Breast cancer screening 16 and cervical cancer prevention in developing countries: Strategies for the future

Abstract

Breast cancer is increasing 3.1 % annually. It is more deadly and more frequent in young women in developing countries compared to young women in the more developed countries. Important reasons for this increased incidence and lethality are poor nutrition (leading to decreased immunity to resist the advance of cancer), delayed access to health care, and poor quality of care when it is fi nally available. Early detection of breast cancer is the key to the control of its lethal effects. Increasing breast health awareness and clinical breast examination are key components of a screening program at the present time. Such a strategy is aimed at detecting Stage I and Stage II cancers and downstaging cancers from the now prevalent presentation at Stage III and Stage IV. For the future, however, a low cost methodology needs to be adopted in order to diagnose small nodenegative cancers by screening the asymptomatic population. Organized screening mammography is not a feasible option for low and mid-resource countries, even in the future. A combination of low prevalence and the expensive infrastructure needed in terms of the equipment and trained health-care professionals makes this an unrealistic option and a potential drain and diversion of health-care funding resources in developing countries. The background of the situation that is currently in existence, problems thereof, and the potential for the use of whole breast ultrasound screening for breast cancer is discussed in this chapter.