SYSTEMATIC LITERATURE REVIEW TO ADDRESS BREAST CANCER ISSUES IN LOW-AND MIDDLE-INCOMES COUNTRIES FROM 1990—2008

Author(s)

Donatus U. Ekwueme, PhD, MS, Senior Health Economist1, Steve S. Coughlin, PhD, MPH, Epidemiologist2, Jacqueline Miller, MD, MPH, Medical Officer1, Janet Bobo, PhD, Senior Epidemiologist3, Erin Justen, MPH, Program Officer41CDC, Atlanta, GA, USA; 2 Department of Veterans Affairs, Washington, DC, DC, USA; 3 Battelle, Centers for Public Health Research and Evaluation, Seattle, WA, USA; 4 CDC Foundation, Atlanta, GA, USA

OBJECTIVES: Breast cancer prevention and control in low-and middle-income countries (LMCs) are critical emerging issues. Most LMCs lack sufficient resources for screening, early detection, and treatment of breast cancer. However, little is known about what works to reduce the burden of breast cancer in low-resource settings or how best to maximize public health interventions. The purpose of this study was to assemble a knowledge base of studies in LMCs on breast cancer prevention, early detection, treatment, and palliative care that address issues of equity, access, and costs. METHODS: We conducted a systematic literature search via PUBMED and other computerized electronic databases. We classified each citation as relevant, peripherally relevant, not relevant, or unknown and maximized the criteria by using free-text words and medical subject headings. All citations identified were independently reviewed by three members of the research team. Relevant studies were selected if they met inclusion criteria: published in English or Spanish between January 1, 1990 and April 30, 2008. RESULTS: A total of 1907 citations were identified, of which, 53.2% were excluded as “not relevant;” 27.1% were considered likely to be “relevant”; 5.5% were coded “peripherally relevant”; and 6.0% were “unknown”. All relevant articles (516) coming from 60 LMCs met the inclusion criteria and were abstracted. We found 80 articles on East Asia/Pacific countries; 82 on Europe/Central Asia countries; 76 on Latin American/Caribbean countries; 64 on Middle East/North Africa countries; 100 on South Asia countries; 71 on Sub-Saharan Africa countries; and 43 articles with no region-specific focus. We identified three articles on palliation and end-of-life care and a small number of articles reported cost data or economic analyses. CONCLUSIONS: The review contains a wealth of practical information that would be extremely useful to the myriad of clinicians and public health professionals working to prevent and treat breast cancer in LMCs.

Conference/Value in Health Info

2009-05, ISPOR 2009, Orlando, FL, USA

Value in Health, Vol. 12, No. 3 (May 2009)

Code

PCN9

Topic

Clinical Outcomes

Topic Subcategory

Comparative Effectiveness or Efficacy

Disease

Oncology

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