bluuebunny/crossref_metadata_2025 huggingface dataset:
Advances in Early Screening and Detection My Name Is Chiluba Daka Aged 46 Years. I Am a Recent Breast Cancer Survivor. I Am Single With No Children Emerging From a Developing Country, Which Only Has One Cancer Diseases Hospital Is What Has Prompted Me to Write Something
Authors: Daka C.
Published: September 2018

Amount raised: K80,000 Background and context: Breakthrough cancer trust held a fundraising dinner dance to raise finances to build a wellness center in Lusaka. Aim: Wellness center to house care givers and patients once discharged from the cancer diseases hospital, especially those patients from upcountry towns. Strategy/Tactics: We have other fundraisers billed up for this year such as dinner dance. We have partners and well wishers who donate toward our cause, but we plan to also start one weekend per month a no car policy, which will enable people to walk and raise money toward breast cancer awareness and screening. This in turn will enable us screen women for breast cancer without an extra cost, as this has been a challenge having only one cancer diseases hospital in the country. Program process: Costs and returns: We have a number of pledges from well wishers, but also have planned fundraising walks too. What was learned: Having just completed my treatment in 2017, I see the challenges faced by many especially for those who live outside Lusaka. Accessing mammograms and ultrasound services is unaffordable for many, unless they go to the hospital during the free cancer awareness and screening month in October. During our awareness walk we meet a lot of people in the streets and handout flyers. Then we realised a lot of people are unaware of breast cancer and the symptoms and only learn of them once a loved one is diagnosed with it. They do not even know simple self-breast checks.
Overcoming Challenges of Holistic Cancer Care in Low-Resource Settings
Authors: Akintude E.S. , Lawal I. , Osinowo A. , Okeremi A.
Published: September 2018

Background and context: Live does not remain the same after receiving the news of cancer in a family. Most people face some degree of depression, anxiety, fear or distress when cancer becomes part of their lives. The disruptive effect of cancer on family happiness is worsen by high cost of care, this is particularly relevant in low resource settings where health poverty is prevalent and most healthcare expenses are out of pocket. My family never remained the same from the point we received the diagnosis of colon cancer in my late husband. While I derive satisfaction in the knowledge that we fought the disease with everything we had up until the time of his death, I am however certain that the attendant stress would have been significantly lessened had healthcare providers availed us with all the necessary information required for us to cope with the condition. Consequently, Niola Cancer Care Foundation was conceptualized to bridge the identify gaps. Aim: To support healthcare providers in providing holistic care to cancer patients in low resource settings. Strategy/Tactics: Drawing largely from the experience and knowledge acquired during the care and management of my late husband and subsequent requests from careers of cancer patients for guidance, we conceptualized Cancer Assistance Network (CAN) with the aim of providing support to cancer patients and the carer to ease their challenges in accessing care in Nigeria. Program/Policy process: Cancer patients and their carers are recruited into the Cancer Assistance Network either through our routine hospital visits or by client-initiated contact. To facilitate individualization of support to suite individual patient's needs and requirements, the client requesting assistance is required to answer specific questions relating to the disease condition, treatment received so far and area of assistance required from Niola Cancer Care Foundation. Based on agreed criteria, the level of support that can be rendered is discussed. The support is categorized into 3 broad headings; financial, informational and emotional support. Outcomes: Finance is the primary reasons why most patients or their carer seek support from Niola Cancer Care Foundation. Unfortunately, most times we are not able to meet their financial requirements leading to initiation disappointment. We are however able to restore hope and confidence as we provide informational and emotional support. What was learned: Healthcare professionals for whatever reasons seems not to be comfortable discussing holistic cancer care with patients particularly those with advanced state requiring palliative care. Consequently, there is a disconnect between patients and healthcare professional's expectation of outcome. We are working with healthcare professionals to better understand factors responsible for poor communication of expected outcome between them and the patients.
Pattern of Cancer Among the Yemeni Population
Authors: Saleh G.
Published: September 2018

Background: The increased number of reported cases in Yemen is an alarming situation that is considered as an important health problem. The aim of the present paper is to describe the pattern of the cancer among the Yemeni population as regards to age and sex distribution, residency and site of the cancer. Methods: The registered cases of cancer in the abroad treatment office in Al Thawra hospital, Taiz governorate for the year 2012 were revised and analyzed by the author to describe the pattern of cancer. Epi-Info software was used in the analysis of the data. Results: A total of 342 cases were registered for abroad treatment during the period of the study. Sex distribution showed male to female ratio of 48% and 52% respectively. The most leading sites of cancer among females were: breast (20%), musculo-skeletal (16%), digestive and endocrine (12%). Among males they were: digestive system (26%), musculo-skeletal (20%), brain (11%), and respiratory system (9%). 61% of the studied cases were among the age group (21-50) years with a maximum peak between (21-40) years. Most of the cancer cases were from Taiz city (45%). Conclusion: Cancer of the breast among females and digestive system among males comprised the majority of registered cases. Residency distributions showed Taiz city preponderance (45%). However increasing the awareness of the public about the problem of cancer and its risk factors beside improving the facilities for early detection of cancer as well as establishing registration centers for cancer in different parts in Yemen and further studies by health professionals to investigate the risk factors for cancer are mandatory.
Nationwide Cancer Control Program in India: 3 Decades of Experience With Fundraising Report
Authors: Gupta P. , Tripathi N.
Published: September 2018

