I would like to understand the current landscape of patterns in the diagnosis/ treatment and outcome measure of current therapeutic interventions that are available in LMICs for cancer.
Hi,
Cancer Patients usually come at very late stages. In case of oral cavity, if any unusual growth or ulcer is seen, biopsy is done in order to conclude the diagnosis. As soon as Cancer is confirmed, the best possible treatment done is to remove the abnormal tissue along with the margins of the healthy tissue. Patient is kept on follow up. This has its own significance so as to keep a check on recurrence.
Cancer pattern and outcomes in low-middle income greatly differs from that of high income countries. It will also vary between countries within the low-middle income groups. Mostly, cancers of the esophagus, stomach, mouth, lungs, and pharynx in men, and uterine cervix, breast, ovary, stomach, esophagus, and mouth in women are commonly seen in India. Next, is the stage at diagnosis. Most or around 80% of all cancer patients are diagnosed in advanced stages (Stage III and IV). Thus, the outcomes to conventional treatments are relatively poor in comparison. Lack of specialized services in the rural or under develop areas, low level of cancer awareness , and virtual absence of population-based cancer screening contributes to the late diagnosis of cancer in low-middle income countries. In India for example, more than 70% of our population resides in rural areas, however, almost every cancer diagnostic and treatment centers are located either in urban or semi-urban regions. This also contributes to drop-out during the course of treatment leading to incomplete or sub-optimal treatment, and thus poor outcomes. There are many gaps that needs to be addressed in low-middle income countries to fight cancer, given its socio-economic impact in these countries. I hope this would be useful .
Patterns of diagnosis, treatment and outcomes measurements of cancer cannot be described unless we have data. These can be found in literature.
From modest work and readings, I can state the following broad views:
The incidence rate of cancer in general is higher in rich developed countries than in LMIC. But the case fatality and mortality is the reverse.
Also the facilities for diagnosis and adequacy of treatment is better in developed countries than in most LMIC. Survival as a result is lower in LIMC.
There is the Journal of global oncology but information is very patchy esp cancer incidences and treatment outcomes . You can read up on the Ghana Khumasi cancer registry.
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