title: Public health oncology: a framework for progress in low- and middle-income countries.
abstract: BACKGROUND
  The problems of cancer are increasing in low- and middle-income countries (LMCs), which now have significant majorities of the global case and mortality burdens. The professional oncology community is being increasingly called upon to define pragmatic and realistic approaches to these problems.
  
  
  METHODS
  Focusing on mortality and case burden outcomes defines public health oncology or population-affecting cancer medicine. We use this focus to consider practical approaches.
  
  
  RESULTS
  The greatest cancer burdens are in Asia. A public health oncology perspective mandates: first, addressing the major and social challenges of cancer medicine for populations: human rights, health systems, corruption, and our limited knowledge base for value-conscious interventions. Second, adoption of evolving concepts and models for sustainable development in LMCs. Third, clear and realistic statements of action and inaction affecting populations, grounded in our best cancer science, and attention to these. Finally, framing the goals and challenges for population-affecting cancer medicine requires a change in paradigm from historical top-down models of technology transfer, to one which is community-grounded and local-evidence based.
  
  
  CONCLUSIONS
  Public health oncology perspectives define clear focus for much needed research on country-specific practical approaches to cancer control.
authors.affiliation: The International Breast Cancer Research Foundation, Madison, USA. Electronic address: richardibcrf@gmail.com.
authors.forename: R R
authors.initials: RR
authors.lastname: Love
authors.affiliation: Women's College Research Institute, the University of Toronto, Toronto, Canada.
authors.forename: O M
authors.initials: OM
authors.lastname: Ginsburg
authors.affiliation: Division of Cancer Treatment and Diagnosis, The Radiation Research Program, National Cancer Institute, Bethesda, USA.
authors.forename: C N
authors.initials: CN
authors.lastname: Coleman
mesh_terms: D003906:Developing Countries; D006297:Health Services Accessibility; D006801:Humans; D008495:Medical Oncology; D009369:Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D011634:Public Health; D012959:Socioeconomic Factors