Breast Cancer: Unforeseen Public Health Priority in Developing Countries 240111

8/2/2019 Breast Cancer: Unforeseen Public Health Priority in Developing Countries 240111

1/62

Mnhblbc Gczbn Kic~h(

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2/62

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icvbìch dnchvd |r|vng|)

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3/62

Mz`g n}bfniln

v` cinlf`vn


4/62

E~hr( :??1


5/62


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Eci~czr( :??4


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D f J L b F h b L b


17/62

Dcz}czf( Jznc|v Lcilnz bi Fn}nh`pbia L`~ivzbn|I`} 6( :??2; I`jnh Hc~zncv Cgczvrc \ni( Lcilnz |~z}b}`z


18/62

Mz`g cinlf`vn

v` n}bfniln


19/62

3) N}bfniln v` cinlf`vn v` n}bfniln

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20/62

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21/62

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22/62

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lìvz`h( vzncvgniv cif

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gciinz cpphrbia bii`}cvb}n

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lcilnz

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23/62

Qdbvn _cpnz m`z p`hblr cif |vzcvnar -


24/62

Qdbvn _cpnz m`z p`hblr cif |vzcvnar -Hcilnv L`ggb||bì Znp`zv

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v` ntpcif clln|| v` lcilnz lczn cif lìvz`h

bi h`qnz cif gbffhn'bil`gn l`~ivzbn|)C~vd`znf jr; AVM)LLL

ntpnzv| mz`g vdn lcilnz lczn cif ah`jch dnchvd l`gg~ibvbn|lì}ninf jr

vdn Dcz}czf \ld``h `m _~jhbl Dnchvd( vdn Dcz}czf Gnfblch \ld``h(vdn Dcz}czf Ah`jch Ns~bvr Bibvbcvb}n cif vdn Fcic'Mczjnz Lcilnz Bi|vbv~vn)

H b h M k m AVM LLL


25/62

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v` bim`zg q`zk bi ci bvnzcvb}n mc|dbì

Bgphngnivcvbì

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26/62

Ldchhnian cif fb|pz`}n vdngrvd| cj`~v lcilnz

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28/62

G`zn vdci 4>. `m pnfbcvzbl lcilnz

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fn}nh`pbia l`~ivzbn| vdcv ~|n hn||

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H vd hbv j v f v b


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Hnvdchbvr jr lcilnz vrpn cif l`~ivzr bil`gn

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30/62

>/4? lcilnz fn|s~bhbjzb~g$Mznik/Hcilnv :?3?"

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cfe~|vnf hbmn'rncz|" h`|v q`zhfqbfn v`

lcilnz czn bi HGBL|( rnv vdn|n l`~ivzbn|

dc}n ìhr c }nzr |gchh |dczn `m ah`jchzn|`~zln| m`z lcilnz y >. `z hn||)

q`z|n bi lnzvcbi znabì|5

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`m inq lcilnz lc|n|( cif 3>. `m vdn ah`jch

p`p~hcvbì


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|~lln||m~hhr _cbi cif |~mmnzbia

L`ilnivzcvb`i `m g`zvchbvr5


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L`ilnivzcvb`i `m g`zvchbvr5

ntcgphn Lnz}blch lcilnz

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33/62

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Fncvd mz`g pzn}nivcjhn cif vzncvcjhn lcilnz b| og`zn

ntlh~|b}no v` vdn p``z

C}`bfcjhn pcbi cif |~mmnzbia pczvbl~hczhr cv nif `m hbmn

b| ìhr pnzgbvvnf m`z vdn p``z

Mbicilbch bgp`}nzb|dgniv mz`g vdn l`|v| `m lczn cif

nmmnlv| `m vdn fb|nc|n b| lìlnivzcvnf cgìa vdn p``z

Vdn lcilnz `m p`}nzvr


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BV LCI JN F@IN5 Mz`g n}bfniln v` clvbì5Bii`}cvbì Bibvbcvb}n _czvinz|dbp| bi HGBL|

Vzncvbia lcilnz bi HGBL| ~|biabii`}cvb}n fnhb}nzr cif mbicilbia5 vc|k |dczbia cif |dbmvbia Bimzc|vz~lv~zn |dbmvbia Cpphblcvbì `m vnldi`hàr `m

l`gg~iblcvbì \`lbch _z`vnlvbì cif dnchvd bi|~zciln

G`fnh|5

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H`qnz gbffhn'bil`gn5 E`zfci

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CLLN\\

S^CHBVR

MBICILBCH_Z@VNLVB@I


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bgp`||bjhn bi p``z l`~ivzbn|)

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vzncvbia fz~a'|~|lnpvbjhn fb|nc|n)

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@~vl`gn| bi GFZ'VJ pcvbniv| bi

Hbgc( _nz~ znlnb}bia cv hnc|v m`~z

g`ivd| `m vdnzcpr

Gbviblk nv ch( L`gg~ibvr'jc|nf vdnzcpr m`z g~hvbfz~a'zn|b|vcivv~jnzl~h`|b| bi Hbgc( _nz~) INEG :??


