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Journal of Oncology
Volume 2011, Article ID 150423, 8 pages
Research Article

Improving Breast Cancer Control via the Use of Community Health Workers in South Africa: A Critical Review

1Division of Public Health Practice, Harvard School of Public Health, 677 Huntington Avenue, Landmark 3rd Floor East, Boston, MA 02115, USA
2Department of Epidemiology, Boston University School of Public Health, 715 Albany St, Talbot Building, Boston, MA 02118, USA
3Center for Community-Based Research, Cantor Center for Nursing Research and Patient Care Services, Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA 02115, USA

Received 14 May 2010; Accepted 23 August 2010

Academic Editor: Malcolm Moore

Copyright © 2011 Brianna M. Wadler et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Breast cancer is a growing concern in low- and middle-income countries (LMCs). We explore community health worker (CHW) programs and describe their potential use in LMCs. We use South Africa as an example of how CHWs could improve access to breast health care because of its middle-income status, existing cancer centers, and history of CHW programs. CHWs could assume three main roles along the cancer control continuum: health education, screening, and patient navigation. By raising awareness about breast cancer through education, women are more likely to undergo screening. Many more women can be screened resulting in earlier-stage disease if CHWs are trained to perform clinical breast exams. As patient navigators, CHWs can guide women through the screening and treatment process. It is suggested that these roles be combined within existing CHW programs to maximize resources and improve breast cancer outcomes in LMCs.