Application of Cancer Screening Guidelines in Resource Limited Settings

Area of Science:

• Public Health
• Oncology
• Health Systems Research

Background:

• Cancer screening is promoted globally, but its effectiveness is limited in low-resource settings.
• International guidelines often overlook the fragmented infrastructure and unique societal beliefs in low- and middle-income countries (LMICs).
• Suboptimal implementation hinders the demonstrable impact of cancer screening on disease burden in under-resourced regions.

Purpose of the Study:

• To critically examine cancer screening implementation for breast, cervical, colorectal, and oral cancers in LMICs.
• To identify gaps in implementation and system preparedness based on global/national guidelines and local capacity.
• To explore the potential and challenges of emerging innovations like digital health and AI in cancer screening.

Main Methods:

• Perspective piece analyzing existing global and national cancer screening guidelines.
• Assessment of implementation challenges in LMICs, considering diagnostic, referral, and treatment capacities.
• Review of societal and health belief system differences impacting screening adoption.

Main Results:

• Significant variation exists in screening age groups, test modalities, and intervals across countries.
• Emerging technologies like AI present opportunities but also raise concerns about validation, ethics, and equitable access.
• Current implementation often fails to align evidence-based recommendations with local feasibility.

Conclusions:

• Cancer screening can be a cost-effective intervention ('best buy') only with substantial investment in early diagnosis and treatment pathways.
• Successful implementation necessitates robust system readiness and phased strategies tailored to local contexts in LMICs.
• Without adequate preparedness, large-scale screening programs risk resource misallocation without reducing disease burden.