KARACHI: “Each year, more than 14 million people are diagnosed with cancer, the majority of whom live in low- and middle-income countries. Approximately two thirds of global cancer deaths occur in less developed countries, where case fatality rates are higher due to late-stage presentation and less accessible treatment, according to a WHO report.
The cancer burden continues to grow globally, exerting tremendous physical, emotional and financial strain on individuals, families, communities and health systems. Many health systems in low- and middle-income countries are least prepared to manage this burden, and large numbers of cancer patients globally do not have access to timely, high-quality diagnosis or treatment.
The consequence is avoidable suffering and deaths from cancer. Solutions exist. Cancer, when identified early, is more likely to respond to effective treatment, resulting in a greater probability of surviving as well as less morbid and less expensive treatment. The value of detecting cancer early is clear, and significant improvements can be made in the lives of cancer patients.
There are two distinct strategies that promote early detection, and health planners must understand their difference, relevance to particular cancer types, system requirements and impact to develop the most effective programmes. Early diagnosis identifies symptomatic cancer cases at the earliest possible stage compared to screening that seeks asymptomatic cancer or pre-cancerous lesions in a target population without symptoms. Improving early diagnosis capacity is an important strategy to cancer control in all settings, strengthening health systems and providing universal health coverage. It is founded on core principles in delivering clinical services that include community empowerment and engagement, improving health literacy, access to primary care, diagnostic capacity including pathology, strong referral mechanisms, coordination and accessing timely treatment.
Effective cancer care requires that these services are accessible, well coordinated and provided without delay. This guide is intended to support programme managers in cancer control by clarifying the concept of early diagnosis and helping users to operationalize early diagnosis programmes. Implementing the elements of this guide will depend on the local context.
There is no single approach that fits all situations thus necessary adaptations are required. Action is needed urgently to reduce premature mortality from noncommunicable diseases (NCDs), including cancer, and to achieve targets in Global Action Plan for the Prevention and Control of NCDs 2013-2020 and 2015 United Nations Sustainable Development Goals. In all countries, the desire to detect cancer early means that governments must address barriers to timely cancer diagnosis and to high-quality cancer care. By identifying appropriate strategic investments in cancer control, we can achieve these targets and reduce the burden of cancer globally.
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