Planning Cancer Control in Latin
America and the Caribbean
Lancet Oncology Commission Report
• First, unique, multidisciplinary report of Cancer Control in the overall
region of 47 countries and territories of Latin America
The Team
– 71 Leading Oncologists, Cancer Researchers, Health Economists,
Epidemiologists, Radiologists, Pathologists, Advocates, Industry and
others on the Front-line of Cancer Care
– International Cancer team from Harvard Medical School
– The Lancet Oncology Editorial team in London, their independent
external reviewers and 5 experts in cancer control who offered
commentaries
Acknowledgements and Special Thanks
– The LACOG Coordinating Office and LACOG Group - Special
thanks to Dr. Carlos Barrios, Dr. Gustavo Werutsky, and
Laura Voelcker
– Dr. David Collingridge, Editor of The Lancet Oncology and
his Editorial Team in London
– Media assistance: Ms Daisy Barton TLO; Guilherme Wendt
– The Massachusetts General Hospital International Cancer
Group
– The RV Mais Agency in Sao Paolo
Acknowledge and Thank 71 Contributing Authors
Primary Writers:
Paul Goss, Brittany L Lee, Tanja Badovinac-Crnjevic, Kathrin Strasser-Weippl, Yanin ChavarriGuerra, Jessica St Louis, Cynthia Villarreal-Garza, Karla Unger-Saldaña, Mayra Ferreyra,
Márcio Debiasi, Pedro E R Liedke, Diego Touya, Gustavo Werutsky, Michaela Higgins, Lei Fan,
Claudia Vasconcelos
Co-Authors:
Eduardo Cazap, Carlos Vallejos, Alejandro Mohar, Felicia Knaul, Hector Arreola, Rekha
Batura, Silvana Luciani, Richard Sullivan, Dianne Finkelstein, Sergio Simon, Carlos Barrios,
Rebecca Kightlinger, Andres Gelrud, Vladimir Bychkovsky, Gilberto Lopes,
Stephen Stefani, Marcelo Blaya, Fabiano Hahn Souza, Franklin Santana Santos, Alberto
Kaemmerer, Evandro de Azambuja, Andres Felipe Cardona Zorilla, Raul Murillo, Jose
Jeronimo, Vivien Tsu, Andre Carvalho, Carlos Ferreira Gil, Cinthya Sternberg, Alfonso
Dueñas-Gonzalez, Dennis Sgroi, Mauricio Cuello, Rodrigo Fresco, Rui Manuel Reis, Guiseppe
Masera, Raúl Gabús, Raul Ribeiro, Renata Knust, Gustavo Ismael, Eduardo Rosenblatt, Berta
Roth, Luisa Villa, Argelia Lara Solares, Marta Ximena Leon, Isabel Torres-Vigil, Alfredo
Covarrubias-Gomez, Andrés Hernández, Mariela Bertolino, Gilberto Schwartsmann, Sergio
Santillana, Francisco Esteva, Luis Fein, Max Mano, Henry Gomez, Marc Hurlbert, Alessandra
Durstine, Gustavo Azenha
Thank: Dr Julio Frenke fo help in reviewing Part 2
Conflicts of Interest – 9 Speakers
No Conflict of Interest to declare:
– Paul Goss, Yanin Chávarri Guerra, Cynthia
Villarreal-Garza, Brittany Lee, Marcio Debiasi,
Pedro Liedke, Tanja Badovianac-Crnjevic,
Gustavo Werutsky and Henry Gomez
Background and Statement of the Problem of Cancer Control
in LA and the Caribbean:
• Latin America:
– A complex region 33 countries and 14 territories
• Diverse health-care systems, access to care, socioeconomic, geographic,
environmental, cultural, and ethnic factors
• Region threatens to be overwhelmed by cancer over the next
1-2 decades resulting in;
– Significant human suffering
– A sharp rise in cost (currently ~$ 4billion annually)
•
Cancers are diseases of ageing people
– By 2020 in LA >100 million people > 60 years
– By 2030 1∙7 million new diagnoses and 1 million deaths annually
• LA Cancer
– Is less frequent than US
– But mortality/frequency rates are ~ 60% higher (0.59 in LA
vs 0.35 in US)
– Largely because of more advanced disease at diagnosis
• Current Cancer Control Systems
– React to the sickest patients with stage 4 cancer
– In-hospital care of these patients consumes a large
fraction of the available resources and budget
• LA Cancer Control generally favors more wealthy, educated, urban
minority
– 320/590 million (54%) lack adequate health-care
• Most urban poor, rural and remote populations and ~50 million
indigenous people, have poor or no health care coverage
• Expenditures per cancer patient:
• USA ≥ 8x more of GDP
• USA 17x more in absolute dollar amount
• Medical spending per new cancer diagnosis is $8 in LA
compared to $460 in the US
Goals of our Commission
– To highlight the rapidly rising cancer burden in Latin
America
– To galvanize local and international interest and
attention to Cancer Control in Latin America
– To provide ministries, health care personnel and other
stakeholders a “fact-checked” framework for
discussion to take measures to avert widespread
human suffering and a potential threat to their
economies
Topics included in our Commission Report
1.
2.
3.
4.
Current health systems in Latin America
Urban and rural cancer care in Latin America
Cancer care for indigenous peoples
Cost of cancer care in Latin America and the
Caribbean and future challenges
5. Medical education: the role of the academic and
commercial sector
6. Primary and secondary cancer prevention and
screening: status, opportunities, and challenges
Topics included in our Commission Report (cont’d):
7. Molecular testing and personalised medicine
8. Clinical perspectives
9. Challenges and opportunities at the oncology
and palliative-care interface
10. Participation, conduct and corporate
responsibility in clinical trials
11. Patient advocacy
THANK YOU