ANNOUNCEMENT: BHGI, PAHO Collaboration Produces Spanish Translation of Key Breast Cancer Medical Tool

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Strides in Global Dissemination of Clinical "Guidelines for Breast Health and Cancer Control"

Seattle, July 2007—The Breast Health Global Initiative's (BHGI) "Guidelines for International Breast Health and Cancer Control" ("Guidelines") are now available in Spanish through a collaboration with the Pan American Health Organization's (PAHO) Unit on Noncommunicable Disease. PAHO's sponsorship of the translation of the Guidelines has made the BHGI evidence-based "best practices with limited resources" freely available for downloading via the BHGI and PAHO websites.

The Spanish publication presents an overview of the Guidelines first published in English in 2006 and addresses the issues of early detection and access to care, diagnosis and pathology, treatment and allocation of resources, and health systems and public policy based upon real resources to effectively combat the burden of breast cancer in low-and middle-income countries (LMCs).

The Guidelines are intended to help policymakers and health care providers in LMCs improve breast cancer outcomes through evidence-based, economically feasible and culturally appropriate practices.

Translation of the "Guidelines for International Breast Health and Cancer Control" into the world's major languages is a long-standing goal of BHGI, and future plans include translation into Russian, Chinese, and Arabic. The partnership with PAHO to produce a Spanish translation grew out of discussion at the International Union Against Cancer Conference in Washington in July 2006.

"The availability of these Guidelines in Spanish is a major leap forward in reaching ministries of health, health care providers, and policymakers in Spanish-speaking countries," said Dr. Benjamin O. Anderson, chairman and director of BHGI. "With this and future translations, we hope to lessen the global burden of this devastating disease. As a leading international organization and public health agency for countries of the Americas, BHGI is tremendously grateful to PAHO for their partnership in this endeavor to improve breast health and cancer treatment for medically underserved Spanish-speaking countries around the world," said Anderson.

"Breast cancer is a growing problem in Latin America, with some 90,000 cases reported every year, many of them at advanced stages because of poor access to preventive and curative services," said PAHO Director Dr. Mirta Roses. "The availability of these Guidelines in Spanish will be an important contribution for those interested in expanding health services to reach Latin American women early and to improve their quality of life."

Breast cancer is newly diagnosed in more than 1 million each year and is the most common cause of cancer-related deaths among women worldwide. Women in low- and middle-income countries are more likely to die of the disease than women in richer countries, in part because their cancers are commonly detected and treated in advanced stages, when treatment is more expensive and least successful.

Major scientific advances in detection and management of breast cancer have improved outcomes in developed countries, but health care providers in lower income countries face resource constraints that limit their ability to apply these advances to improve breast cancer care. The Guidelines for International Breast Health and Cancer Control address this problem by recommending the most appropriate and applicable "best practices" for countries with limited resources.

The Guidelines recommend a stepwise, tiered system of resource allocation on four levels—basic, limited, enhanced and maximal—depending on the availability of resources. In the areas of detection and access to care, for example, they recommend that countries with very basic health systems educate women about performing breast self-examination to detect lumps. For countries with more but still limited resources, they recommend targeted outreach and education on clinical breast examination to women in at-risk groups, followed by ultrasound or mammography to confirm the discovery of suspected lumps.

The Guidelines call for additional research to assess how these recommendations can be best implemented in limited-resource settings.

The Breast Health Global Initiative is an extensive international alliance of organizations and individuals around the world devoted to medically underserved women sponsored by the Fred Hutchinson Cancer Research Center and Susan G. Komen for the Cure.

The Pan American Health Organization, founded in 1902, works with all the countries of the Americas to improve the health and quality of life of their peoples. It serves as the Regional Office of the World Health Organization (WHO).

For more information about BHGI on the Web, go to www.fhcrc.org/science/phs/bhgi or e-mail Senior Program Manager Leslie Sullivan, lsulliva@fhcrc.org.