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Analysis
Weak surveillance and policy attention to cancer in global health: the example of Mozambique
  1. Cesaltina Lorenzoni1,2,
  2. Laura Oliveras3,4,
  3. Alba Vilajeliu3,4,
  4. Carla Carrilho1,2,
  5. Mamudo R Ismail1,2,
  6. Paola Castillo3,5,
  7. Orvalho Augusto6,
  8. Mohsin Sidat6,
  9. Clara Menéndez3,7,
  10. Alberto L Garcia-Basteiro3,7,8,
  11. Jaume Ordi3,5
  1. 1 Department of Pathology, Maputo Central Hospital, Maputo, Mozambique
  2. 2 Department of Pathology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
  3. 3 ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
  4. 4 Department of Preventive Medicine and Epidemiology, Hospital Clinic-Universitat de Barcelona, Barcelona, Spain
  5. 5 Department of Pathology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
  6. 6 Community Health Department, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
  7. 7 Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
  8. 8 Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam, The Netherlands
  1. Correspondence to Dr Alberto L Garcia-Basteiro; alberto.garcia-basteiro{at}manhica.net

Abstract

Cancer is an emerging public health problem in sub-Saharan Africa due to population growth, ageing and westernisation of lifestyles. The increasing burden of cancer calls for urgent policy attention to develop cancer prevention and control programmes. Cancer surveillance is an essential prerequisite. Only one in five low-income and middle-income countries have the necessary data to drive policy and reduce the cancer burden. In this piece, we use data from Mozambique over a 50-year period to illustrate cancer epidemiological trends in low-income and middle-income countries to hypothesise potential circumstances and factors that could explain changes in cancer burden and to discuss surveillance weaknesses and potential improvements. Like many low-income and middle-income countries, Mozambique faces the dual challenge of a still high morbidity and mortality due to infectious diseases in rural areas and increased incidence of cancers associated with westernisation of lifestyles in urban areas, as well as a rise of cancers related to the HIV epidemic. An increase in cancer burden and changes in the cancer profile should be expected in coming years. The Mozambican healthcare and health-information systems, like in many other low-income and middle-income countries, are not prepared to face this epidemiological transition, which deserves increasing policy attention.

  • Cancer
  • registry
  • surveillance
  • low- and middle-income countries
  • Mozambique

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjgh-2017-000654

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    Footnotes

    • CL, LO and AV are shared first authors.

    • CL, LO and AV contributed equally.

    • Handling editor Seye Abimbola

    • Contributors CL, LO and AV wrote the first draft. All other authors provided critical comments and drafted the original version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.