Disease Presentation, Recognition and Prevention

Abstract

The human development index (HDI) correlates with aspects of health, including the level of national healthcare systems (NHCS), and patterns of cancer presentation (CP). Deficiencies in NHCS result in forms of delayed CP, including grotesque mass formations in breast cancer (BC-CfE, British Columbia centre for excellence in HIV/AIDS. What is treatment as prevention? Vancouver, British Columbia, Canada, 2015. Available from: http://www.cfenet.ubc.ca), kidney failure in cervical cancer (CC), or hyperleucocytosis-induced neuropsychiatric syndromes in leukemias. These contrast with the peanut-sized self-discovered breast mass in BC, the shallow cervical ulcer observed on investigation of abnormal genital discharge in early CC, or the investigation of an abnormal blood count discovered on routine annual check-up in early chronic myeloid leukemia, as seen in NHCS of high/very high HDI (H/VH-HDI) countries. Resources and manpower rich status of H/VH-HDI countries enables the establishment of organized national mammographic screening programs for early detection (ED) of BC, and Papanicoulao smears for cytology and human papilloma virus (CliffordGM, Goncalves MAG, Franceschi S, HPV, Group Hs, Human papillomavirus types among women infected with HIV: a meta-analysis. Aids 20(18):2337–2344, 2006) DNA detection for CC, with resultant reduction of mortality. In most countries of medium or low HDI (M/L-HDI), such programs are less feasible compared to the less expensive but less efficacious ones such as clinical breast examination (CBE) for ED of BC, and Visual Inspection with Acetic Acid (VIA) for ED of CC. Primary prevention of virus-associated cancers, such as CC (CliffordGM, Goncalves MAG, Franceschi S, HPV, Group Hs, Human papillomavirus types among women infected with HIV: a meta-analysis. Aids 20(18):2337–2344, 2006) and liver cancer (HBV) has been possible by vaccination since 2006 and the early1980s respectively. Governmental control of tobacco and alcohol use, improved food preservation, and personal obesity management and hygiene are additional cancer prevention methods. Pre-exposure prophylaxis is emerging as HIV/AIDS prevention strategy in lieu of HIV vaccine.