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Z~zch Zqcifc( J~zkbvv| hrgpd`gc


Znabgni `m

}bilzb|vbin(

lrlh`pd`|pdc

gbfn(

bivzcvdnlch

gnvd`vzntcvn

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\vbhh bi zngb||b`i

vdznn rncz| hcvnz

Lnivzch Dcbvb

?`

il`h`

ab|v|

@^VHBIN


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3) N}bfniln v` cinlf`vn v` n}bfniln

:) Lcilnz bi HGBL|5 |` g~ld g`zn lci

jn f`in


39/62

Vdn npbfngbl `m jznc|v lcilnz5îm`z|nni ldchhnian bi HFL|

\`gn 6>. `m vdn g`zn vdci 3 gbhhbì inq lc|n|`m jznc|v lcilnz fbcai`|nf ncld rncz( cif g`zn

vdci >>. `m jznc|v'lcilnz'znhcvnf fncvd|( `ll~z

bi h`q' cif gbffhn'bil`gn l`~ivzbn|)%

\~ld l`~ivzbn| i`q mcln vdn ldchhnian `mnmmnlvb}nhr fnvnlvbia cif vzncvbia c fb|nc|n vdcv

pzn}b`~|hr qc| lì|bfnznf v`` ~il`ggì v` gnzbv

vdn chh`lcvbì `m pznlb`~| dnchvd lczn f`hhcz|)\`~zln5 _`zvnz( _) $:??1") *Qn|vnzibubia Q`gni| Zb|k|0 Jznc|v

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Grvd )}nz|~| ))znchbvr5

jznc|v lcilnz bi HGBL|

c fb|nc|n `mfn}nh`pnf

l`~ivzbn| cif

qnchvdr q`gni)

c fb|nc|n `m`hfnz q`gni

hn|| `m cdnchvd pzb`zbvr

vdci lnz}blch

lcilnz)

G`zn vdci dchm `m lc|n|cif chg`|v :/< `m fncvd|

fncvd| `ll~z bi vdn

fn}nh`pbia q`zhf)

hczan pz`p`zvb`i `m lc|n|cif =?. `m fncvd| bi

q`gni 8 >6)

G`zn fncvd| cif FCHR|h`|v v` jznc|v lcilnz( bi chh

fn}nh`pbia znab`i| `vdnz

vdci \NC|bc cif \\Cmzblc)


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Bi fn}nh`pbia znabì|( jznc|v lcilnz

G`|v mzns~niv lc~|n `m lcilnz'znhcvnf fncvdbi fn}nh`pbia cif fn}nh`pnf znabì| :=4(??? `m vdn 6>4(??? fncvd| pnz rncz czn bi

HBGL|5 >4.

G`|v l`ggì lcilnz bi fn}nh`pnf ciffn}nh`pbia znabì|

6)6 gbhhbì q`gni chb}n $fbcai`|nf"5 d`q

gcir bi fn}nh`pbia znabì|0 :??45 3)?. `m qdbld

czn mz`g HBGL|

3?)2. `m chh bilbfniv lcilnz| |nlìf v` h~ia

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HGBL|5

r`~ianz q`gni( dbad fncvd zcvn|(

B HBGL\ d db d vb m


45/62

Gntbl`5 knr n}bfniln

\biln :??= jznc|v lcilnz b| vdn ,: lc~|n `mfncvd cg`ia q`gni can


46/62

M~nivn5Hùci`( Kic~h( Agnu'Fciv|( Czzn`hc'@zinhc| r Gifnu( :??4( Vnifnilbc| ni hc g`zvchbfcf p`z lilnz fn gcgcni Gtbl`( 3212':??1) MÎ\CH^F( F`l~gniv` fn vzcjce`) @j|nz}cv`zb` fn hc \ch~f( lì jc|n ni fcv`| fn hc @G\ r hc

\nlznvczc fn \ch~f fn Gtbl`)

G`zvchbvr cif can cv fncvd5 jznc|v ciflnz}blch lcilnz bi Gntbl` 32>>':??1

:??=5 JL9LL)m`z vdn mbz|v vbgn bi g`zn vdci >

fnlcfn|)

Acp 7 y: rncz|)C| `m vdn nczhr 4?|( vdn c}nzcan can

cv fncvd mz`g JL b| h`qnz vdci LL)

Lnz}btJznc|v

Zcvn pnz 3??(??? q`gnicfe~|vnf m`z can

C}nzcan can $rncz|"

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Jznc|v lcilnz cif


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Jznc|v lcilnz cif\na~z` _`p~hcz)

C| `m Mnj :??1 chh Gntblciq`gni fbcai`|nf qbvd jznc|v

lcilnz dc}n vdn zbadv v`mbicilbch pz`vnlvb`i bi dnchvdm`z jznc|v lcilnz vzncvgniv


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Nczhr Fnvnlvb`i 7 |~z}b}ch

\vcan cv fbcai`|b|\~z}b}ch zcvn|(

^\ CL\

? ' 3 24.

: ' < 46.

6 :1.

