WHO issues new cancer guidelines

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KAMPALA. The World Health Organisation (WHO)has issued new guidelines for early cancer diagnosis to improve the chances of survival for people living with cancer.
The guidelines launched ahead of the World Cancer Day on February 4, also recommend that governments especially in low and middle income countries ensure that the time between symptom onset to initiation of treatment should be less than 90 days.
“Early diagnosis strategies improve cancer outcomes by providing care at the earliest possible stage, offering treatment that is more effective, less costly and less complex,” the WHO report reads in part.
The guidelines suggest a situation analysis should be performed to identify barriers and deficits in services and prioritise interventions.
In order to achieve this, WHO gives a three-step approach to early diagnosis which include awareness and accessing care, clinical evaluation and access to treatment to reduce delays in care, avoid loss to follow up and optimize the effectiveness of treatment.
“A coordinated approach to building early diagnosis capacity should include empowerment and engagement linked to integrated, people-centred services at all levels of care, building capacity in diagnostic assessment, pathology and tests as well as improving referral mechanisms and establishing care pathways between facilities can overcome common barriers to timely diagnosis,” the report reads further.
In Uganda, regional referral hospitals have decried the absence of cancer specialists, including pathologists to carry out diagnosis on suspected cancer patients, inadequate supply of drugs and ill-equipment.
As a result, these hinder early treatment of cancer patients leading to low survival rates in a country where at least 60,000 new cases are registered every year at the Uganda Cancer institute (UCI)
The cancer survival rate in the country, according to UCI, is at only 20 per cent while death rate once diagnosed with the problem is at a whopping 80 per cent.
Although UCI attributes the high cancer death rate to late presentation of the ailment by patients, regional hospitals say they lack the capacity to carry out timely diagnosis even in cases of early presentation.
To address the challenges, WHO says financial, geographic, logistical and sociocultural barriers must also be considered and addressed as per national context to improve access to timely cancer treatment.
Additionally, the body suggests that a robust monitoring and evaluation system is critical to identify gaps in early diagnosis, assess programme performance and improve cancer services.
New WHO figures released this week indicate that each year 8.8 million people die from cancer, mostly in low- and middle-income countries.
According to Dr Etienne Krug, Director of WHO’s Department for the Management of non-communicable Diseases, Disability, Violence and Injury Prevention, one problem is that many cancer cases are diagnosed too late.

Most people diagnosed with cancer live in low- and middle-income countries, where two thirds of cancer deaths occur. Less than 30% of low-income countries have generally accessible diagnosis and treatment services, and referral systems for suspected cancer are often unavailable resulting in delayed and fragmented care. The situation for pathology services was even more challenging: in 2015, approximately 35% of low-income countries reported that pathology services were generally available in the public sector, compared to more than 95% of high-income countries.

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