Major Success Story

While Portugal has made strides in reducing the rates of the diseases described above, its biggest success has been in tackling addiction, particularly to heroin.

In the 1980s and 1990s, a major opioid epidemic made addiction one of the most common diseases in Portugal. By the mid-1990s, over one percent of Portugal’s population was addicted to heroin, and cocaine use was also prevalent.

To address this epidemic, Portugal took the opposite approach to other countries struggling with a similar epidemic, such as the United States. Whereas the U.S. cracked down on drug use and initiated a war on drugs, Portugal completely decriminalized all drugs, including heroin, in 2001. Dealing drugs was still illegal and punishable with jail time, but users caught with less than a 10-day supply of any drug were sent to mandatory medical treatment.

This system completely bypassed the legal system, treating addiction as a health issue instead of a crime. This approach led to a 75 percent reduction in drug cases and a 95 percent reduction in drug-related HIV infections. Deaths due to overdoses or drug-related infections in Portugal are currently five times lower than the average across the European Union.

A model for change?

While any radical change in policy must be considered in the context of each country’s current legal system and culture, aspects of Portugal’s approach to addiction constitute a model that could be successfully implemented across the world.

The basis of this model are outreach programs whose employees keep track of local drug users and encourage them to quit. If they accept, they provide them with free counseling and treatment and daily methadone to wean them off the opioids. If they refuse to quit at that time, then outreach workers hand out clean needles and condoms to reduce the spread of HIV/AIDS.

This model is also economically efficient. The U.S. currently spends approximately $10,000 per household to uphold its current drug policy, while Portugal currently spends $10 per citizen.

The most common diseases in Portugal are similar to those across the European Union. What makes Portugal stand out is its reaction to one particular disease: addiction. If Portugal brings this innovation to other realms of disease prevention, it could be poised to drastically lower its disease burden in the coming decades.

– Olivia Bradley

Photo: Flickr



Sub Saharan AfricaWith cancer claiming the lives of about 450,000 Africans per year, drug manufacturers, in a deal with the American Cancer Society (ACS) and the Clinton Health Access Initiative (CHAI), have decided to bring life-saving treatments to tens of thousands Africans in need of major healthcare improvements.

The agreement was made between two major pharmaceutical companies: Pfizer, located in the U.S. and Cipla, one of the giants in the Indian pharmaceutical world. Both will cut the prices of 16 cancer treatment drugs, including chemotherapies, for six countries in sub-Saharan Africa that are most affected by the disease.

The six countries receiving major discounts on cancer medicines are Ethiopia, Nigeria, Kenya, Uganda, Rwanda and Tanzania. A press release by the ACS reveals these are the countries in major need of health improvement, as 44 percent of all cancer cases occurring in sub-Saharan Africa each year happen in these six targeted countries.

According to the Pharmaceutical Journal, there were an estimated 626,000 new cases of cancer in sub-Saharan Africa in 2012, leading to a total of 447,000 deaths by cancer. The World Health Organization predicts this figure could double by 2030 if nothing is done, with killings reaching almost one million sub-Saharan Africans. In comparison to the U.S., with 90 percent of women surviving five years with breast cancer, Uganda and Gambia have survival rates of 46 percent and 12 percent, respectively.

Some of the factors explaining the start of Africa’s cancer crisis are the lack of training for providers, shortages of medications and the insufficiency of diagnostic and therapeutic equipment. Another barrier to quality care for cancer patients in Africa is linked to biology. In fact, there are differences in tumor biology between African cancer patients and patients in developed countries. As an example, African patients often have bigger tumors than patients in other regions, which demands much more care as well as adequate infrastructure to research solutions for curing the disease.

Funding is also a major problem for sub-Saharan Africa, as global funding for cancer prevention and treatment in other low-income countries represents only two percent of global health spending. This is far lower than the health spending for diseases such as HIV, malaria and tuberculosis.

Having access to high-quality and affordable cancer treatment facilities and medicine in sub-Saharan Africa has become a major goal for ACS and its partner organizations. On top of this agreement, they are preparing long term strategies that will improve the lack of care facing many African patients for years to come.

Sarah Soutoul

Photo: Flickr

Zika Virus Kills Cancer Cells

To most, “Zika virus” is synonymous with “devastation.” Here is a quick summary of Zika’s recent global impact:

  • Between January 1, 2007, and April 6, 2016, 62 nations and territories reported Zika virus transmission.
  • Zika Virus brought widespread infection to the Regions of the Americas in 2015.
  • The most recent outbreak indicated by the World Health Organization occurred in India in May 2017.
  • Based on initial research, the scientific community concedes that Zika virus is a cause of microcephaly and Guillain-Barré syndrome.
  • No vaccines or treatment exist for the mosquito-borne Zika virus.

