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A cancer epidemic among the poor

South China Morning Post — 2 March 2011

Cancer is an enormous – and growing – global public health problem. And, of the 7.6 million cancer deaths every year, 4.8 million occur in the developing world. A disease formerly considered more pervasive in affluent countries now places its heaviest burden on poor and disadvantaged populations.

In some African countries, fewer than 15 per cent of cancer patients survive for five years following diagnosis of cervical and breast cancer, diseases that are highly curable elsewhere in the world. These are shocking statistics.

The increase in cancer’s impact on the poor reflects factors such as demographic growth, population ageing, the spread of unhealthy lifestyles (including tobacco use), and lack of control of cancer-associated infections.

If no action is taken, the number of cancer deaths in the developing world is forecast to grow to 5.9 million in 2015 and 9.1 million in 2030, while cancer deaths in wealthy countries are expected to rise by 40 per cent over the next 20 years.

Throughout the developing world, most health care systems are designed to cope with episodes of infectious disease. But most lack the funds, equipment and qualified personnel needed to provide basic care for cancer patients. They also have little capacity for prevention, public education, or early diagnosis and treatment.

Many of these patients do not have to die. We know that around one-third of cancers can be prevented. This figure could be increased markedly if more emphasis were placed on identifying additional environmental and lifestyle-associated factors that increase cancer risks. In addition, a diagnosis no longer has to be a death sentence, because one-third of cancers can be cured if detected early and treated properly.

The World Health Organisation and the International Atomic Energy Agency, which helps to build countries’ capacity for radiation medicine, are working closely together to improve cancer control in developing countries.

Preventive measures such as public health initiatives to curb smoking can be remarkably effective. Vaccines against hepatitis B and human papillomaviruses, if made available at affordable prices, could contribute significantly to the prevention of liver and cervical cancers, respectively.

We are seeing promising results in individual countries, but our efforts are just a drop in a vast ocean of need. In order to respond to the growing cancer epidemic, we need nothing less than concerted global action similar to the successful mobilisation against HIV/Aids.

Cancer should be seen as a vital part of the global health agenda. World leaders should be made aware of the scale of the cancer crisis facing developing countries.

The UN General Assembly’s Summit on Non-Communicable Diseases in September provides an opportunity to focus the world’s attention on cancer in developing countries. Let us make cancer control one of the good news stories of 2011.

Margaret Chan is director general of the World Health Organisation. Yukiya Amano is director general of the International Atomic Energy Agency. Copyright: Project Syndicate

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