WHO Outlines New Framework for Early Detection and Management of Breast Cancer

Dr Tedros Adhanom Ghebreyesus

The World Health Organization (WHO) has released new framework guidelines with the goal of saving 2.5 million lives from breast cancer by 2040 through a combination of early detection, timely diagnosis, and comprehensive management.¹

In 95% of countries, breast cancer is the first- or second-leading cause of female cancer deaths; however, approximately 80% of deaths from breast and cervical cancer occur in countries with low or middle income. In high-income countries, the 5-year survival rates exceed 90% for patients with breast cancer. However, that rate falls in low- and middle-income countries.²

Higher fatality rates from breast cancer in low- and middle-income countries and among disadvantaged populations stem from late-stage diagnosis and limited access to quality treatment. In some low- or middle-income countries, these rates are compounded by a lack of awareness regarding the benefits of early detection and effective therapies.

The Global Breast Cancer Initiative (GBCI), which was established by the WHO in 2021, is aiming to reduce breast cancer mortality by 2.5% per year over a 20-year period through 3 pillars outlined in the WHO’s new guidelines. The pillars include:

• Health promotion for early detection (pre-diagnostic interval): The GBCI has set a goal of a stage I or II diagnosis for more than 60% of patients with invasive cancers.
• Timely breast diagnostics (diagnostic interval): Patients should undergo diagnostic evaluation, imaging, tissue sampling, and pathology within 60 days of diagnosis.
• Comprehensive breast cancer management: More than 80% of patients need to undergo multimodality treatment without abandonment.

“Countries with weaker health systems are least able to manage the increasing burden of breast cancer. It places a tremendous strain on individuals, families, communities, health systems, and economies, so it must be a priority for ministries of health and governments everywhere,” Dr Tedros Adhanom Ghebreyesus, director-general of WHO, stated in a news release.¹ “We have the tools and the know-how to prevent breast cancer and save lives. WHO is supporting more than 70 countries, particularly low- and middle-income countries, to detect breast cancer earlier, diagnose it faster, treat it better and give everyone with breast cancer the hope of a cancer-free future.”

The framework pointed to a clear need to strengthen health care systems so they are capable of adapting to the growing burden of breast cancer through sustainable, cost-effective, and equitable early detection methods and treatment services, particularly in low- and middle-income countries.

“Countries need to ensure that this framework engages and integrates into primary health care. This effort would not only support health promotion, but also empower women to seek and receive health care throughout the life cycle,” Dr Bente Mikkelsen, director for Noncommunicable Diseases at WHO, said. “With effective and sustainable primary health care, we can really see a pathway to universal health coverage.”

References

1. WHO launches new roadmap on breast cancer. World Health Organization. News release. February 3, 2023. Accessed February 3, 2023. https://www.who.int/news/item/03-02-2023-who-launches-new-roadmap-on-breast-cancer
2. Global breast cancer initiative implementation framework: assessing, strengthening and scaling up of services for the early detection and management of breast cancer: executive summary. World Health Organization. February 3, 2023. Accessed February 3, 2023. https://www.who.int/publications/i/item/9789240067134