Description of the Project

PROJECT SLACOM-BCRF
BREAST CANCER IN LATIN AMERICA

FIRST PHASE: October 2005 – September 2006 (Finished)

The international communication of the results obtained at the end of the first stage (October 2005 – September 2006) of the BCRF-SLACOM project in the Latin American and Caribbean area, has begun, development of which is being generously supported by the BCRF.

The basic objective of this first period was to analyze the present situation of the prevention, diagnosis, treatment and other medical and health care aspects of breast cancer in Latin America.
         
Once the situation profile is established, proposals and action plans will be defined in the following stages of the project, to improve those situations detected as very distant from the internationally accepted standards. These proposals and action plans will be adapted to the economical-technical reality of the countries involved.

The closing of this first stage, has contributed mainly to the results of the survey carried out in 9 countries of our region (Argentina – Brazil – Mexico –Chile – Uruguay- Paraguay – Peru – Venezuela – Colombia), during which we have collected the knowledge and experience on Breast Cancer of almost 100 outstanding specialists (oncologists, radiotherapists, breast cancer surgeons and general surgeons) who run the most important Cancer Centers of each country.

Three groups of 20 leader’s oncologists from México, Brazil and Argentina; two groups of 10 from Chile and Peru; and four groups of 5 from Uruguay, Paraguay, Venezuela, and Colombia, gave us a very clear understanding about the real scenario in the whole region.

The Advisory Technical Committee prepared and developed a survey consisting in 66 questions on: prevention, early diagnosis, mammography studies, surgery, radiotherapy, adjuvant chemotherapy, therapeutic chemotherapy and others, together with questions on professional education on breast cancer and some health care characteristics on breast cancer of each country.

All the information captured during the survey, its integral processing, and the evaluation and final detailed analysis, describe with a high level of reliability and precision the existing reality regarding Breast Cancer in each one of the countries involved in the study, in this manner fulfilling the primordial objective to be reached in this first stage of the project.

For the first time, this project provides reliable data on the real situation of breast cancer care in Latin America, a region of the world that has 110.000 new cases of breast cancer each year and it is expected to triple these numbers for the year 2050.

A final detailed report has been developed on this first stage of the Project, in which we describe the principal actions carried out, the information obtained on each country and its regional integration, the evaluation and detailed analysis of the reality detected in each case, and the final conclusions reached by the study.

This report has been submitted to a rigorous process of review and critic from a panel of outstanding specialists on the subject, both from the regional as well as the international fields, to be finally presented for its corresponding publication.

We are now working on direct distribution of the results and conclusions obtained, through diverse communication mechanisms. Among others, the following stand out:

- Submission for abstract presentation to the next ASCO Annual Meeting – Chicago – June 2007;
- Publication of the results in our web page;
- Distribution of executive contents among our members and other professionals interested in the subject;
- Presentations of the Project in several congresses, courses, and other medical meetings to be carried out during this year.
- We have already agreed with the corresponding organizers, to carry out specific sessions presenting the first result of the BCRF-SLACOM Project in the following events:

- ICACT – 18th International Congress on Anti Cancer Treatment – Paris, France February 2007.
- INCTR meeting – Río de Janeiro, Brazil – March 2007
- Breast Health Global Initiative (BHGI) 2007 Global Summit on International Breast Health Care, Budapest, Hungary - October 1-4, 2007

We have achieved a very detailed picture of the reality and an accurate description on the state of the Breast Cancer situation in each country of the region, an essential requisite to be able to develop the second phase of the project (now in progress) which will produce, within a solid professional consensus, Guidelines and Recommendations to be spread and introduced on the subject in each country of the region.

SECOND PHASE: October 2006 – September 2007 (In process)

On October 2006 we started the second stage of the Project, which consists, mainly, in comparing the results obtained during the first stage, that exposes the vision and knowledge of the leading specialists in each country of the region, with the breast cancer care standards existing in said countries, which will be surveyed by the corresponding governmental organisms and/or scientific entities.

Based on this compared information, we will work within a frame of consensus between the professionals of the region, to establish Guidelines and Minimal Clinical Recommendations for the care of Breast Cancer in each one of the countries of Latin America and the Caribbean.

In future stages of the Project, the best strategies will be established to achieve a positive and quick implementation of the Guidelines and Minimal Clinical Recommendations in each one of those countries, paying attention to their own potentialities and limitations in order to optimize the resources.

Public Health experts have been consulted in each country under study, to let us know about the best sources available to obtain the required information in each case.

Given the fact that this particular stage requires of very varied information and of complex accessibility, the requests for information are carried out through our corresponding regional offices in charge of the project.

All the information, and its corresponding analysis, is always referred to some of the following specific topics on Breast Cancer:

Mammographic studies
Epidemiology
Diagnosis
Surgical treatment
Chemotherapy and hormone treatment
Radiotherapy treatment
Treatment of advanced and terminal patients
Alternative treatments
Follow-up
Teaching and Education
Clinical Research
Along these first four months, the following tasks have been carried out in each one of the countries involved: 

1– Data and information:

A MDS (Minimum Data Set) is established so that the new information to be obtained is the one necessary and sufficient to grant a greater level of replies.
This task has required consulting multiple professionals in Public Health in several countries to ensure that the set of data that shapes the MDS is widely representative of the reality in each sector of the region.

2– Guidelines and Standards of Care:

a)  Information is obtained on diagnostic and therapeutic guidelines.
b) The gap between the perception of the surveyed experts and the situation according to official organisms is investigated.
c)  Reference data for the measurement of the compliance is determined.

3– Evaluation criteria:

The evaluation is carried out in accordance to each health specialty and sub-specialty per country.

4– Measurement units for guidelines and standards of care follow-up:

The specialists’ compliance with the existing guides and rules are measured per specialty and sub-specialty.

5– Information on expenses

The collection of official economic data of the different governments has begun.
         
At this time we are dealing with the initial stages of the data collection, which will be finally closed by May 30th. We are entering and validating the data in the Central Data Base, and we also started the compilation process of all the information available for statistical analysis and obtain the expected results by country and globally.

We are satisfied and proud of the work done up to now, and profoundly grateful to the BCRF for the grant awarded, without which it would not have been possible to carry out this task successfully.

secretaria@slacom.org.

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