Zimbabwe: Initiative to Reduce Global Breast Cancer Mortality Until 2040 Launched

Breast cancer has affected many women and men in Zimbabwe.

According to latest figures published by the Zimbabwe National Cancer Registry (ZNCR), breast cancer accounts for 8 percent of the most frequently occurring cancers among Zimbabweans of all races in 2017.

At 13.5 percent, breast cancer was noted as one of the leading causes of cancer among Zimbabwean black women.

Yesterday, a major new collaborative effort, the Global Breast Cancer Initiative, was launched by the World Health Organization (WHO).

The objective of the initiative is to reduce global breast cancer mortality by 2.5 percent per year until 2040.

This will avert an estimated 2.5 million deaths.

The new Global Breast Cancer Initiative complements other WHO efforts on cancer, the Global Initiative for Childhood Cancer, established in 2018, and the Global Strategy to Accelerate the Elimination of Cervical Cancer, launched in 2020.

“In recognition of International Women’s Day, WHO is hosting an advocacy event ‘Hearing the call of women with breast cancer’ during which the new Initiative will be presented to the global cancer community.

“Although we have seen substantive progress in reducing breast cancer mortality in many high-income countries during the last two decades, little progress has been made in low-and middle-income countries,” said Dr Bente Mikkelsen, Director of the Department of Noncommunicable Diseases at WHO.

Added Dr Mikkelsen: “The higher mortality in these lower-income countries is a result of late-stage diagnosis and inadequate access to quality care. Together, we can address this unacceptable inequity.”

WHO further said breast cancer survival five years after diagnosis now exceeds 80 percent in most high-income countries, compared with 66 percent in India and just 40 percent in South Africa.

The premature deaths and high out-of-pocket expenditure that arise when breast cancer services are unavailable or unaffordable result in social disruption, impoverishment, family instability and orphaned children and also threaten economic growth, WHO points out.

According to WHO, the importance of addressing this situation has become all the more urgent given that breast cancer has now overtaken lung cancer as the world’s mostly commonly-diagnosed cancer, and is responsible for one in six of all cancer deaths among women, according to statistics released by the International Agency for Research on Cancer (IARC) in December 2020.

WHO said the establishment of WHO’s new Global Breast Cancer Initiative follows a steady escalation in the recognition of breast cancer as a public health priority during the last decades.

Through the Initiative, WHO, working in unison with other UN agencies and partner organisations, will provide guidance to governments on how to strengthen systems for diagnosing and treating breast cancer, which in turn is expected to lead to improved capacities to manage other types of cancer.

Three pillars: health promotion, timely diagnosis and comprehensive treatment and supportive care

“Global partners, experts and other organizations will be convened through the Initiative to map existing activities, develop roadmaps, and establish multisectoral working groups to address health promotion and early detection, timely breast cancer diagnosis, and comprehensive breast cancer treatment and supportive care,” said Dr Ben Anderson, leading the work on the new Initiative at WHO. “The demand for a global approach, that brings together the best expertise on breast cancer control from around the world, is high, as is the excitement about what can be achieved.”

Health promotion, the first pillar, will include public education about the signs and symptoms of breast cancer, risk reduction strategies (such as avoiding obesity, limiting alcohol intake and encouraging breastfeeding), and reducing the stigma associated with breast health that exists in some parts of the world.

WHO added that timely breast cancer diagnosis should reduce delays between the time a patient first interacts with the health system and the initiation of breast cancer treatment.

Although breast tumours do not change in days or weeks, cancer survival rates begin to erode when delays to initiate treatment are greater than three months. Current delays in some settings and among certain vulnerable populations can be more than a year. Basic diagnostic services are feasible in all settings, so long as they are well-organized and lead to timely referral for specialist care.

Comprehensive treatment and care for breast cancer treatment should include access to surgery, chemotherapy and/or radiotherapy as well as rehabilitation support for women following treatment and palliative services to reduce pain and discomfort.