What are the health needs and challenges?

Cancer is the second leading cause of death in the Americas, where an estimated 1.1 million people are newly diagnosed and 600,000 people die each year. Breast and cervical cancer are among the most common cancers in women (approximately 43,000 women died from breast cancer in 2012). Despite these diseases being highly amenable to early detection and cure, women continue to die prematurely, partly because of the limitations in access to cost-effective screening and treatment.

Cancer registration is necessary for cancer control, as knowledge of the country’s particular cancer situation and patterns is needed to make informed decisions on the targeted interventions to reduce incidence and mortality. High-quality population based cancer registries (PBCR) at the national level are the ideal standard for cancer registration.  In Latin America and the Caribbean, these exist in only two countries (Costa Rica and Uruguay), although there are regional cancer registries in many countries, as well as ongoing efforts to establish PBCR.

Partnership activities and how they address needs and challenges

For over 15 years, PAHO has supported the Ministries of Health of countries in Latin America and the Caribbean in the ramping up of their cancer prevention and treatment initiatives. In 2014, PAHO Foundation and the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) began a three-year partnership to increase awareness of breast and cervical cancer and improve screening and earlier detection services to reduce the numbers of women who prematurely die from these cancers.

The first year of this partnership saw great progress in three main areas. First, raising awareness of breast and cervical cancer to encourage women to engage in screening and early detection services. In order to do this, the partnership produced a number of educational materials for the public on breast and cervical cancer prevention, detection and treatment. Second, carrying out a pilot project with the Ministry of Health in Chile to strengthen national cervical cancer screening programs as well as a series of policy workshops with government officials and health experts. Third, holding a cancer registry training with relevant officials in 11 countries, in collaboration with the International Agency for Research on Cancer (IARC) and hosted by the National Cancer Institute of Argentina.

There are two pillars of the partnership:

Awareness raising and capacity building of healthcare professionals
Health information, education and communication activities were developed to raise public awareness and to support an informed, empowered community of women. PAHO Foundation and IFPMA gave support to the efforts of Ministries of Health, regional cancer civil society groups, NGOs, women’s groups and other community based organizations.

A toolkit with educational messages on HPV, HPV vaccination, cervical cancer screening and cervical cancer treatment was created and disseminated throughout the region. Spanish language guidelines for program managers and health professionals on how to design and deliver programs for comprehensive cervical cancer prevention and control were shared with the Ministries of Health in Latin America. English language guidelines have also been disseminated in the Caribbean.

In collaboration with the national cervical cancer program manager from the Ministry of Health, the partnership offers healthcare provider training to strengthen the national cervical cancer screening program, focusing on HPV test-based strategies to improve screening coverage and pre-cancer treatment rates. The program also disseminates the current evidence on breast cancer screening and early detection and train providers at the primary health care level on early signs and symptoms of breast cancer.

Trainings for primary health providers on Visual Inspection using Acetic Acid (VIA) took place throughout Latin America, as well as a pilot screening program using HPV DNA testing for cervical cancer.

Building capacity for cancer registration
Through the Latin America cancer registry “hub’’ based in Argentina, and a training “hub’’ to be established in the Caribbean, the partnership supports capacity building of cancer registries, including a series of training courses to improve information on cancer incidence and mortality.

Working with the country cancer registry personnel, the initiative assists selected countries with cancer data quality assurance, statistical analysis and presentation of data in a cancer report. The report would highlight the cancer situation, illustrating cancer incidence, mortality and trends, to be presented to the main health authorities and inform national cancer control plans.

The partnership has helped to build cancer registry capacity, training the staff of cancer registries from across the continent, which also includes support in analyzing national cancer data for possible future publication in the Cancer Incidence in Five Continents report.

Materials

The Women’s Cancer Initiative (infographic with PAHO Foundation)
Annual report (PDF)
Nuevas hojas informativas para los profesionales de salud (Breast Cancer: Knowledge summaries for health professionals – English versions to follow shortly)

Prevención: Factores de Riesgo del Cáncer de Mama y Prevención (Descarguelo aquí)
Detección Temprana: Concientización Sobre la Salud Mamaria y Exploración Clínica de las Mamas (Descarguelo aquí)
Detección Temprana: Fisiología de Mama y el Examen Clínico de Mama (ECM) (Descarguelo aquí)
Planificación: Mejora del Acceso a la Atención para el Cáncer de Mama (Descarguelo aquí)
Planificación de Programas Integrales contra el Cáncer de Mama: Un Llamado a la Acción (Descarguelo aquí)

Women’s Cancers in Latin America and Caribbean (infographic with FIFARMA; Registries; Cancers;Screening)
Cáncer en Mujeres en América Latina y el Caribe (infografía con FIFARMA; Registros; Cáncer; Prevención)
Our Engagement on NCDs (IFPMA webpage)

As of 2022, Bristol Myers Squibb is no longer an active member of this initiative.