Amount raised: In last decade INR 169,708,369 mobilized through sponsored cancer awareness programs. Background and context: With an eagle's eye our vision of eighties resulted in the incorporation of Cancer Aid Society on 8th of December 1987 at Lucknow. Founders of the Cancer Aid Society perceived the threats early and initiated the fight against cancer by developing a self-sustainable model without external financial assistance unfurling series of events internationally. As of now ours is a holistic model on cancer prevention integrated with NCDs, tobacco and palliative care demonstrating replicability within different communities and scalability across the worlds largest democracy having its own network of branches. Aim: Self-sustainable model prevention and control of tobacco, cancer integrated with other NCDs, palliative care and advocacy. Strategy/Tactics: Sponsored cancer awareness programs are organized free of cost in schools and colleges however we accept voluntary donations from the community if any. As schools have contact with the child and their family from kindergarten to senior secondary, they inculcate the spirit of humanitarianism and work for social amelioration improving the overall health of the citizens strengthening the fight against cancer. It covers the need of the current and future generations on cancer control. Program process: Keeping with the ages old adage “Prevention Is Better Than Cure” thousands of community awareness campaigns are organized in educational Institutions every year by mobilizing a million volunteers who generate awareness among twenty million people all over India on health, hygiene, tobacco abuse including passive smoking, carcinogens, balanced diet, regular exercise, obesity, clean drinking water, pollution of air, water and land etc. This plays an integral part in inculcating healthy lifestyle and keeping children away from tobacco at an age when they are vulnerable and tempted the most further grooming our future generation when they are most receptive and in the process of developing habits. They multiply awareness manifold improving the overall health of the community. Costs and returns: As the program follows an integrated and holistic approach on prevention and control of cancer and other NCDs virtually it lacks any administrative costs and offers 100% returns on investments. In last decade INR 144,968,969 spent in sponsored cancer awareness programs. What was learned: With our 30 years of experience of working at grass root community level all across India in spite of regional complexities in terms of multiple languages, cultures, castes, religions etc. ISO 9001 NGO accreditation has given us teeth since 2004 streamlining our functioning through documentation and continuous improvement program through reporting monitoring and feedback. As of now we are ready to share our experiences at international level.
Hellenic Alliance for Metastatic Breast Cancer: A Platform of Support, a Platform for Life
Authors: Tarampikou A. , Saridaki Z. , Kolokotroni S. , Christopoulou A. , Agelaki S. , Galani E. , Psyrri A. , Nikolaidi A. , Linardou H.
Published: September 2018

Background and context: W4O-Hellas (Women for Oncology-Hellas, a network of women professionals in oncology) and K.E.F.I. (an association of cancer patients) joined forces to create the “Hellenic Alliance for Metastatic Breast Cancer”, a project awarded through the SPARC initiative. The project is consisting among others, on creating, promoting and maintaining a Web-based platform of education, information, communication, advocacy and support for MBC patients in Greece. Aim: The aim of the platform is to provide education at patients and caregivers on various aspects concerning the disease, from diagnosis to palliative care, the available medical facilities, social services, benefits and allowances, clinical trials and issues concerning quality of life and psychological support. Strategy/Tactics: The development of an innovative Web-based tool was included in the “Hellenic Alliance for Metastatic Breast Cancer” project. It was overseen by a steering committee with W4O-Hellas and K.E.F.I. representatives, journalists, health economics advisors and state representatives. A support team was also created, to run and update the platform. Program/Policy process: The platform (“w4life.gr” reading “women for life” or “life for women with stage 4 disease”) is functional since June 2016 and was officially presented to the public on November 2016. The site´s structure is consisting of the main sections and an online forum. The sections contain information about the disease, the access to doctors, medical facilities, social services and patient groups, quality of life, nutrition and exercise issues, patient guidance and clinical trials available in Greece. The online forum is accessible 24 hours per day, and provides information and update about the network´s actions and upcoming seminars and forums. There is also a patient support direct line available on weekdays and access to other useful links. An online survey measuring quality of life data are running through the platform and the results will be presented in the near future. Since last year, a mobile application was also created aiming to an easier and user friendly access. Outcomes: By March 2018, the platform had 27,018 page views, 10,416 users who completed 13,020 sessions, with average session duration 2:23 minutes and bounce rate 74.54%. w4life received two awards from the Boussias-Health Care Business Awards-2017. The Gold Award, in the e-Health category digital applications for information and integrated patient care and a Silver Award for actions aimed at information, awareness, and prevention. What was learned: During the severe Hellenic socioeconomic crisis we have found that an alternative approach, as the above described, of dedicated oncologists toward their patients is needed, easy to use, helpful and sustainable and can provide important information and comfort to women with mBC their families and caregivers.
First Things First: Adopting a Holistic, Needs-Driven Approach to Improving the Quality of Routinely Collected Data
Authors: Mokokwe L. , Maabane G. , Zambo D. , Ralefala T. , Shulman L. , Ramagola-Masire D. , Tapela N. , Grover S. , Ho-Foster A.
Published: September 2018

