title: Progress and remaining challenges for cancer control in Latin America and the Caribbean.
abstract: Cancer is one of the leading causes of mortality worldwide, and an increasing threat in low-income and middle-income countries. Our findings in the 2013 Commission in The Lancet Oncology showed several discrepancies between the cancer landscape in Latin America and more developed countries. We reported that funding for health care was a small percentage of national gross domestic product and the percentage of health-care funds diverted to cancer care was even lower. Funds, insurance coverage, doctors, health-care workers, resources, and equipment were also very inequitably distributed between and within countries. We reported that a scarcity of cancer registries hampered the design of credible cancer plans, including initiatives for primary prevention. When we were commissioned by The Lancet Oncology to write an update to our report, we were sceptical that we would uncover much change. To our surprise and gratification much progress has been made in this short time. We are pleased to highlight structural reforms in health-care systems, new programmes for disenfranchised populations, expansion of cancer registries and cancer plans, and implementation of policies to improve primary cancer prevention.
authors.affiliation: Centre for Oncology and Hematology, Wilhelminen Hospital, Vienna, Austria; The Global Cancer Institute, Boston, MA, USA.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Strasser-Weippl
authors.affiliation: The Global Cancer Institute, Boston, MA, USA; Hemato-Oncology Department, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico; Avon International Breast Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Yanin
authors.initials: Y
authors.lastname: Chavarri-Guerra
authors.affiliation: Instituto de Cancerología, Centro de Cáncer de Mama, Tecnologico de Monterrey, Monterrey, Nuevo León, Mexico; Departmento de Investigación y de Tumores Mamarios, Instituto Nacional de Cancerologia, Mexico City, Mexico.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Villarreal-Garza
authors.affiliation: Dana Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
authors.forename: Brittany L
authors.initials: BL
authors.lastname: Bychkovsky
authors.affiliation: Hospital Mae de Deus, Porto Alegre, Rio Grande do Sul, Brazil; Hospital Sao Lucas da PUCRS, Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Marcio
authors.initials: M
authors.lastname: Debiasi
authors.affiliation: Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; Instituto do Câncer 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 Geriatrics, Cancer Care in the Elderly Clinic, 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: Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
authors.forename: Don
authors.initials: D
authors.lastname: Dizon
authors.affiliation: Sociedad Latinoamericana y del Caribe de Oncología Médica, Buenos Aires, Argentina.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Cazap
authors.affiliation: Medical Oncology, Centro Paulista de Oncologia and Oncoclinicas do Brasil Group, São Paulo, Brazil; Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Gilberto
authors.initials: G
authors.lastname: de Lima Lopes
authors.affiliation: Department of Oncology, University of the Republic, Montevideo, Uruguay.
authors.forename: Diego
authors.initials: D
authors.lastname: Touya
authors.affiliation: Hospital do Câncer de Barretos, Barretos, São Paulo, Brazil.
authors.forename: Joāo Soares
authors.initials: JS
authors.lastname: Nunes
authors.affiliation: The Global Cancer Institute, Boston, MA, USA; Avon International Breast Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: St Louis
authors.affiliation: The Global Cancer Institute, Boston, MA, USA; Avon International Breast Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Vail
authors.affiliation: The Global Cancer Institute, Boston, MA, USA; Avon International Breast Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Bukowski
authors.affiliation: Instituto de Cancerología, Centro de Cáncer de Mama, Tecnologico de Monterrey, Monterrey, Nuevo León, Mexico.
authors.forename: Pier
authors.initials: P
authors.lastname: Ramos-Elias
authors.affiliation: Cátedra CONACYT, Unidad de Epidemiología, Instituto Nacional de Cancerologia, Mexico City, Mexico.
authors.forename: Karla
authors.initials: K
authors.lastname: Unger-Saldaña
authors.affiliation: Universidade Federal de São Paulo, Brazil, São Paulo, Brazil.
authors.forename: Denise Froes
authors.initials: DF
authors.lastname: Brandao
authors.affiliation: Oncology Department, Maria Curie Hospital, Buenos Aires, Argentina.
authors.forename: Mayra E
authors.initials: ME
authors.lastname: Ferreyra
authors.affiliation: Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA.
authors.forename: Silvana
authors.initials: S
authors.lastname: Luciani
authors.affiliation: Federal University, Minas Gerais, Brazil; EVA-Group Brasileiro de Tumores Ginecológicos, Brazilian Gynecologic Oncology Group, Bahia, Brazil.
authors.forename: Angelica
authors.initials: A
authors.lastname: Nogueira-Rodrigues
authors.affiliation: Clinica AMO, Salvador, Bahia, Brazil.
authors.forename: Aknar Freire
authors.initials: AF
authors.lastname: de Carvalho Calabrich
authors.affiliation: Division of Gynecologic Oncology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
authors.forename: Marcela G
authors.initials: MG
authors.lastname: Del Carmen
authors.affiliation: Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
authors.forename: Jose Alejandro
authors.initials: JA
authors.lastname: Rauh-Hain
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Schmeler
authors.affiliation: Grupo Argentino de Investigación Clínica en Oncología-GAICO, Rosario, Santa Fe, Argentina.
authors.forename: Raúl
authors.initials: R
authors.lastname: Sala
authors.affiliation: The Global Cancer Institute, Boston, MA, USA; Avon International Breast Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: pgoss@mgh.harvard.edu.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Goss
mesh_terms: D017691:Caribbean Region; D003695:Delivery of Health Care; D019049:Developed Countries / Q000191:economics; D006801:Humans; D007348:Insurance, Health / Q000191:economics*; D007843:Latin America; D009369:Neoplasms / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control