A roadmap for improving cancer care in South Asia

A sequence of 5 papers, printed at the moment in The Lancet Oncology by a College of Pittsburgh-led worldwide crew, highlights crucial public well being challenges associated to most cancers management within the eight international locations that kind the South Asian Affiliation for Regional Cooperation (SAARC) and the Rohingya refugee inhabitants in Bangladesh. The sequence underscores limitations contributing to vital disparities in most cancers outcomes and identifies actionable options to deal with these challenges in one of the complete efforts to grasp this area’s most cancers burden. 

The papers name for a complete, coordinated method to deal with the most cancers burden in SAARC international locations -; Afghanistan, Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan and Sri Lanka -; that are house to greater than 1.92 billion individuals. The authors urge policymakers and different stakeholders to implement culturally delicate approaches to enhance most cancers prevention, screening, early detection and therapy on this area. 

Though most cancers incidence charges in SAARC international locations are decrease in comparison with the remainder of the world, mortality charges are increased. Most cancers incidence is on the rise, with lung, breast, oral and cervical cancers the commonest. That is largely as a result of late-stage diagnoses due to a extreme scarcity of early detection applications, restricted entry to therapies and insufficient healthcare infrastructure. 

These points are compounded in refugee settings, notably among the many practically a million Rohingya inhabitants residing in refugee camps in Cox’s Bazar, Bangladesh, the place overcrowded camps, restricted assets, insufficient infrastructure and political limitations worsen the state of affairs. 

“Within the SAARC international locations, we face a crucial scarcity of educated oncology professionals, restricted healthcare infrastructure and vital healthcare disparities between city and rural areas, all of which influence entry to top quality most cancers care,” stated corresponding writer Saiful Huq, Ph.D., professor within the Division of Radiation Oncology on the College of Pittsburgh Faculty of Drugs and director of the Medical Physics Division at UPMC Hillman Most cancers Middle.

There’s a large want for efficient interventions to enhance care throughout your entire most cancers continuum – from prevention and prognosis to therapy and palliative look after individuals residing in these international locations, which is sort of one quarter of the world’s inhabitants.”

Saiful Huq, Division of Radiation Oncology, College of Pittsburgh

Within the sequence of papers, Huq and his coauthors describe limitations particular to every SAARC nation and people which might be widespread throughout the area. These embody a ignorance about most cancers signs, threat components resembling smoking and chewing betel nut, cultural stigmas, myths that most cancers is untreatable or contagious, lack of entry to well being care services in rural and distant areas, monetary difficulties confronted by many sufferers and their households and inadequate authorities funding in most cancers care. 

A serious barrier to most cancers care is the scarcity of educated most cancers care professionals in SAARC nations -; together with oncologists, medical physicists, radiation technologists and oncology nurses -;pushed by inadequate instructional and coaching applications. Moreover, the SAARC international locations face disparities in most cancers analysis funding and a scarcity of infrastructure to help large-scale complete most cancers therapy efforts. 

“SAARC nations face a myriad of challenges in offering accessible and equitable most cancers care to their various populations,” stated Huq. “As a primary step to addressing these challenges, there’s an pressing have to strengthen every nation’s nationwide most cancers management program with the intention to develop methods to improve well being care infrastructure, notably in rural and underserved areas, and investing within the coaching, training and retention of expert healthcare professionals.” 

Different key suggestions embody increasing most cancers registries to enhance information assortment that may inform coverage selections for most cancers management efforts and strengthen analysis capability; launching public well being campaigns to advertise prevention; selling early detection and consciousness of most cancers threat components; and fostering regional collaboration and partnerships to make sure higher entry to most cancers therapy. The papers emphasize that regional networks may play a major function in advocacy and useful resource mobilization, notably for international locations with restricted well being care budgets. 

Among the many Rohingya refugee inhabitants, most cancers -; notably hepatocellular carcinoma, oral most cancers and cervical most cancers -; is a rising concern. The papers name for culturally delicate and multi-pronged interventions to deal with these points, together with partnerships with native leaders and communities to lift most cancers consciousness, cut back stigmas, enhance well being literacy and strengthen capability for most cancers screening, therapy and palliative care. 

To boost consciousness and drive coverage adjustments, Huq will launch this sequence of papers on December 12 on the International Well being Catalyst Summit in Bangladesh to an viewers that may embody Nobel laureate Muhammad Yunus, chief advisor of the Interim Authorities of Bangladesh; ambassadors from SAARC international locations; and different stakeholders. 

“The dedication of Dr. Huq and your entire International Well being Catalyst to bettering most cancers care across the globe is really wonderful and I used to be honored to have the chance to collaborate with him in highlighting this crucial problem,” stated coauthor Heath Skinner, M.D., Ph.D., professor and chair of the Division of Radiation Oncology on the Pitt Faculty of Drugs and chief medical officer of the Radiation Oncology Community of UPMC Hillman. 

Different authors of the sequence are listed in The Lancet Oncology papers on-line. 

This analysis was supported by funding from the Nationwide Institutes of Well being awards R25CA288263 and R13CA257481 supporting the International Well being Catalyst and the Division of Radiation Oncology on the Pitt Faculty of Drugs.