Background and context: Routine collection of quality oncology data remains underprioritized in resource limited settings. For breast cancer (BC) care at Princess Marina Hospital (PMH) in Botswana, this hampers its use for oncology program evaluation and clinical research. The Peo Data Acquisition Core (DAC), part of a consortium for planning of a noncommunicable diseases center for research excellence in Southern Africa, engaged relevant stakeholders and departments at PMH to establish health care worker driven processes that support sustained improvements in the quality of routinely collected breast cancer data. Aim: Assess PMH BC care needs to support the improvement of routinely collected data. Strategy/Tactics: Conventional routine data quality assessments guide iterative identification of data quality gaps for improvement, but tend to consume additional human resources to implement and prioritize data quality over existing provider concerns. We undertook a holistic approach to identifying needs challenging the improvement of data routinely collected about PMH BC patients. Program/Policy process: A need assessment began with mapping of patient care process, capturing process steps, including subprocesses, actors, and an inventory of related data capture systems. The assessment also gathered care providers' perceptions of challenges to providing care as well as perceptions of the up-time of an existing electronic health record (EHR). Outcomes: BC patient management involves multiple care providers who attend to patients in different locations within the hospital. Except for EHR captured laboratory data, nearly all other documentation of patient care occurred through paper-based registers, diaries and general clinical forms. Providers indicated the overbooking of patient appointments and use of different formats to manage patient data as key challenges for them. EHR appointment scheduling components appear underutilized by providers, and a brief monitoring of provider perceptions of the EHR's speed and reliability suggests it is poorest in the mornings - at a time when providers are the busiest attending to patients. What was learned: Needs assessment findings suggest several opportunities to respond to provider recognized challenges through greater adoption of EHR usage. Establishment of a Quality Improvement (QI) group that champions improvements in routine BC data quality should integrate standardization of patient data formats and EHR centralized appointment booking. QI group composition should include both care providers and an EHR IT technician.
Improving Access to Treatment of Gynecologic Cancers/Cervix Cancers
Authors: Abdel-Wahab M. , Paez D. , Zubizarreta E. , Polo A.
Published: September 2018

Aim and purpose: The session aims at outlining actions that the healthcare community can take to improve the current situation and inform cervix cancer control plans. Highlighting the need to address opportunities in the prevention and management of cervix cancer, the session will provide guidance on primary, secondary and tertiary prevention and management of cervix cancer and will discuss the role of radiotherapy, while showcasing examples of collaboration. Audiences: Healthcare professionals with a special interest in women's cancers/cervix cancer and healthcare services planning. Cancer care advocates and patients advocates Decision makers involved in the planning of health care services Stakeholders in LMICs Suggested panel participants: Cherian Varghese, WHO Topic “The UN Joint Global Programme on Cervical Cancer Prevention and Control” The speaker will present this important initiative that builds on the world's collective endeavors so that in a generation, death from cervical cancer ceases to be a public health issue. Kennedy Lishimpi Topic, “Case study: Zambia” Illustrate how Zambia went from having no radiotherapy facilities to being able to offer up-to-date treatment to cancer patients Lusaka, Zambia Ted Trimble, NCI Topic, “NCI Activities in Support of Cervical Cancer” To present the important initiatives of the NCI/NHI to tackle the burden of gynecologic cancers Bethesda, Maryland May Abdel-Wahab, IAEA Topic, “International Program Results on the Ground in Support of Cervical Cancer” The speaker will present available support cooperation, education and training, and the need for enhanced safety and quality and use an example of interventions in Africa.
Developing National Cancer Guideline: A Step Toward Standardized Multidisciplinary Management in Indonesia
Authors: Gondhowiardjo S. , Giselvania A. , Munandar A. , Jayalie V.F.
Published: September 2018