M~nivn5 Cgnzblci Lcilnz \`lbnvr) Jznc|v Lcilnz Mclv| - Mba~zn|( :??1':??4) Cvhcivc( AC) 5 Cgnzblci Lcilnz \`lbnvr( Bil)(

r \nlznvczc fn \ch~f) _z`azcgc fn Cllbi5 Lilnz fn gcgc) Gtbl`( F)M)

Gntbl`5 >'3?. bi |vcan ?'3;=?'1?. bi BBB'B]

BG\\ G b 6? >?. m


49/62

BG\\ Gtbl`5 6?'>?. `m lc|n| cznfnvnlvnf bi |vcan| BBB'B]) 4>+ bi BB+

3?.


50/62

Qdr0

Dnchvd( |`lbch cif dnchvd

|r|vng jczzbnz|

Jczzbnz 35 Bins~bvr bi cffbvb`i v` hclk `m


51/62

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52/62

Jczzbnz :5 _``z s~chbvr |nz}bln|

q`gni fbcai`|nf qbvd jl znp`zvnf pz`jhng| qbvdpz`}bfnz| qdni |nnkbia fbcai`|b|)

Bi z`~vbin( cii~ch znpz` dnchvd/@JARI }b|bv/ _C_ |lznnibia(

vdnzn qc| i` JLN _dr|blbci bi|b|vnf q`gci qc| `}nzznclvbia cif |niv dnz

d`gn qbvd i` fbcai`|b|

Dnchvd pz`mn||b`ich| cif mbz|v'hn}nh lczn pz`}bfnz| znp`zv hclk

`m |ni|bvb}bvr `m dnchvd pnz|`iinh znhcvbia v` vdn zns~n|v| `m

q`gni znaczfbia jznc|v dnchvdZN\^HV\ MZ@G C ICVB@ICH S^CHBVCVB]N \V^FR IBANIFC NV CH( :??2


53/62

Jczzbnz


54/62

Jczzbnz 6 5 Hclk `m mbicilbch pz`vnlvbìm`z nczhr fnvnlvbì)

M~nivn5 Az``v nv ch( :??=) VdnJznc|vE`~zich

\biln Mnjz~czr `m :??1( n}nzr Gntblciq`gci dc| vdn zbadv v` mbicilbch pz`vnlvbì$m~hh dnchvd bi|~zciln" m`z vdn vzncvgniv `mjznc|v lcilnz) \na~z` _`p~hcz fn \ch~f)

Rnv( nczhr fnvnlvbì b| ìhr l`}nznf m`zvd`|n chzncfr bi|~znf cif fbmmbl~hv v` clln||cif vdnzn b| c vdzncv `m c ldcian I@G

cif nczhr fnvnlvbì b| ~icmm`zfcjhn5

gcggàzcpdr( jb`p|r cif pcvd`hàr ' cvvdn g`|v |~j|bfbunf hn}nh bi c p~jhbld`|pbvch ' l`|v| g`zn vdci ìn gìvd `m

|~j|b|vniln bil`gn)

Bfnivbmr cif cpphr bii`}cvbì| bi l`~ivzr' cif


55/62

Bfnivbmr cif cpphr bii`}cvbì| bi l`~ivzr cif

dnchvd |r|vng'|pnlbmbl fnhb}nzr gnldcib|g|

@pvbgbun d~gci cif pdr|blch zn|`~zln|cif dczin|| vdn pzbgczr cif |nlìfczr

hn}nh| `m lczn5

Vc|k |dbmvbia/|dczbia $nt) JLN" Bimzc|vz~lv~zn |dbmvbia $nt)

ldng`vdnzcpr"

G`jbhbun l`gg~iblcvbì vnldi`hàr$zng`vn/vnhnlì|~hvcvbì m`z s~chbvr cif

|cmnvr; vnhn|rinzar"


56/62

_z`enlv cif `jenlvb}n|

@jenlvb}n|5

3" F`qi|vcan

:" Ntpcif clln|| v` lczn lh`|nz

v` d`gn


57/62

L`zn pzènlv l`gpìniv|

3" Ntpcif p`vnivbch m`z nczhr fnvnlvbì

Vzcbibia `m dnchvd pz`g`vnz|

Bgpz`}nf znmnzzch |r|vng

Vzcbibia `m pzbgczr lczn'hn}nh pdr|blbci| cif i~z|n| $ 33"

:" Ntpcif p`vnivbch m`z lczn cif vzncvgniv bi |nlìfczr hn}nh

d`|pbvch| \~pnz}b|bì cif lcpclbvr j~bhfbia mz`g vnzvbczr v`

|nlìfczr fb|vzblv d`|pbvch|

Lnivnz| m`z ldng`vdnzcpr cif |~z}b}`z|dbp |nlìfczr

cif pzbgczr hn}nh Clznfbvcvbì `m |nlìfczr lnivnz| |` \_\\ lci mbiciln


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_czvblbpcvbia bi|vbv~vbì|5

L`gb|bi Iclbìch fn _z`vnllbi \`lbch ni \ch~f

Gbib|vzr `m Dnchvd `m Echb|l`( G`znh`|( I~n}` Hnì

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Breast Cancer: Unforeseen Public Health Priority in Developing Countries 240111