Presentation (CTI)

OBJECTIVES: National breast cancer policies signal whether governments have translated global goals into service priorities, resource commitments, and accountability mechanisms. Using the WHO Global Breast Cancer Initiative (GBCI) as the reference framework, we assessed whether national policies across 194 WHO Member States cover the access, pathway, financing, and monitoring elements needed for implementation readiness.
METHODS: We conducted a global policy content analysis of breast cancer-related national policy documents. Documents were identified by combining four repositories--the International Cancer Control Partnership, WHO Country Planning Cycle Database, WHO NCD Document Repository, and IARC/WHO CanScreen5--with supplementary searches of official sources, including health ministries, cancer agencies, screening programmes, and guideline platforms. We converted the GBCI care pathway, three GBCI key performance indicators, and health-system functions into 47 binary policy variables across six domains: policy framing, monitoring indicators, awareness and screening, diagnosis, treatment and supportive care, and health-system enablers.
RESULTS: Mean coverage across 47 variables was 40.8%. Recognition was common: 83.5% of countries embedded breast cancer in broader national policies, 73.7% addressed screening, and 77.8% included registries or information systems. However, only 38.1% had a standalone national breast cancer policy. Coverage showed a policy cascade after recognition and entry points, with diagnostic work-up covered in 67.5%, treatment and supportive care domain coverage at 32.7%, and monitoring indicators at 5.7%. Specific gaps included treatment completion (1.5%), time to diagnosis (2.1%), free or subsidized screening (6.7%), patient navigation (16.5%), and dedicated financing or investment plans (49.5%). Coverage increased with income level, from 30.2% in low-income countries to 48.5% in high-income countries; standalone policies ranged from 3.8% to 64.6%.
CONCLUSIONS: National income appears to shape how far countries translate GBCI priorities into explicit breast cancer policy capacity. Strengthening policy should prioritize financing, diagnostic referral, treatment continuity, navigation, and performance indicators that make breast cancer services accessible and accountable.