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Mendoza-Cervantes D, Otero I, Zujewski JA, Ferrandiz Salazar J, López Córdova G, Muha C, Stevens L. Building a Network of Health Professionals for Breast and Cervical Cancer Control in the Andean Region. J Glob Oncol 2018; 4:1-8. [PMID: 30241215 PMCID: PMC6180811 DOI: 10.1200/jgo.2016.008714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Cancer mortality is approximately twice as high in Latin American countries than in more developed countries. In particular, the countries of the high Andean region of Latin America carry a double burden of breast and cervical cancers. In these countries, there are disproportionately higher mortality to incidence ratios compared with other regions in Latin America. The US National Cancer Institute's Center for Global Health, the Pan American Health Organization, and the Ministry of Health in Peru collaborated to design and execute an education and advocacy workshop in Lima, Peru. The workshop was convened to discuss regional challenges and practices, as well as to support the implementation of Plan Esperanza, Peru's national cancer control plan. METHODS Workshop participants included local and international experts to present the state of the science, health practitioners, and advocacy groups to discuss unique barriers that women in the region experience. RESULTS Inequalities in access to and distribution of medical expertise, lack of continuity of cancer control plans, and the need for sustained public buy-in emerged as obstacles. CONCLUSION The workshop provided a forum to discuss key issues regarding breast and cervical cancer control among health professionals and advocates in Peru and the region. This article outlines the resulting recommendations.
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Affiliation(s)
- Diana Mendoza-Cervantes
- Diana Mendoza-Cervantes, Isabel Otero,
Jo Anne Zujewski, Cathy Muha, and Lisa
Stevens, National Institutes of Health, Rockville, MD; and
Jorge Ferrandiz Salazar and Gabriela López
Córdova, Ministerio de Salud de Perú, Jesús
María, Lima, Peru
| | - Isabel Otero
- Diana Mendoza-Cervantes, Isabel Otero,
Jo Anne Zujewski, Cathy Muha, and Lisa
Stevens, National Institutes of Health, Rockville, MD; and
Jorge Ferrandiz Salazar and Gabriela López
Córdova, Ministerio de Salud de Perú, Jesús
María, Lima, Peru
| | - Jo Anne Zujewski
- Diana Mendoza-Cervantes, Isabel Otero,
Jo Anne Zujewski, Cathy Muha, and Lisa
Stevens, National Institutes of Health, Rockville, MD; and
Jorge Ferrandiz Salazar and Gabriela López
Córdova, Ministerio de Salud de Perú, Jesús
María, Lima, Peru
| | - Jorge Ferrandiz Salazar
- Diana Mendoza-Cervantes, Isabel Otero,
Jo Anne Zujewski, Cathy Muha, and Lisa
Stevens, National Institutes of Health, Rockville, MD; and
Jorge Ferrandiz Salazar and Gabriela López
Córdova, Ministerio de Salud de Perú, Jesús
María, Lima, Peru
| | - Gabriela López Córdova
- Diana Mendoza-Cervantes, Isabel Otero,
Jo Anne Zujewski, Cathy Muha, and Lisa
Stevens, National Institutes of Health, Rockville, MD; and
Jorge Ferrandiz Salazar and Gabriela López
Córdova, Ministerio de Salud de Perú, Jesús
María, Lima, Peru
| | - Cathy Muha
- Diana Mendoza-Cervantes, Isabel Otero,
Jo Anne Zujewski, Cathy Muha, and Lisa
Stevens, National Institutes of Health, Rockville, MD; and
Jorge Ferrandiz Salazar and Gabriela López
Córdova, Ministerio de Salud de Perú, Jesús
María, Lima, Peru
| | - Lisa Stevens
- Diana Mendoza-Cervantes, Isabel Otero,
Jo Anne Zujewski, Cathy Muha, and Lisa
Stevens, National Institutes of Health, Rockville, MD; and
Jorge Ferrandiz Salazar and Gabriela López
Córdova, Ministerio de Salud de Perú, Jesús
María, Lima, Peru
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Resource-stratified implementation of a community-based breast cancer management programme in Peru. Lancet Oncol 2017; 18:e607-e617. [PMID: 28971827 DOI: 10.1016/s1470-2045(17)30592-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 01/26/2017] [Accepted: 02/09/2017] [Indexed: 11/24/2022]
Abstract
Breast cancer incidence and mortality rates continue to rise in Peru, with related deaths projected to increase from 1208 in 2012, to 2054 in 2030. Despite improvements in national cancer control plans, various barriers to positive breast cancer outcomes remain. Multiorganisational stakeholder collaboration is needed for the development of functional, sustainable early diagnosis, treatment and supportive care programmes with the potential to achieve measurable outcomes. In 2011, PATH, the Peruvian Ministry of Health, the National Cancer Institute in Lima, and the Regional Cancer Institute in Trujillo collaborated to establish the Community-based Program for Breast Health, the aim of which was to improve breast health-care delivery in Peru. A four-step, resource-stratified implementation strategy was used to establish an effective community-based triage programme and a practical early diagnosis scheme within existing multilevel health-care infrastructure. The phased implementation model was initially developed by the Breast Cancer Initiative 2·5: a group of health and non-governmental organisations who collaborate to improve breast cancer outcomes. To date, the Community-based Program for Breast Health has successfully implemented steps 1, 2, and 3 of the Breast Cancer Initiative 2·5 model in Peru, with reports of increased awareness of breast cancer among women, improved capacity for early diagnosis among health workers, and the creation of stronger and more functional linkages between the primary levels (ie, local or community) and higher levels (ie, district, region, and national) of health care. The Community-based Program for Breast Health is a successful example of stakeholder and collaborator involvement-both internal and external to Peru-in the design and implementation of resource-appropriate interventions to increase breast health-care capacity in a middle-income Latin American country.
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