Background and context: Along with the development and advancement of cancer management, multidisciplinary approach has been an essential part to achieve a better patient outcome. However, to ensure the best management for cancer patients, national clinical guidelines should be established. Clinical practice guidelines serve a great role in translating evidence from bench to bedside, as well as improving the quality of medical care throughout the country. Until 2014 , before the establishment of National Cancer Control Committee (NCCC), there have been several hospital-based and society-based guidelines, but no national guidelines available. Aim: The development of national cancer guideline aims to ensure best clinical practice on cancer in Indonesia. Strategy/Tactics: The guidelines were developed based on the strategic objective of NCCC-Ministry of Health (MoH) Republic of Indonesia and the Decree of Minister of Health Number 1438/MENKES/Per/IX/2010 about the standard of medical services. Program/Policy process: Under the decree of Minister of Health and NCCC-MoH, all cancer-related discipline represented by expert from each discipline´s professional society were gathered in a “Guideline Development Team” to develop national cancer guidelines. First, there was a discussion on the outline. Then, each specialist/discipline would develop their own management based on the related knowledge. Finally, everyone will discuss together to finalize the compiled guidelines. Outcomes: Eight national guidelines were developed in three years after NCCC established, including breast cancer, cervical cancer, lung cancer, colorectal cancer, nasopharyngeal cancer, brain tumor, prostate cancer and osteosarcoma. Experts of the related discipline were involved in writing the guidelines. Various obstacles occurred during the process of writing the guidelines, including multidiscipline teams involvement and the geographical problem of being an archipelago country. But, having one vision to develop the best medical management for cancer patients, the national guidelines were finally published on the Web site of NCCC and currently waiting for Minister of Health approval. What was learned: Gathering multidisciplinary teams to develop national guidelines was not an easy task. However, by having the same vision and inviting all cancer-related societies, we can make this achievement. Moreover, the decree of Minister of Health was also an essential part to push everyone moving forward.
Patterns of Complementary and Alternative Medicine Use Following a Cancer Diagnosis in Malaysia
Authors: Pathy N.T. Bhoo , Kong Y.C. , Subramaniam S. , Goh P.P. , Ng C.W. , Yip C.H. , Pathy N. Bhoo
Published: September 2018

Background: Worldwide surveys suggest that the use of CAM is becoming increasingly popular among the general population as well as among cancer patients. Aim: We determined the patterns of complementary and alternative medicine (CAM) use in cancer patients, and the associated factors in a multiethnic Asian setting. Methods: Through the Asean CosTs In ONcology (ACTION) prospective cohort study, 1662 newly diagnosed cancer patients were recruited from 12 public and 2 private hospitals in Malaysia. In the current study, we only included 1328 patients who were alive and completed one-year of follow-up. Using questionnaires and cost diaries, patients' sociodemographic factors and disease related factors were measured at baseline, whereas details on CAM use were measured at 12 months. Results: Median age at cancer diagnosis was 53 years. Patients comprised those with breast cancer (33%), gastrointestinal cancers (27%), hematologic malignancies (22%), female reproductive cancers (6%), respiratory cancers (5%), and other types. At one-year, 175 patients reported using CAM (14%), of which 53 comprised patients reporting inability to make necessary household payments (economic hardship) at initial diagnosis. Most CAM users took food or nutritional supplements (75%), spending between RM150 to RM7500 in a year, followed by traditional local medicine (43%), where expenditures ranged between RM50 to RM20,000. A minority practiced homeopathy, and mind-body practices. Fifty-one patients used more than one type of therapy. In CAM users with economic hardship at baseline, median expenditure on CAM was RM1500, with some spending as much as RM10,000. Compared with other cancer types, patients with hematologic malignancies and women with breast cancer were most likely to use CAM. In a multivariable analysis, baseline factors that were associated with CAM use were economic hardship, higher anxiety scores, having female reproductive cancers, or hematologic malignancies, receipt of surgery, and nonreceipt of radiotherapy. Sex, education status, marital status, health insurance status, cancer stage, and systemic cancer therapy do not appear to be associated with CAM use. Conclusion: While the proportion of patients reporting CAM use following a cancer diagnosis appear low in this study, the finding that patients with initial economic hardship were independently more likely to use CAM, warrants attention.
Impact of the Continuity of Nursing Care Delivered by a Pivot Nurse in Oncology on Improving Satisfaction and Quality of Life of Patients With Advanced Lung Cancer
Authors: Kassouf E. , Tehfe M. , Florescu M. , Blais N.
Published: September 2018

