title: Challenges to effective cancer control in China, India, and Russia.
abstract: Cancer is one of the major non-communicable diseases posing a threat to world health. Unfortunately, improvements in socioeconomic conditions are usually associated with increased cancer incidence. In this Commission, we focus on China, India, and Russia, which share rapidly rising cancer incidence and have cancer mortality rates that are nearly twice as high as in the UK or the USA, vast geographies, growing economies, ageing populations, increasingly westernised lifestyles, relatively disenfranchised subpopulations, serious contamination of the environment, and uncontrolled cancer-causing communicable infections. We describe the overall state of health and cancer control in each country and additional specific issues for consideration: for China, access to care, contamination of the environment, and cancer fatalism and traditional medicine; for India, affordability of care, provision of adequate health personnel, and sociocultural barriers to cancer control; and for Russia, monitoring of the burden of cancer, societal attitudes towards cancer prevention, effects of inequitable treatment and access to medicine, and a need for improved international engagement.
authors.affiliation: Harvard Medical School, Boston, MA, USA; Avon Breast Cancer Center of Excellence, Massachusetts General Hospital, Boston, MA, USA. Electronic address: pgoss@partners.org.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Goss
authors.affiliation: Wilhelminen Hospital, Center for Oncology, Hematology and Palliative Care, Vienna, Austria.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Strasser-Weippl
authors.affiliation: Harvard Medical School, Boston, MA, USA; Department of Hematology-Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA; International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Brittany L
authors.initials: BL
authors.lastname: Lee-Bychkovsky
authors.affiliation: International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA; Cancer Center and Cancer Institute, Shanghai Medical College, Fudan University, Breast Surgery Department, Shanghai, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Fan
authors.affiliation: International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA; Cancer Center and Cancer Institute, Shanghai Medical College, Fudan University, Breast Surgery Department, Shanghai, China.
authors.forename: Junjie
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authors.lastname: Li
authors.affiliation: International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA; Hemato-Oncology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
authors.forename: Yanin
authors.initials: Y
authors.lastname: Chavarri-Guerra
authors.affiliation: International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA; Oncologia Hospital de Clínicas de Porto Alegre and Instituto do Cancer Mãe de Deus, Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Pedro E R
authors.initials: PE
authors.lastname: Liedke
authors.affiliation: Department of Surgical Oncology/Clinical Research, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India.
authors.forename: C S
authors.initials: CS
authors.lastname: Pramesh
authors.affiliation: International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA; University Hospital Zagreb, Department of Oncology, Zagreb, Croatia.
authors.forename: Tanja
authors.initials: T
authors.lastname: Badovinac-Crnjevic
authors.affiliation: Harvard Medical School, Boston, MA, USA; Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Sheikine
authors.affiliation: State Key Lab of Medical Genomics, Shanghai Institute of Hematology, Rui-Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Zhu
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Cancer Epidemiology, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: You-lin
authors.initials: YL
authors.lastname: Qiao
authors.affiliation: Cancer Center and Cancer Institute, Shanghai Medical College, Fudan University, Breast Surgery Department, Shanghai, China.
authors.forename: Zhiming
authors.initials: Z
authors.lastname: Shao
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
authors.forename: Yi-Long
authors.initials: YL
authors.lastname: Wu
authors.affiliation: Fourth Military Medical University, State Key Laboratory of Cancer Biology & Xijing Hospital of Digestive Diseases, Xi'an, Shaanxi Province, China.
authors.forename: Daiming
authors.initials: D
authors.lastname: Fan
authors.affiliation: Organisation for Oncology and Translational Research, Hong Kong, China; UNIMED Medical Institute, Comprehensive Centre for Breast Diseases, Hong Kong, China.
authors.forename: Louis W C
authors.initials: LW
authors.lastname: Chow
authors.affiliation: Institute of Public Health Economics and Management, Central University of Finance and Economics, Beijing, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Economics, School of Economics, Central University of Finance and Economics, Beijing, China.
authors.forename: Qiong
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Cancer Center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Shiying
authors.initials: S
authors.lastname: Yu
authors.affiliation: University of California, Berkeley, CA, USA; Cancer Institute & Hospital Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Gordon
authors.initials: G
authors.lastname: Shen
authors.affiliation: Department of Thoracic Surgery, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Jie
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authors.lastname: He
authors.affiliation: King's Health Partners Cancer Centre, King's College London, Guy's Hospital, London, UK.
