Kampala, Uganda. The world observed World Cancer Day on Sunday. In this regard, the Mulago National Referral Hospital’s Uganda Cancer Institute (UCI) maintains a comprehensive commitment to enhance the fight against cancer.
Under this year’s theme, ‘Close the care gap: Everyone deserves access to cancer care’, the institute plans to increase the capacity of its radiotherapy department by acquiring more treatment machines, expanding treatment rooms, and enhancing overall infrastructure.
This ambitious expansion aims to transform UCI into a 350-bed hospital from its current capacity of 130 beds, allowing for increased patient accessibility and quality cancer care.
In addition to infrastructure development, UCI is actively recruiting and training additional healthcare professionals, particularly radiation oncologists and medical physicists, to manage the surge in patient numbers effectively.
The institute is also streamlining the referral system, collaborating with healthcare facilities to minimize delays in patient care.
Furthermore, UCI is establishing regional cancer centres across Uganda to decentralize cancer treatment and reduce the burden on the central facility in Kampala.
However, the public awareness initiatives remain crucial to UCI’s commitment, as the institute continues to educate the public about cancer prevention, early detection, and the importance of seeking prompt medical advice.
According to the institute, radiotherapy is free, while other cancer treatments, including chemotherapy, incur charges. Although, authorities say, the least expensive chemotherapy dose is priced at approximately Ugx300,000.
WHO/IARC Report
The International Agency for Research on Cancer (IARC), the cancer agency of the World Health Organization (WHO), has unveiled the latest estimates on the global burden of cancer.
Simultaneously, the WHO has released survey findings from 115 countries, shedding light on the insufficient financial support for crucial cancer and palliative care services within the framework of Universal Health Coverage (UHC).
In 2022, a staggering 20 million new cancer cases were diagnosed, resulting in 9.7 million deaths. This grim reality emphasizes the escalating burden of cancer on a global scale, with a particularly disproportionate impact on underserved populations. The urgency to address these inequities worldwide is paramount.
Survival Rates and Alarming Statistics
The IARC’s estimates, drawing from the most reliable data available in various countries, reveal that approximately 53.5 million individuals were alive within five years following a cancer diagnosis.
However, the stark truth remains that 1 in 5 people will develop cancer in their lifetime, and tragically, 1 in 9 men and 1 in 12 women will succumb to the disease.
Cancer and Universal Health Coverage
The WHO’s comprehensive survey encompassing 115 countries exposes a disheartening reality – only 39% of these nations include the fundamentals of cancer management in their financed core health services for all citizens, known as ‘health benefit packages’ (HBP).
More concerning is the fact that a mere 28% of these countries extend coverage to palliative care, encompassing pain relief for individuals in general, not exclusively linked to cancer.
Addressing the Disparities
The data presented in the IARC’s estimates and the WHO’s survey underscore the pressing need to confront cancer inequities globally.
The lack of adequate financial backing for priority cancer and palliative care services within the UHC framework is a significant obstacle that needs immediate attention.
Three major cancer types in 2022(Lung, Breast And Colorectal)
The latest data from the International Agency for Research on Cancer’s Global Cancer Observatory presents estimates that reveal ten specific cancer types collectively constituted nearly two-thirds of global new cases and deaths in 2022.
Covering 185 countries and encompassing 36 different types of cancer, the statistics offer a comprehensive overview.
Lung cancer emerged as the most prevalent cancer worldwide, accounting for 2.5 million new cases, representing 12.4% of the total new cases.
Following closely was female breast cancer with 2.3 million cases (11.6%), followed by colorectal cancer (1.9 million cases, 9.6%), prostate cancer (1.5 million cases, 7.3%), and stomach cancer (970,000 cases, 4.9%).
In terms of cancer-related fatalities, lung cancer took the lead, causing 1.8 million deaths (18.7% of total cancer deaths), followed by colorectal cancer (900,000 deaths, 9.3%), liver cancer (760,000 deaths, 7.8%), breast cancer (670,000 deaths, 6.9%), and stomach cancer (660,000 deaths, 6.8%). The resurgence of lung cancer as the most common cancer is likely attributed to persistent tobacco use, particularly in Asia.