Background: Health care organizations around the globe have been implementing different strategies aimed at improving their care systems to obtain better patient–physician interaction and resolve underlying issues leading to patient dissatisfaction. In an effort to improve continuity of care inside a network of interdisciplinary teams, the Ministry of Health and Social Services of Québec has implemented the recruitment of pivot nurses in oncology services. Aim: To determine whether continuous nursing care for lung cancer patients, compared with standard care, yields more improvements in terms of patient satisfaction and quality of life. Methods: This study was conducted at the Notre Dame University Hospital in Montreal. Patients were selected from the outpatient admissions' list, three months after the start of their treatment, and divided into two cohorts: the continuity of care (CC) cohort, where patients were followed by a PNO, and the usual care (UC) cohort, who received standard care from the oncology clinic staff. Participants in both groups completed the Princess Margaret Hospital Patient Satisfaction with Doctor Questionnaire (PMH/PSQ-MD), the FACT-L Scale for quality of life assessment and questions evaluating the understanding of their health status and disease. Another ten questions were dressed specifically to the CC in regards to nursing care and the health care system in Quebec. Results: The current study has shown a significant impact of implicating a PNO in the care of patients with advanced lung cancer. Patients in the CC cohort displayed better quality of life assessment scores and expressed higher levels of satisfaction compared with their peers in the UC cohort. Other variables examined revealed an adequate fulfillment of the PNO role as regarded by the participants, except for matters of an intimate nature. Conclusion: The PNO appears to have an substantial role in the care of patients with advanced lung cancer. Continuity of care seems to improve patients' quality of life and satisfaction by reducing the symptom strain experienced by ambulatory patients.
Ebene Joining Hands Fundraising Campaign
Authors: Moonesawmy S.
Published: September 2018

Amount raised: 641,704 Mauritian rupees Background and context: Link to Life Cancer Support Centre, is the first cancer NGO that has been founded in 2012 in Mauritius. With the increasing rate of cancer, 2607 new cases in 2016, it a must for us to sensitize, prevent and provide screening for cancer. As a cancer support association, it is quite difficult to get funds for the running of the NGO as well as the various activities. Apart from the CSR (corporate social responsibility) that some companies willingly give to us we have to innovate in creating novel fundraising campaign each year. The Ebene Joining Hands also known as the Ebene Chain is an innovative fundraising campaign that was performed in June 2016. Ebene is a suburb on the island of Mauritius and this region has been promoted as being the new information technology hub. It is a cluster of modern skyscrapers from afar with more than 150 to 200 companies. Link to Life campaign was mainly to collaborate with the various companies in Ebene to raise funds for one of our main projects which is free transport facilities to cancer patients. Aim: Create awareness on cancer and related activities of the NGO. Make the companies contribute toward the fight against cancer. Sensitize the public in general about cancer. The Ebene Joining Hands - uniting our force together “hand in hand” we are able to give a helping hand to cancer patients. Break the taboo on cancer/common cancer myths. Empower cancer beneficiaries. Strategy/Tactics: Create a cancer support truck whereby cancer patients and survivors will be in it. The truck will then drive along a predestined track which will cover the entire Ebene hub region. With the help of two main companies Minerva Fiduciary Ltd. and Afrasia Bank, we have been able to create a successful fundraising campaign. The various companies in Ebene were contacted to introduce them the fundraising project. The said company will have to contribute to a minimum fee of 2500 Mauritian rupees and at the same time, we would sensitize their staff to participate in the Ebene Joining Hands event, whereby they will be on the track, hold the hands of the person next to them, waiting for the cancer support truck to pass by. They will then lift their hands up and applaud by welcoming the cancer survivors on the truck. Timing of the event was taken into consideration. Since most of the employees were during their working time, we had to fix the event during lunch time for a period of 30 to 45 minutes (i.e., from noon to 1:45 pm). Costs: Rs. 130,000 What was learned: Preparation for such event will have to be done well in advance. Attitude is everything. All participants were here to show their support. The patients were proud to have participated to the campaign and were deeply moved by the welcome that they have received on the streets.
The Association of Neighbourhood Built and Social Environment and Cancer: Evidence From Australia
Authors: Feng Y. , Elshaug A.
Published: September 2018

Background and context: Australia is among the worst countries in terms of cancer incidence and displays substantial variations in cancer outcomes across multiple geographic scales. Aim: This research project aims to examine how neighborhood social and environmental attributes interact with individual risk factors, affect cancer outcomes and contribute to the geographic variations in cancer outcomes. Specifically, it will answer the following research questions: What neighborhood built and social environment attributes are associated with individual health outcomes? How do neighborhood features influence cancer outcomes, at multiple geographic scales? At what geographical scales the variations in cancer outcomes are the most pronounced and how much is contributed by neighborhood attributes? What initiatives and guidelines should be developed and at what level: local neighborhood, regional, state, national level? Strategy/Tactics: Innovative geospatial techniques will be developed to analyze cancer risk factors and variations at multiple spatial levels utilizing population-based hospital inpatient data in NSW, Australia Program/Policy process: The study is the first population-based study evaluating how neighborhood influences cancer outcomes from multiple scales in the Australian context. The project has tangible potentials to be translated into initiatives and practices. This includes various levels such as local neighborhood, state and national level for the prevention and control of cancer and ultimately improve cancer outcomes in Australia. Outcomes: A large proportion of geographic variations in cancer outcomes are contributed by differences in the neighborhood built and social environment characteristics, which interact with individual risk factors and have synergistic effects on cancer outcomes. What was learned: Neighborhood physical and social environment has a strong effect on cancer outcomes. Through modification of neighborhood attributes, we can reduce the exposure to neighborhood risk factors and promote healthy lifestyle choices, which, in turn, reduce cancer incidence and improve survival rates. Effective initiatives and guidelines for cancer control should be developed and at all government levels including the local neighborhood, regional, state, national level.
Religious Gathering as a Tool for Collaborative Cervical Cancer Prevention: Report From Nigeria
Authors: Onwuka C. , Umezurike C. , Hendricks C.-E. , Eguzo K.
Published: September 2018

