Even as survival rates of many types of cancers are improving in countries where health systems are strong, a large number of cancer patients across the world do not have access to timely quality diagnosis and treatment.
Cancer accounted for an estimated 9.6 million deaths in 2018 globally, roughly 1 in 6 deaths. Approximately, 70% of deaths from cancer occur in low- and middle-income countries, according to WHO data.
The incidence of cancer is expected to swell to 29.5 million by 2040, up from 18.1 million in 2018, according to Globocan data.
Asian countries bear the largest burden — with as much as 48.1% of the total cancer cases in the world, followed by Europe at 23.5%.
Despite advances in understanding the causes, treatments and outcomes of cancer, it remains one of the most feared illnesses.
Only less than 30% of low-income countries reported that treatment services were generally available as of 2015, compared to more than 90% of high-income countries.
Only one in five low- and middle-income countries have the necessary data to frame cancer policy.
Worldwide, lung, liver, stomach, colorectal and prostate cancers are the 5 most common types of cancer that kill men. Breast, lung, colorectal, cervical and stomach cancers are most common among women.
Cancer is a leading cause of death for children and adolescents around the world and approximately 300,000 children aged 0 to 19 years old are diagnosed with cancer each year.
The most common categories of childhood cancers include leukaemias, brain cancers, lymphomas and solid tumours, such as neuroblastoma and Wilms tumour.
In high-income countries, more than 80% of children with cancer get cured, but in many low- and middle-income countries (LMICs), only about 20% are cured.
Infections like human papillomavirus (HPV) and hepatitis B virus (HBV) are responsible for up to 25% of newly diagnosed cancer cases in low- and middle-income countries. Vaccination against these two viruses could prevent 1.1 million cancer cases each year.
Only a very small percentage of people who need palliative care are currently receiving it.
Besides the huge cost burden that cancer inflicts, these economies lack adequate policies to drive cancer care.
Socioeconomic disparities in cancer health is a major concern. For many cancers, mortality rates are highest among minority populations. Breast cancer, for example, is most prevalent among white women in the US, but African American women are more likely to die from the disease, in part because they are often diagnosed with more advanced cancer, according to the American Association for Cancer Research (AACR).
Mortality high in India
“Uterine cancer and stomach cancer have gone down drastically in India due to improvements in personal hygiene among women and the availability of quality potable water,” says Dr Narayanankutty Warrier, Medical Director, MVR Cancer Centre and Research Institute, Kozhikode.
However, thyroid cancer continues to show its dominance — along with multiple myeloma — in Kerala, compared to other states.
Lung cancer has become number one in India, not because of smoking but probably due to environmental pollution
In India, cancer-related mortality continues to be high. Lack of affordability of treatments and the stigma associated with cancer are contributing factors. Inadequate knowledge about clinical trials and propaganda against these also are hindrances that lead to high mortality, he adds.
“The incidence to mortality ratio in developed countries is 0-33 compared to double that in India, “ says Dr Anil D’Cruz, Director- Oncology, Apollo Hospitals. “That is, every 2 out of 3 patients die of cancer after diagnosis in India compared to 1/3 in the west.”.
The reasons are multifactorial, but are primarily related to late diagnosis and lack of access to quality cancer care in our country.