South African Breast Cancer Policy

Breast Cancer Prevention and Control Policy

By Trish Muzenda and Lelani Hobane

Breast cancer is the leading type of cancer diagnosed in women globally. Since 2008, the incidence of breast cancer has been evenly distributed globally, with 50% of breast cancer incidence occurring in the developing world. However of the total cases, approximately 58% of breast cancer mortality occurs in the developing world. Given these statistics, it is ever more important for governments in developing nations to take issues of breast cancer seriously and design contextual prevention and control strategies. In South Africa, the lifetime risk for breast cancer is 1 in 29. This risk is high and therefore requires that the department of health have guidelines that are there for screening of cases so as to improve diagnosis of breast cancer as well as treatment and rehabilitation following breast cancer diagnosis. To mirror the growing importance of breast health care in South Africa, the South African National Department of health has published a revised Breast cancer Policy brief as of June 2017. This policy outlines the guidelines to be used by all stakeholders towards health promotion, screening and treatment of breast cancer. Whilst the policy does touch on prevention of breast cancer, the backbone idea in the breast cancer policy of 2017 lies in improving the screening capacity for breast cancer.

Through the National Health Insurance (NHI) which is the central means by which the government aims to achieve universal coverage, the government is revitalising service delivery, changing the way that health services are financed, ensuring the provision of primary care, improving access to qualified human resources for health, and ensuring the availability of quality assured medical products. For the breast cancer policy, this can be seen in that much thought has been put into the use of all primary healthcare facilities as centres for the opportunistic education of women on general breast health including breast cancer risk factors. The policy also advocates for the education of women on how to practise Breast Self-Examination (BSE) and the importance of receiving a routine clinical breast examination (CBE). Additionally the establishment and maintenance of Specialised Breast Units set up in various tertiary level health facilities are to be used as referral points for suspected breast cancer cases for further diagnosis.

Source link: Breast Cancer Policy 2017.

Racial Variation in Cervical Cancer Mortality Rates

Study Reveals Significantly Higher Cervical Cancer Mortality Rates among Black Women Compared to White Women

By Harris Onywera

Cervical cancer is the first and second most common cancer type among reproductive-age women in South Africa and world, correspondingly. The incidence rate per 100,000 population is higher in less developed regions (15.7%) than in more developed regions (9.9%). Globally, it is estimated that 527,624 cervical cancer cases reported annually, concomitantly with about 50.4% new cervical cancer deaths.

There is documented evidence for racial disparity in cervical cancer mortality rates. A recent survey estimating the cervical cancer mortality rates in the US from the Surveillance, Epidemiology, and End Results and National Centre for Health Statistics county mortality data (2000-2012) found that after correcting for hysterectomy, Black and White women had 76% and 48% higher cervical cancer mortality rates, respectively, than previously estimated. The prevalence of hysterectomy (surgical removal of the uterus) was higher in Black women than in White women. Prior to excluding women with hysterectomies, (uncorrected) cervical cancer mortality rate was 5.7 and 3.2 per 100,000 in Black and White women, respectively (Figure 1). In the same order, the corrected rates were 10.1 and 4.7 per 100,000. It was also observed that age-specific cervical cancer mortality rates were higher among women aged 65+ years, with up to 126% increase among Black aged 65-69 years. The percentage increase for White women of the same age was 75%. For White women, cervical cancer mortality rate was highest (96%) among women aged 75-79 years. Black women of similar age still exhibited a high increase of 122%.

In my opinion, I think it would be of great public health relevance to perform a similar kind of analysis in sub-Saharan region where cervical cancer mortality rates are underreported, yet very high.

For more information, visit the sources provide below.

Figure 1. Age-specific cervical cancer mortality rates, uncorrected and corrected for the prevalence of hysterectomy, in (A) white and (B) black women.
Figure 1. Age-specific cervical cancer mortality rates, uncorrected and corrected for the prevalence of hysterectomy, in (A) white and (B) black women.

Source link: Bruni et al. (2017) and Beavis et al. (2017).

Oncopig Model for Cancer Research

Oncopig  Cancer Model: A New Approach in Cancer Research for Humans

By Ramadhani Chambuso

Oncopig Cancer Model is a novel transgenic swine model that recapitulates human cancer through the development of site and cell specific tumors. For decades, cancer research progress has been markedly hampered by the lack of a phenotypically, genotypically, anatomically, and physiologically relevant large animal models.

On the other hand, small animal models, such as mouse models, have played a major role in our understanding of the genetic basis of cancer and the role of specific genes and gene mutations in the development and progression of cancer. However, due to vast differences between humans and rodents or zebrafish for example, the ability to model complex diseases such as cancer and translate results into clinical practice is quite limited

In a nutshell, large animal models of cancer comprise a smaller portion of cancer models than small animal cancer models. Therefore, these large animal models recapitulate transcriptional hallmarks of the human disease while also exhibiting clinically relevant histologic and genotypic tumor phenotypes.

Adopted from cancerresearch#Oncopig
Adopted from cancerresearch#Oncopig

Source link: Schachtschneider et al. (2017)

Breast Cancer Screening using Mammography

Breast Cancer Screening with Mammography in Women Aged 40-49 Years is Still Controversial

By Ramadhani Chambuso

The incidence and mortality rates from breast cancer are expected to rise as a result of the ageing population. To reduce the burden of this disease, many countries have implemented mammography screening for early detection and treatment of breast cancer for all women aged from 50 years for every 2 years. However, there is a debate about whether breast cancer screening should be extended to younger women (i.e., 40–49 years). Generally, for effective cancer screening programme, the benefits should outweigh the harms. Some negative effects of breast cancer screening include radiation exposure from mammography, pain during the mammography procedure, consequences of false positive and false negative tests, and the occurrence of over-diagnosis. Therefore, based on the current evidence from randomised trials, extending mammography screening to younger age groups cannot be recommended.

Adopted from
Adopted from

More information can be accessed from Mammography and Breast Cancer Screening.

Source link: van den Ende et al. (2017)