Background and context: Cervical cancer is the second most common cancer and a leading cause of mortality affecting Nigerian women. There is prevalent ignorance about the disease and reduced access to screening services in Nigeria due to a variety of reasons. Many religious leaders often view cancer as evil, thus perpetuating a culture of fear and denial. Religious events have been used to promote health awareness and access to preventive services in Nigeria, but not usually for cancer screening. A cancer survivor might use a religious event to provide a strong avenue for improving cancer awareness and access to screening. Aim: Report describes a successful collaborative integration of cervical cancer screening into a religious event led by a breast cancer survivor. Strategy/Tactics: The 2018 Annual Women's Gospel Forum at Susanna Homes was used by a cancer survivor to teach women about cervical cancer and early diagnosis. Information was circulated among the Church of Christ fellowship in southern Nigeria. Program/Policy process: A medical team (gynecologist and pathologist) provided free cancer screening to consenting women using Papanicolaou test VIA simultaneously, with Pap preceding VIA. All smears were handled according to standard protocol and the findings were classified using the Bethesda system for reporting Papanicolaou test. Participants were taught about cervical cancer, counseled on screening and follow-up care prior to consent. Data were analyzed using descriptive statistics. Outcomes: Seventy-nine women at the event consented to the screening. The average participant was aged 51 years, but 90.6% (58/64) were above 30 years. Most (92.4%; 73/79) women were negative for squamous intraepithelial lesions (SILs), and six women had a low grade squamous intraepithelial lesion (LSIL). The prevalence of abnormal cervical cytology in this outreach was 7.6% (6/79), and mostly affected women aged 61-60 years. Table 1 describes the Papanicolaou test results. The result of VIA was recorded as positive or negative. What was learned: Participants provided positive feedback regarding integrating cervical cancer screening into a religious event, as it improved access and addressed ignorance. Leadership by a cancer survivor helped demystify the disease and encouraged women to be screened. Having a pathologist on site improved slides quality and reporting turn-around time. Project shows that collaboration between clinicians and religious leaders can improve cancer prevention. More physicians should be trained to provide these services and collaborate with community/religious organizations to provide screening outside of the clinical setting.[Table: see text]
Cancer Control in Low- and Middle-Income Countries
Authors: Humura F.
Published: September 2018

Background: Cancer is also referred to as malignant tumor or neoplasm. It is one of the leading causes of death on the global scale. The knowledge and tools to manage and even cure cancer patients exist in developed countries but are unavailable to many who live in the developing world, resulting in unnecessary loss of life. Strategies are needed to close the gap between developed and developing countries in cancer survival and the effects of the disease on human suffering. It is also pertinent to bridge the gap to ensure universal health coverage which is very important to achieve the sustainable development goals. Aim: The aim of this abstract is to review the barrier to cancer control in developing world especially the low-and middle-income countries. Method: Selected papers amounting to 79 papers in PubMed from 2007 to 2017 were used from peer-reviewed literature and relevant publicly available documents with the appropriate keywords searched. Results: In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries and also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. Cancer is low or absent on the health agendas of low- and middle-income countries (LMCs) despite the fact that more people die of cancer in these countries than from AIDS and malaria combined. International health organizations, bilateral aid agencies, and major foundations which are instrumental in setting health priorities also have largely ignored cancer in these countries. Conclusion: and recommendations: There is an urgent need to improve health services for cancer control in developing countries to ensure health equity which is one of the key areas to be addressed in other to achieve sustainable development goals. Current resources and much-needed investments must be optimally managed. To achieve this, recommended investment should be focused in the following key priorities: capacity building in oncology health services research, policy and planning relevant to developing countries, development of high-quality health data sources, more oncology-related economic evaluations in developing countries, exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international collaboration as well as political leadership. Horizontal integration with programs for other diseases will be important.
Workforce Capacity and Capability Building Through Metrics-Based Mentoring Partnerships
Authors: Balogun O.D. , Nwachukwu C. , Grover S. , Schroeder K. , Sherertz T. , Brereton H. , Van Dyk J. , Pipman Y. , Shulman L. , Chao N.
Published: September 2018

