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J Glob Oncol. 2018 Sep;4:1-11. doi: 10.1200/JGO.2016.008227. Epub 2017 Mar 8.

Advancing Reliable Data for Cancer Control in the Central America Four Region.

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Marion Piñeros and Mathieu Laversanne, International Agency for Research on Cancer, Lyon, France; Silvina Frech, US National Cancer Institute, Bethesda, MD; Lindsay Frazier, Dana-Farber/Children's Cancer Center, Boston MA; Joaquin Barnoya and Eduardo Gharzouzi, Instituto de Cancerologia; Claudia Garrido, Unidad Nacional Oncología Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya, Washington University in St. Louis, St. Louis, MO; Andrea Chacón, Unidad Nacional para la Prevención y control del Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos, Asociación Salvadoreña para la Prevención del Cáncer, San Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez, Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia Rojas, Rosario Pereira, and Carla Rivera, Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and Douglas R. Morgan, Vanderbilt University, Nashville, TN.


The Central America Four (CA-4) region, comprising Guatemala, Honduras, El Salvador, and Nicaragua, is the largest low- and middle-income country region in the Western Hemisphere, with over 36 million inhabitants. The CA-4 nations share a common geography, history, language, and development indices, and unified with open borders in 2006. The growing CA-4 cancer burden among the noncommunicable diseases is expected to increase 73% by 2030, which argues for a regional approach to cancer control. This has driven efforts to establish population-based cancer registries as a central component of the cancer control plans. The involvement of international and academic partners in an array of initiatives to improve cancer information and control in the CA-4 has accelerated over the past several years. Existing data underscore that the infectious cancers (cervical, stomach, and liver) are a particular burden. All four countries have committed to establishing regional population-based cancer registries and have advanced significantly in pediatric cancer registration. The challenges common to each nation include the lack of national cancer control plans and departments, competing health priorities, lack of trained personnel, and sustainability strategies. General recommendations to address these challenges are outlined. The ongoing regional, international, and academic cooperation has proven helpful and is expected to continue to be a powerful instrument to contribute to the design and implementation of long-term national cancer control plans.

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