November 4, 2009 — An international task force of cancer specialists and charities is meeting this week to develop strategies for curbing rising breast cancer rates in developing countries, the AP/Washington Post reports. The task force is led by Felicia Knaul -- a public health specialist and director of Harvard University's Global Equity Initiative -- and Lawrence Shulman of the Dana Farber Cancer Institute. Almost two-thirds of women in developing countries are not diagnosed with the disease until it has spread, the AP/Post reports. Compounding the problem are new data from Harvard that show women in developing countries appear to develop breast cancer, on average, about 10 years earlier than women in the U.S.
The team plans to launch cancer care programs in parts of Africa. In a two-part approach, the task force aims to first educate midwives and other rural health care providers on how to conduct routine manual breast exams, particularly where mammography machines are unattainable. The specialists acknowledged that the method might not detect the smallest tumors, but it could significantly improve diagnosis in some areas. For the second part of the plan, the task force will attempt to reach agreements with drugmakers to provide lower-cost generic chemotherapy in developing countries -- the same model used to advance HIV/AIDS care in parts of Africa.
The true number of breast cancer cases in developing countries is unknown because of poor diagnosis and insufficient record-keeping. However, the Harvard report estimated that 55% of the 450,000 expected breast cancer deaths worldwide this year will be in developing countries. The breast cancer rate in the poorest countries will rise by 36% by 2020, the report estimates (Neergaard, AP/Washington Post, 11/3).