Background: Globally, cancer is the second leading cause of death. Low- and middle-income countries (LMICs) especially lack the sufficient healthcare and oncology workforces needed to screen, diagnose and treat individuals with cancer. While traditional academic and training programs designed to produce healthcare professionals in these countries fill a critical role, few programs exist that maintain, develop, and increase the knowledge, skills, and professional performance of current healthcare and oncology workforces. Mentoring partnerships and twinning programs can provide ongoing education and training that strengthen and build workforce capacity and capability for the full scope of cancer care. Aim: The goal is to achieve resource-appropriate multimodality cancer-care using guideline- and protocol-based education and training and also to develop the capability to conduct world quality research. The model utilizes in-person, in-country site visits lasting from several weeks to months and ongoing connectivity through weekly telemedicine video conferences. Methods: The International Cancer Expert Corps (ICEC) and partner organizations are establishing a network of global and multisectoral partnerships that builds human capacity and capability needed to establish sustainable cancer programs that function at world-class standards. The three-fold mentor-mentee approach ( www.iceccancer.org ) is built by 1) enlisting hubs of expertise to include academic medical centers/universities, private practices and an ICEC Central Hub, 2) enrolling the breadth of expert-mentors needed from a university, practice, professional society and interested individuals, and 3) identifying centers in LMICs - clinics/hospitals/and other care delivery sites in underserved areas, and associates - physicians/allied healthcare workers- seeking mentoring and education. Results: Recent implementation of the ICEC 5-Step Progression Plan provides guidance and serves as an assessment tool for measuring progress between the hubs-centers programs and expert-associate. Twinning programs (hubs-ICEC centers) have been established in multiple sites worldwide including in Africa, Asia and Eurasia. Conclusion: Implementation of the ICEC 5-Step Progression Plan provides a platform from which to track the current stages and progress of twinning mentor-mentee programs, and to evaluate new programs. This information guides the programs and also provides metric-based investment in global health. Critically as the skills in associates and ICEC centers grows, they achieve expert-mentor status and centers become hubs to serve the surrounding regions, thereby enabling geometric growth in cancer care to meet the needs of the growing global burden of cancer. The content is the personal opinion of the authors and not their organizations.
Strategies to Motivate Cancer-Affected Individuals and Their Families to Mobilize Their Kith and Kin, Neighbours and Community to Assess Their Awareness Level to Accept and Attend Screening Clinic to Prevent Cervical Cancer
Authors: Ghosh S. Sarkar , Mukhopadhyay A. , Mathai S. , Bhaumik J.
Published: September 2018

Background and context: Cervical cancer is second most common cancer among women across the world. It is a public health problem especially in a developing country like India, as it alone accounts for one-quarter of the worldwide burden of cervical cancer. It is estimated by ICMR that a total of 100,000 new cases were diagnosed in 2016. This figure is expected to touch 1,04,000 during 2020. If treated in early stages more than 90% 5-year survival may be expected. However, less than 10% of our patients are diagnosed early resulting in an overall poor outcome. We do not have any organized national program for cervical cancer screening that might help in reducing the incidence of and death from cervical cancer. Aim: The aim of this study was to evaluate the efficacy of establishing a hospital-based opportunistic screening clinic with the underlying intention of disseminating awareness and knowledge by empowering cancer affected women to mobilize women folks or relatives known to them for voluntary participation in screening clinic. Strategy/Tactics: We have initiated the following measures: 1. Enlisting the phone numbers of female cancer patients from hospital records and contacting their families for participating in the screening clinic. 2. One to one counseling of patients suffering from any other cancer and involving their accompanying family members to avail the facility. 3. Encouraging them to bring their neighbors, relatives, friends to participate. 4. To identify patient representatives involved in community work like NGOs, clubs, religious institutes etc. and empower them with knowledge for motivating others to participate. 5. Development of IC (information and communication) materials like standees, leaflets, audio visuals for people waiting in hospital lobby. 6. Involving the male members of the family in encouraging the women to participate in the screening. 7. Assess the awareness level of women participating in the screening clinic. Program/Policy process: To create awareness and empower the affected cancer people and their relatives/attendants to participate and to mobilize the community for voluntary participation in screening clinic for prevention of cervical cancer. Outcomes: The outcome measure is assessed by the number of healthy women of any age coming forward to attend the screening/vaccination/awareness clinic per one cancer affected women. We have already registered 270 participants and screened 268 women for cervical cancer. Seventeen women were detected with HPV infection and underwent colposcopy. Interest in vaccination of young girl in the family was generated by people visiting our hospital. What was learned: The strategy to establish “screening clinic” for women with help of cancer patients has proved to be effective in reaching out to the community through the involvement of their kith and kin.
Radiotherapy Cancer Registry (Hospital Based)
Authors: Balakrishnan M. , Subhashini J. , Rajesh I. , Simon P.
Published: September 2018

