胃腸および消化器系

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National Cancer Control Plans: Comparative analysis between South Africa and Brazil focusing on Colorectal Cancer Control

Sphindile Magwaza, Guido Van Hal, Muhammad Hoque

 According to WHO, National Health policies should define people-centred care and address the social determinants of health. Similarly, reliable information systems are critical for decision-making and informing public health strategies. The objective of comparative study was to compare South Africa and Brazil’s colorectal cancer (CRC) control policy frameworks focusing on CRC epidemiology, risk factors, screening, and measures for early detection and control and surveillance approaches in each country. These countries are in the upper middle income category as defined by the World Bank, have similar patterns of cancer burden, health system infrastructure. And are part of the economic cooperation with China, Russia and India called BRICS. Methods: A literature search targeted WHO website, GLOBOCAN, PubMed and Medline sources to identify CRC guidelines for South Africa and Brazil published from year 2000 to year 2020. Data was extracted to a table by policy key components for comparison. Results: Both country cancer plans were informed by epidemiology and aligned to the WHO guidelines and STEPS surveillance mechanism. The national cancer registry was last published in 2014 for South Africa and in 2018 for Brazil. Both country policies cover the full spectrum of prevention, early detection, diagnosis, treatment and palliative care. CRC screening plan did not exist in South Africa. Operational plans on risk factors with annual targets existed in both countries. Inequity of CRC services at regional level and between public and private sectors affected both countries. Conclusion: South Africa and Brazil address the cancer risk factors proactively. Gaps remain to ensure equity of colorectal cancer services in each country. Partnership opportunities exist to facilitate population based survey in South Africa, support equity of cancer services in both countries given the CRC projections. The partnership is the catalyst to advance harmonised and optimised CRC control programme through innovation in both countries.