What positive news related to this devastating threat could possibly exist?

In a startling new study, the Washington University School of Medicine—in conjunction with the University of California San Diego School of Medicine—assert that Zika virus kills cancer cells in adult human brains. The Journal of Experimental Medicine published the results in a report in early September. It posits that injecting the Zika virus into the brain at the same time as surgery could potentially remove life-threatening tumors.

The Zika virus attacks malignant brain tumors called glioblastomas. Glioblastoma is one of the most challenging cancers to treat. The conventional treatment is brain surgery followed by radiation and rounds of chemotherapy within 2 to 4 weeks after surgery. Follow-up procedures must begin as soon after surgery as possible, as new glioblastomas can generate rapidly. Frequent patient observation with magnetic resonance imaging (MRI) or computed tomography (CT) scans is another vital element of ongoing medical care.

Still, most tumors reappear within six months. A small population of cells, called glioblastoma stem cells, often survives the treatments and continues to divide, producing new tumor cells to replace the ones killed by the cancer drugs. Glioblastoma stem cells are hard to kill because they can avoid the body’s immune system and are resistant to chemotherapy and radiation. However, researchers believe that the Zika virus kills cancer cells, preventing new tumors from recurring after surgically removing the original tumor.

Despite such aggressive treatment, glioblastoma cells remain deadly: most patients die within 15 months. According to the American Association of Neurological Surgeons, nearly 52 percent of all primary brain tumors are glioblastomas. Each year in the United States, this widespread form of brain cancer affects approximately 12,000 people. U.S. Sen. John McCain announced he is battling with glioblastoma in July 2017.

The Washington University – University of California San Diego School experiment revealed that the Zika virus favored destroying glioblastoma stem cells over normal brain cells in mice. Two weeks later, the mice with Zika virus injected into their cancerous tumors exhibited smaller tumors than those without the virus. Mice with Zika virus injected into their brain tumors seemed to survive longer than those without the injections.

Despite differences in the biological systems of mice and humans, the research team believes their proposal the Zika virus kills cancer cells merits pursuing. The joint research team hopes to begin human trials in the next 18 months.

According to Michael S. Diamond, MD, Ph.D., the Herbert S. Gasser Professor of Medicine at Washington University School of Medicine, “These cells are highly resistant to conventional therapies.” Diamond continued, “While the Zika virus does harm to the brains of developing fetuses, it may prove effectual in the treatment of glioblastoma in adult brains.”

Heather Hopkins

Photo: Flickr

Top 3 Diseases in Israel
While Israel has been able to lower the number of deaths caused by diseases, many conditions in Israel are still prevalent. The death rates from certain diseases in Israel have declined by 80 percent since the 1970s, but there is always room for improvement. Here are the top three diseases in Israel.

Top Three Diseases in Israel

  1. Cancer: Cancer, the major killer in Israel, caused almost one-quarter of total deaths in Israel in 2011. Even though the cancer rate is relatively low compared to other countries, cancer is still a primary cause of death. The most common cancer among Israeli men is lung cancer, which is primarily caused by tobacco smoking. The most common cancer among Israeli women is breast cancer. About 4,500 Israeli women are diagnosed with breast cancer each year, and 900 dying from it. However, according to the Israel Cancer Association, the number of women surviving breast cancer is steadily on the rise thanks to research and technology able to detect early signs. It has also been reported that the lung cancer rate among men is lower than most countries.
  2. Coronary Heart Disease: Coronary Heart Disease is the second most prevalent cause of death in Israel. Together, cancers and heart disease account for 40 percent of deaths. However, like cancer, heart disease in Israel is being contained. The death rate from heart disease in Israel has dropped by 50 percent since 1998, partly due to declines in smoking and national campaigns against obesity, diabetes and hypertension. The people of Israel have been willing to change their lifestyles to prevent heart disease. There are also reliable ambulance services in Israel to respond to any emergency.
  3. Diabetes: Diabetes is the next leading cause of death after cancer and heart disease. Compared to other countries, deaths from diabetes are high in Israel. But the country has tried a number of ways to defeat diabetes including using an artificial pancreas, medical smartphones and glucose-sensing enzymes. Researchers have also been looking for a cure with the help of the Juvenile Diabetes Research Foundation and the Israel Science Foundation. Scientists are also working on an antibody to block killer cells that destroy helpful cells in the pancreas.- Emma MajewskiPhoto: Flickr

Cancer affects the lives of children all over the world, but it is estimated that up to 90% of children with cancer live in developing countries. In low-income countries where access to healthcare is limited, childhood cancer survival rates are as low as 10 to 20%. Although HIV/AIDS infections amongst children remain a critical health priority in sub-Saharan Africa, cancer is emerging as one of the major causes of childhood death on the African continent. Treatment of childhood cancer in Africa is of growing concern.