Sex-specific variations were observed in both incidence and mortality rates globally. Breast cancer was the most frequently diagnosed cancer and the leading cause of cancer death for women, while lung cancer held the same status for men. Breast cancer was predominant in the majority of countries (157 out of 185).
For men, prostate and colorectal cancers ranked second and third in terms of occurrence, while liver and colorectal cancers were the second and third most common causes of cancer death.
Among women, lung and colorectal cancers were the second and third most prevalent in terms of both new cases and fatalities.
Cervical cancer, positioned as the eighth most frequently occurring cancer globally and the ninth leading cause of cancer death, recorded 661,044 new cases and 348,186 deaths.
Despite varying incidence levels, cervical cancer stands as a target for elimination as a public health problem through the WHO Cervical Cancer Elimination Initiative, especially in the 25 countries, many of which are in sub-Saharan Africa, where it is the most common cancer among women.
Disparities in Cancer Burden, Care
Recent global estimates highlight a stark reality – cancer does not discriminate, but access to diagnosis and quality treatment does.
Striking inequities in the cancer burden, particularly concerning breast cancer, have been unveiled through an analysis based on the Human Development Index (HDI).
Simultaneously, the World Health Organization’s (WHO) global survey on health benefit packages (HBPs) reveals significant gaps in cancer services, amplifying the urgency for international collaboration and increased investments to address these disparities.
Breast Cancer Disparities
The analysis based on HDI categorically underscores the glaring disparities in breast cancer diagnosis and mortality.
In countries with very high HDI, the statistics reveal that 1 in 12 women will be diagnosed with breast cancer in their lifetime, and sadly, 1 in 71 women will succumb to the disease.
In stark contrast, countries with low HDI show a lower incidence of breast cancer (1 in 27 women) but a higher mortality rate (1 in 48 women).
Dr. Isabelle Soerjomataram, Deputy Head of the Cancer Surveillance Branch at IARC, emphasizes that women in lower HDI countries face a 50% lower likelihood of being diagnosed with breast cancer, yet they grapple with a significantly higher risk of death due to late diagnosis and inadequate access to quality treatment.
Global Inequities in Cancer Services
The WHO’s global survey on health benefit packages (HBPs) further exposes profound inequities in cancer services worldwide. Lung cancer-related services, for instance, are reported to be 4–7 times more likely to be included in a HBP in high-income countries compared to lower-income countries.
On average, there is a four-fold greater likelihood of radiation services being covered in a HBP in high-income countries compared to lower-income countries.
The starkest contrast is observed in stem-cell transplantation, which is a staggering 12 times more likely to be included in a HBP in high-income countries compared to their lower-income counterparts.
Call to Action
Dr. Bente Mikkelsen, Director of the Department of Noncommunicable Diseases at WHO, underscores the gravity of the situation, stating that the new global survey shines a light on major inequalities and a lack of financial protection for cancer care worldwide.
With over 75 governments actively engaged, WHO is intensifying efforts to develop, finance, and implement policies to promote comprehensive cancer care for all.
However, Dr. Mikkelsen emphasizes that substantial investments are urgently needed to address these global inequities in cancer outcomes.
In 2050, there is a predicted 77% increase in new cancer cases globally, totaling over 35 million cases, compared to an estimated 20 million cases in 2022.
This rise is due to factors like an aging and growing population, changes in exposure to risk factors related to socio-economic development, and key contributors such as tobacco, alcohol, obesity, and air pollution.
Highly developed countries are expected to see the largest absolute increase, with 4.8 million more cases in 2050 compared to 2022.
However, low and medium Human Development Index (HDI) countries face the most significant proportional increases, with a 142% and 99% rise, respectively. Additionally, cancer mortality in these countries is projected to nearly double by 2050.
Dr. Freddie Bray, Head of the Cancer Surveillance Branch at IARC, emphasizes that the impact of this increase will disproportionately affect countries with fewer resources to manage the cancer burden
Dr. Cary Adams, head of UICC, stresses the need for global attention, stating that despite progress in cancer detection and treatment, disparities persist, and access to quality services should not be determined by geographical or economic factors. It is not just a resource problem but also a matter of political will.
END
English 