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The Breast Health Global Initiative (BHGI): Global Collaboration via Development of BHGI Learning Laboratories. Benjamin O. Anderson, M.D. Chair and Director Breast Health Global Initiative Fred Hutchinson Cancer Research Center Professor of Surgery & Global Health Medicine
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The Breast Health Global Initiative (BHGI): Global Collaboration via Development of BHGI Learning Laboratories Benjamin O. Anderson, M.D. Chair and Director Breast Health Global Initiative Fred Hutchinson Cancer Research Center Professor of Surgery & Global Health Medicine University of Washington Seattle, Washington
BREAST HEALTH GLOBAL INITIATIVE • BHGI resource-stratified guidelines • Low-income: Ghana, West Africa • Middle-income: Latin America
BREAST HEALTH GLOBAL INITIATIVE • BHGI resource-stratified guidelines • Low-income: Ghana, West Africa • Middle-income: Latin America
MYTH “Breast cancer REALLY only affects countries of wealth.” FACT:Breast cancer is the most common cancer among women around the globe, and the most likely reason that a woman will die of cancer.
BREAST CANCER EPIDEMIOLOGY:Global distribution of disease Mortality Incidence Ratio: 2002: 1,152,000 cases, 411,000 deaths
BREAST CANCER EPIDEMIOLOGY:Global distribution of disease Globocan 2002 (IARC) Breast cancer in developing countries: 514,000 (45%) cases; 221,000 (55%) deaths
BREAST CANCER EPIDEMIOLOGY:Lower-Middle Income Country Colombia
2020 2005 2050 BREAST CANCER EPIDEMIOLOGY:Population pyramid (female) Globocan 2002 (IARC) - Colombia
BREAST CANCER EPIDEMIOLOGY:Breast cancer demographics 2005 - 2050 Globocan 2002 (IARC) - Colombia
BREAST CANCER EPIDEMIOLOGY:Stage atdiagnosis: United States vs. India USA: 90% DCIS or early staged invasive disease at diagnosis INDIA: 76% locally advanced or metastatic at diagnosis Sources: SEER Survival Monograph (NCI), 2007; Chopra, Cancer Institute Chennai, India, 2001
BREAST HEALTH GLOBAL INITIATIVE:Mission Statement The Breast Health Global Initiative (BHGI) strives to develop, implement and study evidence-based, economically feasible, and culturally appropriate guidelines for international breast health and cancer control for low and middle income countries to improve breast health outcomes.
BHGI GLOBAL SUMMIT 2007:Budapest: Guideline Implementation CONSENSUS STATEMENTS Early Detection Diagnosis Treatment Health Care Systems 8 Stratified Tables 10 Individual Manuscripts Cancer: 113 (8 suppl), 2008
BHGI GLOBAL SUMMIT 2007:Budapest: Guideline Implementation HEALTH CARE SYSTEMS EARLY DETECTION DIAGNOSIS STAGE II STAGE I METASTATIC LOCALLY ADVANCED
BREAST HEALTH GLOBAL INITIATIVE:5-YearImplementation Plan • Dissemination & implementation (D&I) research • Education and training programs • Technology application and development • IMPLEMENTATION STRATEGY: Create BHGILearning Laboratories in different parts of the world to develop and test educational modules based on BHGI guidelines and to model program expansion to other LMCs.
KUMASI, GHANA (west africa) situation analysis 2004 KomfoAnokye Teaching Hospital (KATH) 1,000 bed hospital , Kumasi, Ghana
OBSTACLES TO CARE • Advanced cancer at diagnosis • Mastectomy without systemic treatment • One pathologist for 1,000 bed teaching hospital • Breast pathology reports take 4 –6 months
Public Participation Health Care Delivery Awareness Early Detection LB Brazil LB Colombia Diagnosis Advocacy LB Mexico Survivorship Treatment