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The Breast Health Global Initiative 2018 Global Summit on Improving Breast Healthcare Through Resource-Stratified Phased Implementation: Methods and overview

Duggan C 1 , Dvaladze A 2 , Rositch AF 3 , Ginsburg O 4 , Yip CH 5 , Horton S 6 Show all authors , Camacho Rodriguez R 7 , Eniu A 8 , Mutebi M 9 , Bourque JM 10 , Masood S 11 , Unger-Saldaña K 12 , Cabanes A 13 , Carlson RW 14 , Gralow JR 2 , Anderson BO 1

Affiliations 

  • 1 Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
  • 2 Department of Medicine, University of Washington, Seattle, Washington
  • 3 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
  • 4 Section for Global Health, Division of Health and Behavior, Department of Population Health, Perlmutter Cancer Center, New York University Langone Health, New York, New York
  • 5 Department of Surgery, University of Malaya, Kuala Lumpur, Malaysia
  • 6 School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
  • 7 City Cancer Challenge Foundation, Geneva, Switzerland
  • 8 Cancer Interdisciplinary Service, Riviera Chablais Hospital, Vaud-Valais, Rennaz, Switzerland
  • 9 Breast Surgical Oncology, Aga Khan University Hospital, Nairobi, Kenya
  • 10 Department of Radiation Oncology, University of Ottawa, Ottawa, Ontario, Canada
  • 11 University of Florida Health Jacksonville Breast Center, Jacksonville, Florida
  • 12 Epidemiology Unit, Instituto Nacional de Cancerología - México, Mexico City, Mexico
  • 13 The Susan G. Komen Foundation, Dallas, Texas
  • 14 National Comprehensive Cancer Network, Plymouth Meeting, Pennsylvania
Cancer, 2020 05 15;126 Suppl 10:2339-2352.
PMID: 32348573 DOI: 10.1002/cncr.32891

Abstract

BACKGROUND: The Breast Health Global Initiative (BHGI) established a series of resource-stratified, evidence-based guidelines to address breast cancer control in the context of available resources. Here, the authors describe methodologies and health system prerequisites to support the translation and implementation of these guidelines into practice.

METHODS: In October 2018, the BHGI convened the Sixth Global Summit on Improving Breast Healthcare Through Resource-Stratified Phased Implementation. The purpose of the summit was to define a stepwise methodology (phased implementation) for guiding the translation of resource-appropriate breast cancer control guidelines into real-world practice. Three expert consensus panels developed stepwise, resource-appropriate recommendations for implementing these guidelines in low-income and middle-income countries as well as underserved communities in high-income countries. Each panel focused on 1 of 3 specific aspects of breast cancer care: 1) early detection, 2) treatment, and 3) health system strengthening.

RESULTS: Key findings from the summit and subsequent article preparation included the identification of phased-implementation prerequisites that were explored during consensus debates. These core issues and concepts are key components for implementing breast health care that consider real-world resource constraints. Communication and engagement across all levels of care is vital to any effectively operating health care system, including effective communication with ministries of health and of finance, to demonstrate needs, outcomes, and cost benefits.

CONCLUSIONS: Underserved communities at all economic levels require effective strategies to deploy scarce resources to ensure access to timely, effective, and affordable health care. Systematically strategic approaches translating guidelines into practice are needed to build health system capacity to meet the current and anticipated global breast cancer burden.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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