Background and context: The cancer registry is the information system designed to collect, manage and analyze the data on persons with malignancy (cancer). The objective of the cancer registry is collecting, classifying, evaluation of data and analysis. The purpose of the cancer registry is to identify the incidence, have cancer awareness program and cancer control activities. Aim: To analyze the demography of cancer patients seen at the Department of Radiation Oncology, Christian Medical College (CMC), Vellore, India during the period 2014-2016 and to categorize the data based on age, sex, type of cancer and geographical distribution. Strategy/Tactics: The Department of Radiation Oncology, CMC, Vellore, used to see 3500 to 5000 new patients annually with various malignancies. To develop a cancer registry, a detailed pro forma having three sections of information about the patient was developed. The first section includes patient identification information such as name, hospital ID, RT number, Hospital Based Cancer Registry (HBCR) number, date of registration, and geographic details of patients. The second section has the demographic details of the patient and the third section has the investigation details, the diagnosis and the treatment. Program/Policy process: In this study, we have collected data for the years 2014, 2015 and 2016 and compiled relating to demographic data such age, sex, diagnosis site, and geographic information. For the past three years period i.e., from 2015 to 2017, there were 3691, 4177 and 5036 new patients annually seen in our outpatient section respectively. From the three years data, distribution of patients with respect to age, sex, diagnosis, state and country were analyzed. Outcomes: The maximum numbers of patient seen were head and neck followed by CNS and gynecologic malignancies. The analysis showed the total number of patients seen was increasing every year. The study when compared with respect to sex distribution, the male patients were more than the female patients. There were patients from various states of India and few patients from abroad. The details of the age group, sex, cancer types and geographical distribution will be presented. What was learned: In conclusion, we used to see patients from different parts of India and abroad annually and the number of cancer cases seen are increasing annually. While analyzing the distribution on the types of cancer, head and neck cancer were the maximum followed by CNS, breast, and gynecologic malignancies. Early detection and diagnosis of cancers, for example, head and neck, cervix, and educating the patients on breast cancer by screening methods and on self-examination methods will help to control prevalence of cancer.
Price, Tax and Income Elasticity Effects on Smoking Intensities Among Urban Cigarette Smokers in Kenya: Double-Hurdle Approach
Authors: Kipkorir P.
Published: September 2018

Background: Rationally, tobacco use is enemy number one among risk factors for noncommunicable diseases. It is a widely and broadly established cause of cancer and also responsible for cardiovascular and chronic respiratory diseases. It has been estimated that there are >1.3 billion smokers worldwide, with ∼80% residing in low- and middle-income countries. More than 10% of all deaths resulting from noncommunicable diseases including cancer, cardiovascular, chronic respiratory diseases and diabetes are related to tobacco and most of these occur in these low- and middle-income countries. In Kenya, >2.5 million of the population are adult smokers. Aim: Objectively, this abstract analyzed the price, tax and income elasticity effects on smoking intensities among the urban cigarette smokers for effective tobacco control in Kenya. Methods: The data used was sourced form the household and individual survey questionnaires from the Kenya Global Adult Tobacco Survey 2014. Double-hurdle model was used where the first part of the technique was to distinguish between the urban smokers and urban nonsmokers. The second part was to determine the smoking intensities among those who smoke and also to analyze the effect of price, tax and income elasticity on the individual consumption. Results: The study revealed that price of cigarette had a reducing (β = −2.2343) and very significant ( P < 0.001) elastic effect on smoking intensities among urban smokers while disposable income had a significant ( P < 0.010) but positive (β = −0.0366) inelastic effect on smoking levels of the urban cigarette smokers. Particularly, tax on cigarette has also been depicted to have a significant ( P < 0.001) yet positive and elastic (β = 1.7044) effect on smoking intensities on the urban cigarette smokers. Time spent in education has a significant ( P < 0.001) and negative (β = −3.2240) elastic effect on the smoking intensities of urban smokers. Notably, those who are married (β = −0.6320, P < 0.001) and employed (β = −0.5498, P < 0.010) have significant and negative though inelastic effect on their smoking intensities as compared with the unmarried and unemployed. Conclusion: Summarily, this implies that urban smokers have more income where the proportion spent on smoking is very small. Also, since tax is a function of income, it thus calls for the need to increase the rate of excise tax on cigarette so as to discourage consumption of cigarettes among the urban smokers and thus ultimately realizing and sustaining the health policy goals of reducing and averting the cancer risk factors. Furthermore, continuous use of cost-effective sensitization methods to create awareness and educate people on economic, social and health effects and impacts of tobacco use.