The most common forms of childhood cancer in Africa are leukemia, lymphomas and tumors of the central nervous system. In African countries with high instances of childhood HIV/AIDS, AIDS-related cancers like Kaposi’s sarcoma (a cancer of the blood vessels) are common. In countries with high rates of malaria infections, Burkitt’s lymphoma is the most common childhood cancer.

Lack of Treatment Options

Cancer in Africa is problematic to treat because it remains a largely unknown disease within communities and most patients reach out to doctors when it is too late. Advocacy and creating public awareness are thus key points to tackling childhood cancers.

Furthermore, specialist treatment facilities on the African continent are particularly lacking. Currently, there are more than 450 million children living in African countries, but there are only four specialist children’s hospitals, the majority of which are in South Africa. Most children with cancer never reach a specialist treatment center.

Due to the lack of equipped healthcare facilities, the diagnosis of cancer often takes place too late or healthcare facilities lack the equipment and training to even treat it. In 2016, more than 20 African countries did not have any facilities with a working radiotherapy machine — the most common form of cancer treatment. A survey by the Atomic Energy Agency found that there are only a few hundred radiotherapy machines on the continent of more than a billion people. The majority of these machines are in just a few countries: South Africa, Egypt, Morocco, Tunisia, Nigeria and Algeria. In most African countries, cancer is a death sentence.

New Funding Provides Hope

The Baylor College of Medicine and Texas Children’s Hospital, with additional funding from the Bristol-Myers Squibb Foundation, recently unveiled an initiative to address these issues called Global HOPE (Hematology-Oncology Pediatric Excellence). The plan includes the creation of a network of pediatric cancer care facilities in southern and east Africa in partnership with local governments. The first center will be built in Botswana. They will also train health care providers in Botswana, Malawi, Uganda and other African countries to detect and treat childhood cancers. They expect that this will create a blueprint for childhood cancer care that other countries can follow.

Childhood cancer in Africa, like most noncommunicable diseases on the continent, is of growing concern. These diseases are however increasingly garnering the attention needed to address them in the coming years.

Helena Kamper

Photo: Flickr

Cancer in Resource-Poor Countries
In 2012, 3.5 million women died from cancer. Women are diagnosed with cervical and breast cancer at a rate of about 2 million per year, and the diseases’ outcome can largely be predicted by geography. According to The Lancet, 62 percent of deaths resulting from breast cancer occurred in low- and middle-income countries. Similarly, 87 percent of deaths due to cervical cancer occurred in resource-poor countries. Clearly, fighting cancer in resource-poor countries can be difficult.

These trends are even more concerning given that the number of cancer-related deaths among women is expected to increase to 5.5 million by 2030. Over this same time period, the number of women diagnosed with breast cancer is expected to nearly double, and the number of women diagnosed with cervical cancer is expected to increase by 25 percent.

Most global health efforts targeted toward women focus on sexual and reproductive health. However, non-communicable diseases like cancer, cardiovascular disease, respiratory disease, diabetes, dementia, depression and musculoskeletal disorders constitute the greatest threats to women’s health. Indeed, breast cancer and cervical cancer result in three times as many deaths as childbirth and pregnancy complications do.

Further, the global economic burden of cancer is sizable ($286 billion in 2009), primarily because it keeps people out of the workforce and can lead to premature death. Addressing the burden of cancer on women’s health could lead to increased female participation in activities that benefit countries’ economies.

Even in more developed countries, cancer screenings and appropriate treatments are not equally available to all groups. Women belonging to ethnic and cultural minorities, in particular, may not have access to essential health care.

However, cancer screening and treatment is not as costly as is often assumed. As little as $1.72 per person could provide essential medical interventions to diagnose and treat cancer effectively. This amount is about 3 percent of current health care spending in resource-poor countries.

Mammograms for breast cancer screening and radiography for cancer treatment are not often available in low- and middle-income countries. A series of articles from The Lancet recommended increasing the availability of the HPV vaccine for girls and providing cost-effective screening procedures like clinical breast examinations and cervical cancer screenings through visual inspection with acetic acid.

The articles also called for mastectomy and tamoxifen treatments to be made available to people fighting cancer in resource-poor countries by 2030. The Lancet cited Mexico and Thailand as examples of countries where universal health care coverage has improved the diagnosis, treatment and outcome of cancer in women.

Madeline Reding

Photo: Flickr