Megafu Olajumoke M
Department of Surgery, University of Massachusetts, 55N Lake Ave Worcester, MA, 01655, USA.
Am J Surg. 2025 Jul;245:116350. doi: 10.1016/j.amjsurg.2025.116350. Epub 2025 Apr 14.
Colorectal cancer (CRC) is a growing public health threat in low- and middle-income countries (LMICs), challenging the traditional focus on infectious diseases. This paper examines the rising burden of CRC in LMICs, using Ghana as a case study. CRC incidence is increasing in LMICs, often presenting at younger ages and later stages, with poorer survival rates. This analysis explores CRC's epidemiological trends in Ghana, highlighting management challenges: limited resources, inadequate screening, sociocultural barriers, and social determinants of health. The paper investigates the roles of stakeholders, government agencies, and frontline providers in shaping healthcare infrastructure and addressing the need for specialized care. It examines the gap in global health initiatives regarding chronic diseases such as CRC and funding/policy prioritization challenges. Finally, it proposes policy recommendations for LMICs: robust surveillance systems, tailored screening guidelines, integrated preventive measures, improved access to screening and treatment, and collaborative efforts. Addressing CRC's complex challenges in LMICs requires a shift in global health priorities, recognizing the increasing burden of chronic diseases and ensuring equitable access to prevention, screening, and treatment.
在低收入和中等收入国家（LMICs），结直肠癌（CRC）对公共卫生构成的威胁日益严重，这对传统上关注传染病的情况提出了挑战。本文以加纳为例，研究了低收入和中等收入国家结直肠癌负担不断上升的情况。在低收入和中等收入国家，结直肠癌的发病率正在上升，通常在较年轻的年龄和较晚的阶段出现，生存率较低。本分析探讨了加纳结直肠癌的流行病学趋势，突出了管理方面的挑战：资源有限、筛查不足、社会文化障碍以及健康的社会决定因素。本文调查了利益相关者、政府机构和一线医疗服务提供者在塑造医疗基础设施以及满足专科护理需求方面所起的作用。它审视了全球卫生倡议在诸如结直肠癌等慢性病方面存在的差距以及资金/政策优先排序方面的挑战。最后，它为低收入和中等收入国家提出了政策建议：健全监测系统、量身定制筛查指南、综合预防措施、改善筛查和治疗的可及性以及开展协作努力。应对低收入和中等收入国家结直肠癌的复杂挑战需要全球卫生优先事项的转变，认识到慢性病负担日益加重，并确保公平获得预防、筛查和治疗的机会。
