Breast and cervical cancer control in low and middle-income countries: Human rights meet sound health policy
Breast and cervical cancer control in low and middle-income countries: Human rights meet sound health policy
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DOI：
10.1016/j.jcpo.2013.07.002
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发表时间：
2013-09-01
影响因子：
1.3
通讯作者：
Ginsburg, O. M.
中科院分区：
文献类型：
--
作者：
Ginsburg, O. M.
每年死于乳腺癌和宫颈癌的女性比死于妊娠和分娩的女性多 20 万名。超过 50% 的乳腺癌死亡和 88% 的宫颈癌死亡发生在欠发达地区，这些地区的性别歧视和极端贫困严重限制了女性就医的选择。低收入和中等收入国家 (LMIC) 的卫生系统因相互竞争的优先事项而不堪重负，而护理提供者却没有做好应对日益流行的癌症的准备。患有癌症的女性面临着额外的负担，因为对家庭的主要责任超过了处理个人健康危机的需要。在较为保守的社会中，有关癌症的神话和对妇女身体的禁忌使这些妇女面临着被丈夫抛弃和被社区排斥的巨大风险。然而，面对这些挑战的数十万女性仍有希望。创新的跨学科项目正在美洲、亚洲和撒哈拉以南非洲地区的资源匮乏地区进行试点。有些已经显示出减少乳腺癌和宫颈癌死亡和残疾的巨大希望，同时加强初级保健和卫生系统的整体建设。乳腺癌和宫颈癌控制应被视为减少医疗支出的“最佳选择”投资机会。实施和成本效益研究不仅可以为发展中国家提供合理的癌症政策信息，也可以为资源日益紧张的高收入国家提供信息。卫生和教育部门的女性领导人可以在妇女健康和公平框架内优先考虑癌症方面发挥关键作用。 (C) 2013 作者。由爱思唯尔有限公司出版
Each year, 200,000 more women die from breast and cervical cancer than from pregnancy and childbirth. Over 50% of deaths from breast cancer and 88% of deaths from cervical cancer occur in less developed regions, where gender discrimination and extreme poverty severely limit a woman's choice to seek care. Health systems in low-and middle-income countries (LMIC) are overwhelmed with competing priorities, while providers of care are unprepared to deal with the growing epidemic of cancer. Women with cancer face additional burdens as the need to attend to a personal health crisis is outweighed by primary responsibilities to the family. Myths about cancer and taboos about women's bodies in more conservative societies render these women at significant risk of being abandoned by their husbands and ostracized by their community. However, there is hope for hundreds of thousands of women confronting these challenges. Innovative, interdisciplinary programs are being piloted in lower resource settings throughout the Americas, Asia and sub-Saharan Africa. Some have already shown great promise to reduce death and disability from breast and cervical cancer, while strengthening primary care and health systems overall. Breast and cervical cancer control should be viewed as a "best buy" investment opportunity to reduce health expenditures. Implementation and cost-effectiveness research can inform rational cancer policy not only for developing countries, but also for high-income countries where resources are increasingly strained. Women leaders in the health and education sectors can play a pivotal role in prioritizing cancer within the framework of women's health and equity. (C) 2013 The Author. Published by Elsevier Ltd.