Onyebuchi Chris Ifediora (OCI) Foundation, Suite 2a, Cyfed Complex, Ifite-Amansea Road (Opposite UNIZIK Permanent Site Gate), Awka, Nigeria.
Griffith University Medical School, Gold Coast, Australia.
BMC Public Health. 2019 May 3;19(1):503. doi: 10.1186/s12889-019-6890-2.
The negative impact of cervical and breast cancers in low and lower-middle income countries are worsening, and, along with other non-communicable diseases, occur disproportionately in these resource-limited economies. Most preventive approaches to these cancers require government funding, but few countries with the most at-risk population can afford government-sponsored universal vaccination, screening, diagnostic and treatment programmes, which, along with socioeconomic issues, contribute to the poor outcomes in these mostly developing countries. An urgent need exists, therefore, to find an effective, affordable, cost-effective, culturally-acceptable and sustainable way of reducing these cancers. This paper advocates a re-thinking in the current preventive campaigns.
Using evidence provided by recently-published papers, a case is made for enlightenment campaigns to primarily target teenagers (boys and girls) in high schools of developing countries. Inclusions into the schools' academic curricula are the recommended approach, given that both cancers take hold on populations within that age bracket. This approach, if adopted, may be the only accessible, affordable and realistic approach that gives millions of women in low and lower-middle income countries the chance at survival. Empowering them early instils the self-awareness and confidence necessary for young adults to take charge of their own health. The acquired knowledge, in turn, helps them adopt positive attitudes and preventive behaviours that will, ultimately, prolong their lives.
The recommended approach offers governments and concerned stakeholders an evidence-based option that allows them to deliver cost-effective and sustainable life-saving interventions, while hoping to get around the bottlenecks that limit the large scale implementation of other effective but capital-intensive strategies.
在低收入和中低收入国家，宫颈癌和乳腺癌的负面影响正在加剧，与其他非传染性疾病一起，在这些资源有限的经济体中不成比例地发生。大多数针对这些癌症的预防方法都需要政府资金，但大多数高危人群所在的国家都无法承担政府赞助的普遍疫苗接种、筛查、诊断和治疗计划，这些问题加上社会经济问题，导致这些主要发展中国家的预后较差。因此，迫切需要找到一种有效、负担得起、具有成本效益、文化上可接受和可持续的方法来降低这些癌症的发病率。本文主张重新思考当前的预防运动。
本文利用最近发表的论文提供的证据，提出了一个主要针对发展中国家高中青少年（男孩和女孩）开展启蒙运动的建议。考虑到这两种癌症都发生在该年龄段的人群中，将其纳入学校的学术课程是推荐的方法。如果采用这种方法，这可能是唯一可行、负担得起且现实的方法，可以使低收入和中低收入国家的数百万妇女有机会生存。早期赋予她们权力，可以使她们树立自我意识和信心，从而能够掌控自己的健康。反过来，所获得的知识可以帮助她们采取积极的态度和预防行为，最终延长她们的寿命。
所建议的方法为政府和相关利益攸关方提供了一种基于证据的选择，使他们能够提供具有成本效益和可持续性的拯救生命的干预措施，同时希望能够绕过限制其他有效但资本密集型战略大规模实施的瓶颈。
