Cancer kills more people than HIV, malaria, and tuberculosis combined in low-and middle-income countries
28.05.2018
Globally, cancer remains one of the major causes of morbidity and mortality. It is projected that by 2020, cancer incidence may substantially increase by about 15 million new cases. Although cancer affects many communities worldwide, the prevalence, causes and types differ significantly among communities.
Cancer used to be associated with countries with advanced economies until recently- developing countries have succeeded in attaining lifestyles closely related to those in advanced economies. Now, the disease once associated with affluence has its highest burden on developing countries. The incidence, death and health burden of cancer is projected to rise in the developing world, whereas, these stats are expected to remain fairly stable in the developed world. Even though the total cancer burden may remain highest in advanced societies, less developed economies are closing the burden gap quickly.
This increase in cancer incidence in developing countries reflects a much broader evolution in the global burden of disease from infectious diseases to chronic diseases. Being acute and easily detected, infectious diseases such as HIV, malaria and tuberculosis are more preventable and at such have become less fatal when compared to the progressive long-term chronic diseases such as cancer and diabetes. Globalization of chronic diseases is evident in the fact that for years now, deaths due to chronic diseases have surpassed those from acute and infectious diseases.
The complexity of cancer control has changed and increased significantly given the shift of the disease burden. According to World Health Organization, 70% (about 5.5million) of all deaths resulting from cancer occur in the developing world. If nothing is done, cancer deaths in the developing world are projected to rise to 6.7 million in 2015 and 8.9 million in 2030. These values are more than the projected deaths for HIV, malaria, and tuberculosis combined.
The evolution of cancer globally, and the increased incidence in developing countries can be attributed to several factors including globalization, aging population, diet, urbanization, lifestyle, tobacco and other substance use and infectious agents. Specific types of cancer, such as breast, colon, and prostate cancers, have remained common in the developed world while developing countries are plagued with mostly preventable cancers caused by infectious diseases. Cancer is particularly fatal in developing countries due to late detection, and lack of access to advanced diagnostic technologies and cancer therapies. Additionally, the financial resources, facilities, equipment, infrastructure, staff and training required to cope with chronic care for cancers can be crippling for developing countries. There is also lack of response capacity regarding prevention, health education and promotion, screening and early detection, diagnosis and treatment of cancer. Even when available, the cost of treatment such as surgery, chemotherapy and radiotherapy is often too high. This further contributes to poverty because in these countries, healthcare is paid for out-of-pocket. Epidemiological data, which is not often available in developing countries, are useful to identify trends in cancer burden, morbidity, mortality, detection and prevention, as well as treatment outcomes such as survival. These epidemiological trends showing cancer burden can also show associated economic and policy factors and eventually help in the reduction of cancer cases in these countries.
The preceding paragraphs emphasize the menace of cancer in low and middle income countries especially the fact that it kills more people worldwide than HIV/AIDS, tuberculosis, and malaria combined. Despite this fact, cancer care and control in these countries is lacking in global health programs, including the United Nations Millennium Development Goals (MDGs). It is important to tackle cancer as a public health priority that it is starting by establishing functional primary care health infrastructures, particularly for cancers that are preventable, creating awareness and promoting early detection as well as investing in cost–effective generic drugs.