2015年-世界发展银行全球_Disease_Control_Priorities_Third_Edition___Volume_3_Cancer_363页_7mb

Cancer: Disease Control Priorities, Third Edition

Core Content

The Disease Control Priorities (DCP3) series, specifically the volume on Cancer, is a comprehensive analysis of cancer control strategies in low- and middle-income countries (LMICs). It aims to provide evidence-based guidance to decision-makers on cost-effective, feasible, and affordable interventions to reduce the burden of cancer, aligning with global health goals such as the Sustainable Development Goals (SDGs) and the World Health Organization (WHO) targets for reducing noncommunicable disease (NCD) mortality.

The volume outlines a set of essential interventions that address the most significant cancer burdens in LMICs, including prevention, early detection, treatment, and palliative care. It emphasizes that while some cancers are preventable through measures like tobacco control and vaccination, many remain challenging due to limited access to healthcare and the complexity of treatment.

Main Points

• Global Burden of Cancer: Cancer is a leading cause of death in LMICs, especially in middle-income countries, and its burden is expected to rise due to population aging and declining mortality from other causes.

• Survival Rates: In high-income countries (HICs), most cancer patients survive, but in LMICs, less than one-third do, with some countries reporting even lower survival rates. This disparity is due to late diagnosis, limited access to effective treatment, and poorer healthcare infrastructure.

• Interventions and Packages: The DCP3 volume proposes a set of essential intervention packages that include prevention, early detection, and treatment. These packages are tailored to local epidemiological patterns and available resources, and they aim to maximize health outcomes while minimizing costs.

• Cost-Effectiveness and Affordability: The volume underscores the importance of cost-effectiveness analysis (CEA) and extended cost-effectiveness analysis (ECEA) in guiding health system investments. It argues that many interventions, especially for early-stage cancers, are both cost-effective and affordable.

• Financial Protection: The DCP3 series introduces a focus on financial risk protection, recognizing that high medical costs can push families into poverty, especially in LMICs. It encourages policies that ensure access to affordable and effective cancer care.

• Policy and System Strengthening: The volume highlights the need for national commitments to cancer control, including strengthening health systems, improving cancer registration, and promoting research in LMICs.

• Tobacco Control: Tobacco is identified as the single most important cancer-causing agent globally. The volume advocates for increased tobacco taxes and smoking cessation programs as key strategies to reduce cancer incidence and improve public health.

• Research and Evidence: The volume acknowledges the lack of clinical trials and cost data in LMICs, noting that much of the evidence is derived from HICs and adapted accordingly. It calls for more research to support locally relevant interventions.

Key Information

• Authors and Editors: The volume is edited by Hellen Gelband, Prabhat Jha, Rengaswamy Sankaranarayanan, and Susan Horton, with contributions from over 500 individuals and institutions.

• Supporting Organizations: The Bill & Melinda Gates Foundation, World Bank, and International Agency for Research on Cancer (IARC) have played a significant role in supporting the publication of this volume.

• Series Context: This volume is one of nine in the DCP3 series, which aims to provide a systematic approach to disease control in developing countries, focusing on cost-effectiveness and health impact.

• Publication Details: Published in 2015, the volume includes a foreword by Nobel Laureate Amartya Sen, who emphasizes the importance of action and commitment in the fight against cancer.

Structure of the Volume

The volume is divided into four parts:

Part 1: Burden

• Analyzes the global and regional burden of cancer, including trends and the impact of human development.

Part 2: Interventions

• Focuses on specific cancers such as breast, cervical, oral, colorectal, and childhood cancers.
• Discusses prevention, early detection, and treatment strategies, with a particular emphasis on feasibility in resource-limited settings.

Part 3: Policy, Services, and Research

• Explores policy implications, including the role of national commitments and health system strengthening.
• Addresses cancer services, screening programs, and palliative care.
• Highlights the importance of research in improving cancer outcomes and informing policy.

Part 4: Economics

• Provides an economic overview of cancer control in LMICs.
• Discusses financing models, cost-effectiveness, and affordability.
• Includes a detailed cost-effectiveness analysis of HPV vaccination in China as an example.

Conclusion

The DCP3 Cancer volume is a critical resource for policymakers, health planners, and researchers in LMICs. It emphasizes the importance of early diagnosis and treatment, the role of prevention, and the need for financial protection. By combining scientific evidence with policy insights, it aims to guide the development of effective and equitable cancer control strategies that align with global health objectives.