authors.forename: Arnie
authors.initials: A
authors.lastname: Purushotham
authors.affiliation: King's Health Partners Cancer Centre, King's College London, Guy's Hospital, London, UK; Institute of Cancer Policy, King's College London, Guy's Hospital, London, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Sullivan
authors.affiliation: Administration, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India.
authors.forename: Rajendra
authors.initials: R
authors.lastname: Badwe
authors.affiliation: Department of Medical and Pediatric Oncology, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India.
authors.forename: Shripad D
authors.initials: SD
authors.lastname: Banavali
authors.affiliation: Department of Clinical Hematology, Tata Medical Center, Kolkata, West Bengal, India.
authors.forename: Reena
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authors.lastname: Nair
authors.affiliation: Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
authors.forename: Lalit
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authors.lastname: Kumar
authors.affiliation: Clinical Research and Education, BSES GH Municipal Hospital, Mumbai, India.
authors.forename: Purvish
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authors.lastname: Parikh
authors.affiliation: Eurasian Federation of Oncology Educational & Research Center, Moscow, Russia.
authors.forename: Somasundarum
authors.initials: S
authors.lastname: Subramanian
authors.affiliation: Department of Head and Neck Surgery, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India.
authors.forename: Pankaj
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authors.lastname: Chaturvedi
authors.affiliation: Amrita Institute of Medical Sciences & Research Centre, Head & Neck/Plastic & Reconstructive Surgery, Kochi, Kerala, India.
authors.forename: Subramania
authors.initials: S
authors.lastname: Iyer
authors.affiliation: Department of Preventive Oncology, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India.
authors.forename: Surendra Srinivas
authors.initials: SS
authors.lastname: Shastri
authors.affiliation: Nizam's Institute of Medical Sciences, Panjagutta, Hyderabad, India.
authors.forename: Raghunadhrao
authors.initials: R
authors.lastname: Digumarti
authors.affiliation: Hemato-Oncology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
authors.forename: Enrique
authors.initials: E
authors.lastname: Soto-Perez-de-Celis
authors.affiliation: Astana Oncology Center, Head and Neck Oncology, Astana, Kazakhstan.
authors.forename: Dauren
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authors.lastname: Adilbay
authors.affiliation: Reproductive System Tumors Department, NN Petrov Research Institute of Oncology, St Petersburg, Russia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Semiglazov
authors.affiliation: Department of Thoracic Oncology, Saint Petersburg Medical University, Saint Petersburg, Russia.
authors.forename: Sergey
authors.initials: S
authors.lastname: Orlov
authors.affiliation: Almaty Oncology Centre, Almaty, Kazakhstan.
authors.forename: Dilyara
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authors.lastname: Kaidarova
authors.affiliation: Russian Society of Clinical Oncology, Kidney Cancer Research Bureau, Moscow, Russia.
authors.forename: Ilya
authors.initials: I
authors.lastname: Tsimafeyeu
authors.affiliation: Pathology and Laboratory Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA.
authors.forename: Sergei
authors.initials: S
authors.lastname: Tatishchev
authors.affiliation: Department of Health Economics, Higher School of Economics, Moscow, Russia.
authors.forename: Kirill D
authors.initials: KD
authors.lastname: Danishevskiy
authors.affiliation: Avon Foundation Breast Cancer Crusade, New York, NY, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Hurlbert
authors.affiliation: International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Vail
authors.affiliation: International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: St Louis
authors.affiliation: Breast Cancer Research Centre-Western Australia and Curtin University, Perth, WA, Australia.
authors.forename: Arlene
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authors.lastname: Chan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000453:epidemiology; D001943:Breast Neoplasms / Q000175:diagnosis; D002681:China; D015179:Colorectal Neoplasms / Q000175:diagnosis; D003466:Cultural Characteristics; D055088:Early Detection of Cancer / Q000639:trends; D057217:Economic Development / Q000639:trends; D004787:Environmental Pollution / Q000009:adverse effects; D005006:Ethnicity; D005260:Female; D006296:Health Services / Q000191:economics; D006297:Health Services Accessibility / Q000639:trends; D006280:Health Workforce / Q000639:trends; D054625:Healthcare Disparities / Q000639:trends; D006801:Humans; D007194:India; D008297:Male; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D009369:Neoplasms / Q000517:prevention & control / Q000628:therapy*; D019035:Rural Health Services / Q000639:trends; D012426:Russia / Q000453:epidemiology; D063507:Sexism; D012907:Smoking; D057545:Social Stigma; D019037:Urban Health Services / Q000639:trends