Planning cancer control in Latin America and the Caribbean

Prof Paul E Goss MD a

, Brittany L Lee MD a b, Tanja Badovinac-Crnjevic MD a, Kathrin Strasser-Weippl MD c, Yanin Chavarri-Guerra MD d, Jessica St Louis BA a, Cynthia Villarreal-Garza MD e, Karla Unger-Saldaña PhD x, Mayra Ferreyra MD f, Márcio Debiasi MD g h, Pedro ER Liedke MD g i, Diego Touya MD j, Gustavo Werutsky MD k, Michaela Higgins MD a, Lei Fan MD a, Claudia Vasconcelos MD l, Eduardo Cazap MD m n, Carlos Vallejos MD o, Alejandro Mohar MD p, Felicia Knaul PhD q r, Hector Arreola MD s, Rekha Batura MD t, Silvana Luciani MD v, Richard Sullivan MD u, Dianne Finkelstein PhD a w, Sergio Simon MD y, Carlos Barrios MD z, Rebecca Kightlinger DO aa, Andres Gelrud MD ab, Vladimir Bychkovsky MSc ac, Gilberto Lopes MD ad ae, Prof Stephen Stefani MD af, Marcelo Blaya MD ag, Fabiano Hahn Souza MD ah, Franklin Santana Santos MD ai, Alberto Kaemmerer MD g, Evandro de Azambuja MD aj, Andres Felipe Cardona Zorilla MD ak, Raul Murillo MD al, Jose Jeronimo MD am, Vivien Tsu PhD am, Andre Carvalho MD an, Carlos Ferreira Gil MD ao, Cinthya Sternberg PhD ap, Alfonso Dueñas-Gonzalez MD ar, Dennis Sgroi MD as, Mauricio Cuello MD j, Rodrigo Fresco MD j, Rui Manuel Reis PhD at, Guiseppe Masera MD au, Raúl Gabús MD av, Raul Ribeiro MD aw ax, Renata Knust MD aq, Gustavo Ismael MD ay, Eduardo Rosenblatt MD az, Berta Roth MD ba, Luisa Villa MD bb, Argelia Lara Solares MD bc, Marta Ximena Leon MD bd, Isabel Torres-Vigil DrPH be bf, Alfredo Covarrubias-Gomez MD bc, Andrés Hernández MD bc, Mariela Bertolino MD bg, Gilberto Schwartsmann MD i, Sergio Santillana MD bh, Francisco Esteva MD bi, Luis Fein MD bj, Max Mano MD bk, Henry Gomez MD bl, Marc Hurlbert PhD bm, Alessandra Durstine MBA bn, Gustavo Azenha PhD bn

Summary

Non-communicable diseases, including cancer, are overtaking infectious disease as the leading health-care threat in middle-income and low-income countries. Latin American and Caribbean countries are struggling to respond to increasing morbidity and death from advanced disease. Health ministries and health-care systems in these countries face many challenges caring for patients with advanced cancer: inadequate funding; inequitable distribution of resources and services; inadequate numbers, training, and distribution of health-care personnel and equipment; lack of adequate care for many populations based on socioeconomic, geographic, ethnic, and other factors; and current systems geared toward the needs of wealthy, urban minorities at a cost to the entire population. This burgeoning cancer problem threatens to cause widespread suffering and economic peril to the countries of Latin America. Prompt and deliberate actions must be taken to avoid this scenario. Increasing efforts towards prevention of cancer and avoidance of advanced, stage IV disease will reduce suffering and mortality and will make overall cancer care more affordable. We hope the findings of our Commission and our recommendations will inspire Latin American stakeholders to redouble their efforts to address this increasing cancer burden and to prevent it from worsening and threatening their societies.