Age of onset of breast cancer in Latin America and the Caribbean: a

multidisciplinary approach to understanding determinants and health policy implications

Haga clic para modificar el Felicia Marie Knaul estilo de subttulo del Lizbeth Lpez Carrillo patrn

63% of women diagnosed with breast cancer in low-income countries are below age 54 compared with 36% in high-income countries. these figures are likely to understate real differences in age at onset given late diagnoses in developing countries. The figures for age at death are even more disturbing - 50% versus 22%

Long-term objectives and motivation for the research

Improve the outcomes of women with breast cancer in the LAC region through downstaging and reducing barriers on the demand and supply sides to accessing treatment.
Increase the ability of health systems to target and allocate scare resources for early detection and diagnosis especially among disadvantaged groups, in both the long and short run. Contribute to increased awareness of the need for breast cancer diagnosis and treatment in LAC among women of all age groups, levels of income and ethnic backgrounds. Contribute to the understanding of the complex relationship between poverty and diagnosis, age at onset, age at diagnosis and age at death, as well as incidence, prevalence and mortality in specific populations.

Specific objectives
Determine the extent to which the younger age at diagnosis of breast cancer in LIMCs, and especially LAC, is determined by demographics. Project the pattern and distribution of breast cancer by age group, socioeconomic level, and ethnicity in the LAC region under different scenarios of female labour force participation, education, childbearing, breastfeeding, menarche and menopause, weight gain and obesity. Identify the different barriers to access to early detection of breast cancer in LAC and possible options for their reduction. Improve and contribute to the quality and utilization of existing cancer registries (Cali, Colombia; Costa Rica; Jalisco, Mexico). Identify strategies for future research in LAC and other developing regions. Generate and establish a multi-disciplinary (demography, epidemiology, economics, gender studies, health systems research, development studies, reproductive and womens health and breast oncology) research group dedicated to the study and promotion of a better understanding of the challenge of breast cancer among women in developing countries.

Expected Results and products

at least 4 papers with a regional and global perspective:

a descriptive analysis of the age distribution of diagnosis and death; age-cohort-period analysis; associations between determinants and sociodemographic factors and the distribution by age of diagnosis and death; age-specific projections of incidence and mortality under varying scenarios for sociodemographic and population-based risk factors such as trends in nutrition.

Specific Outputs and Products

series of country-specific policy-focussed documents

Mxico (health service utilization), Colombia (registro de tumores de Cali), Costa Rica (national registry and ethnic differences) Rep. Dominicana (legal versus effective coverage). Comparative document on health system design and inclusion of breast cancer (all aspects of CCC) in the package of covered services Comparative document on resultads of the focus group analysis of barriers to access to early detection and treatment

Specific output and products (Cont.)

Participate in local dissemination and support policy formulation. Participation in research seminars Produce policy briefs Construct and make available data bases.

Age of onset of breast cancer in Latin America and the Caribbean: a

multidisciplinary approach to understanding determinants and health policy implications

Haga clic para modificar el Felicia Marie Knaul estilo de subttulo del Lizbeth Lpez Carrillo patrn

Preguntas de investigacin
Cual es la distribucin por edad del diagnstico y la muerte del cncer de mama en AL, en comparacin a otras regiones en el mundo -desarrolladas y en desarrollo-? Cul es el grado en que la distribucin por edad del cncer de mama en AL puede ser explicada por los patrones y tendencias en la transicin demogrfica, la composicin familiar, la salud reproductiva, la nutricin, la participacin laboral y la educacin, entre otros? Bajo diferentes escenarios demogrficos, de la composicin familiar, los patrones de salud reproductiva, la nutricin, la participacin laboral y la educacin, y manteniendo constantes los insumos del sistema de salud para el diagnstico y el tratamiento, Cul ser el nmero y la distribucin por edades de los casos de cncer de mama en