title: Costs, affordability, and feasibility of an essential package of cancer control interventions in low-income and middle-income countries: key messages from Disease Control Priorities, 3rd edition.
abstract: Investments in cancer control--prevention, detection, diagnosis, surgery, other treatment, and palliative care--are increasingly needed in low-income and particularly in middle-income countries, where most of the world's cancer deaths occur without treatment or palliation. To help countries expand locally appropriate services, Cancer (the third volume of nine in Disease Control Priorities, 3rd edition) developed an essential package of potentially cost-effective measures for countries to consider and adapt. Interventions included in the package are: prevention of tobacco-related cancer and virus-related liver and cervical cancers; diagnosis and treatment of early breast cancer, cervical cancer, and selected childhood cancers; and widespread availability of palliative care, including opioids. These interventions would cost an additional US$20 billion per year worldwide, constituting 3% of total public spending on health in low-income and middle-income countries. With implementation of an appropriately tailored package, most countries could substantially reduce suffering and premature death from cancer before 2030, with even greater improvements in later decades.
authors.affiliation: Center for Disease Dynamics, Economics & Policy, Washington, DC, USA. Electronic address: gelband@cddep.org.
authors.forename: Hellen
authors.initials: H
authors.lastname: Gelband
authors.affiliation: International Agency for Research on Cancer, Lyon, France.
authors.forename: Rengaswamy
authors.initials: R
authors.lastname: Sankaranarayanan
authors.affiliation: Centre for Global Health Research, St Michael's Hospital, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Gauvreau
authors.affiliation: University of Waterloo, Waterloo, ON, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Horton
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Benjamin O
authors.initials: BO
authors.lastname: Anderson
authors.affiliation: International Agency for Research on Cancer, Lyon, France.
authors.forename: Freddie
authors.initials: F
authors.lastname: Bray
authors.affiliation: University of Wisconsin, Madison, WI, USA.
authors.forename: James
authors.initials: J
authors.lastname: Cleary
authors.affiliation: Centre for Global Health Research, St Michael's Hospital, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Anna J
authors.initials: AJ
authors.lastname: Dare
authors.affiliation: University of Cape Town, Cape Town, South Africa.
authors.forename: Lynette
authors.initials: L
authors.lastname: Denny
authors.affiliation: Princess Margaret Cancer Centre, Toronto, ON, Canada.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Gospodarowicz
authors.affiliation: Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: Sumit
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Health Sciences Center, University of Tennessee, Memphis, TN, USA.
authors.forename: Scott C
authors.initials: SC
authors.lastname: Howard
authors.affiliation: Princess Margaret Cancer Centre, Toronto, ON, Canada.
authors.forename: David A
authors.initials: DA
authors.lastname: Jaffray
authors.affiliation: Harvard University, Cambridge, MA, USA.
authors.forename: Felicia
authors.initials: F
authors.lastname: Knaul
authors.affiliation: University of Washington, Seattle, WA, USA.
authors.forename: Carol
authors.initials: C
authors.lastname: Levin
authors.affiliation: Cancer Care Ontario, Toronto, ON, Canada.
authors.forename: Linda
authors.initials: L
authors.lastname: Rabeneck
authors.affiliation: National Cancer Institute, Bethesda, MD, USA.
authors.forename: Preetha
authors.initials: P
authors.lastname: Rajaraman
authors.affiliation: Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada.
authors.forename: Terrence
authors.initials: T
authors.lastname: Sullivan
authors.affiliation: National Cancer Institute, Bethesda, MD, USA.
authors.forename: Edward L
authors.initials: EL
authors.lastname: Trimble
authors.affiliation: Centre for Global Health Research, St Michael's Hospital, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. Electronic address: prabhat.jha@utoronto.ca.
authors.forename: Prabhat
authors.initials: P
authors.lastname: Jha
mesh_terms: D003695:Delivery of Health Care / Q000191:economics*; D003906:Developing Countries / Q000706:statistics & numerical data; D014943:Global Health / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007182:Income; D009369:Neoplasms / Q000175:diagnosis / Q000191:economics* / Q000401:mortality / Q000628:therapy