Cancer in the Developing World

5 million people die from cancer in low and middle-income countries every year, and incidence of cancer in these countries is on the rise. As the control of infectious disease improves, life expectancy increases, as does the risk for the development of non-communicable diseases. Yet, cancer in low and middle-income countries is not viewed as a high priority public health concern. In the face of more immediately pressing public health issues like malaria and HIV, cancer and cancer treatment has taken a back seat. The economic reality faced by these countries is incredibly prohibitive in regards to access to treatment and diagnostic testing. As a result five of the seven million deaths from cancer a year are people living in low and middle-income countries. 

It could be argued that cancer is really a disease of ‘wealth,’ as incidence is highest in high-income countries. Cancer is mostly seen in older populations, as the disease is thought mainly to be the result of genetic factors over time. In areas with low life expectancy people may simply not be living long enough to see cancers develop. This perception of cancer as an issue of ‘wealth’ may also simply be a result of access to diagnostic testing and equipment, as regions with greater access to these services may simply be able to diagnose cancer earlier and more readily. However cancer incidence is growing in low-income areas, especially cancers linked to infectious disease, alcohol and tobacco use rather than sedentary life style and high BMI’s. For example cervical cancer and liver cancer are the most prevalent in Sub-Saharan Africa and South America.

However, the prohibitive cost of cancer treatment contributes to the staggering number or deaths from cancer in low and middle-income countries. Cancer drugs are incredibly expensive, and protected by international intellectual property laws and trade agreements that prevent the manufacture and distribution of more affordable generics. Treatment can also be a very long and painful process that may simply not be an option available to people living in impoverished areas. Preventative measures are also not available in these countries; for example, cervical cancer is most prevalent in low and middle-income countries, specifically in northwest and southeast Africa (see this really cool interactive map of ‘cancer’s global footprint: http://globalcancermap.com/ ). This is likely due to the high correlation between STI’s and cervical cancer, and while vaccines and treatment for the STI’s (mostly HPV) that are most closely linked to these cancers exist they are not widely available outside of the United States and other western countries. Access to this kind of preventative treatment could potentially save millions of lives.

Access to the life saving preventative, diagnostic and therapeutic measures that are currently being developed specifically for cancer is critical to the health and well being of all populations regardless of socioeconomic status.  Cancer is the leading cause of death globally, and sixty percent of all new cancer diagnoses are from low and middle-income countries. Something must be done to prioritize the growing issue of cancer in these regions and to bridge the economic divide that prevents people from getting access to the medical care they so desperately need.