On February 1, the World Health Organization’s (WHO’s) cancer agency published data highlighting the growing burden of cancer around the world, the disproportionate impact of cancer in lower-income countries, and the urgent need to address cancer inequities.
Here’s the big picture:
The International Agency for Research on Cancer (IARC) reported that new cancer cases have globally increased by 50% and cancer deaths by about 18% between 2012 and 2022. The IARC estimates that the global cancer burden will continue to rise over the next 30 years, with new cases increasing by 77% by 2050.
More specifically, the data, which span 36 cancer types and 185 countries, revealed an estimated 20 million new cancer cases and 9.7 million cancer deaths worldwide in 2022 compared with an estimated 14 million new cancer cases and 8.2 million cancer-related deaths one decade prior.
“According to these new estimates, about 1 in 5 men and women will develop cancer in their lifetime, and around 1 in 9 men and 1 and 12 women will die from the disease,” Freddie Bray, PhD, head of the cancer surveillance branch at IARC, noted during a media briefing highlighting key findings from the new report.
“The data represent a wake-up call regarding the current and future implications of cancer in our global society,” said Eduard Teixidor, from Catalan Institute of Oncology, Josep Trueta University Hospital, Girona, Spain, who weighed in on the report via the UK-based Science Media Centre.
US-focused data released earlier this month from the American Cancer Society (ACS) revealed slightly different trends, namely that cancer deaths are declining overall but that these gains are threatened by increasing incidence of many common cancers, including breast, prostate, melanoma, and colorectal cancer (CRC).
According to the WHO report, five cancer types — lung, breast, CRC, liver, and stomach — together comprised about 50% of new cases and deaths globally in 2022.
Lung cancer was the most common cancer worldwide, with about 2.5 million new cases and making up 12.4% of total new cases. Breast cancer ranked a “very close second,” said Bray, with 2.3 million cases, making up 11.6% of total new cases worldwide.
CRC was the third most common cancer worldwide at 1.9 million new cases, or 9.6% of all new cases, followed by prostate cancer at 1.5 million new cases (7.3%), and stomach cancer at 970,000 new cases (4.9%).
Turning to mortality, lung cancer was the top cause of cancer deaths representing 1.8 million deaths, or 18.7% of total cancer deaths, followed by CRC at 900,000 deaths (9.3% of total deaths), liver cancer at 760,000 deaths (7.8% of total deaths), breast cancer at 670,000 deaths (6.9% of total deaths), and stomach cancer at 660,000 deaths (6.8% of total deaths).
Differences emerged by gender in both cancer incidence and mortality.
For women, breast cancer was the most diagnosed cancer and the leading cause of cancer death, whereas for men, it was lung cancer.
For men, prostate cancer and CRC were the second and third most common cancers, whereas liver and CRC were the second and third most common causes of cancer death in men. For women, lung and CRC were second and third for both new cases and deaths.
Cervical cancer was the eighth most common cancer globally and the ninth leading cause of cancer death, accounting for 661,044 new cases and 348,186 deaths.
Notable InequitiesThe global estimates, alongside a survey from WHO, also revealed striking inequities in the cancer burden, especially for female breast cancer, according to the Human Development Index (HDI). The HDI measures three factors: life expectancy at birth, education, and standard of living.
For example, “women in lower HDI countries are 50% less likely to be diagnosed with breast cancer than women in high HDI countries, yet they are at a much higher risk of dying of the disease due to late diagnosis and inadequate access to quality treatment,” Isabelle Soerjomataram, MD, PhD, deputy head of the cancer surveillance branch at IARC, said in a news release.
Specifically, in countries with a very high HDI, 1 in 12 women will be diagnosed with breast cancer in their lifetime, and 1 in 71 women will die of it. In contrast, in countries with a low HDI, only 1 in 27 women will be diagnosed with breast cancer in their lifetime, but 1 in 48 women will die from the disease.
The data also revealed global inequities in cancer services, with most countries failing to adequately finance “priority” cancer and palliative care services as part of universal health coverage.
“Cancer services are neglected in public sector financing, with only 39% of countries including a core set of priority cancer services in their health benefit packages. If we include palliative care, that number decreases to 28%,” André Ilbawi, MD, WHO technical lead on cancer, said during the briefing.
In addition, governments often don’t prioritize services on the basis of impact or cost effectiveness, Ilbawi said.
For example, “many low-cost generic medicines and technologies are not being included in the benefit package of the poorest countries,” Ilbawi reported. “This includes, for example, that no low-income country offers cervical cancer screening with the [human papilloma virus] test only. But in these same countries, other higher-cost, less cost-effective interventions are being included.”
Failing to include cancer as part of universal health coverage triggers a vicious cycle, Ilbawi said. “When people diagnosed with cancer are told they have to pay out-of-pocket, they’re less likely to seek help, less likely to receive treatment, and less likely to complete their care,” he added. “That makes cancer more deadly and more expensive for economies, particularly as the burden of cancer increases.”
The Future BurdenBy 2050, the WHO estimates that the number of new cancer cases will reach 35.3 million, a 77% increase from the estimated 20 million cases in 2022. The increase reflects population growth and aging as well as changes in exposure to risk factors, including tobacco, alcohol, obesity, and air pollution, the agency explained.
High-HDI countries are expected to experience the greatest absolute increase in incidence, with an additional 4.8 million new cases predicted in 2050 vs 2022.
Yet, the proportional increase in incidence will be most striking in low-HDI countries (142% increase) and in medium-HDI countries (99%) which have the fewest resources to manage the cancer burden, Bray noted. Likewise, cancer mortality in these countries is projected to nearly double in 2050.
“While advances are being made in cancer diagnosis and treatment, these often come with a high economic impact,” said Teixidor, commenting via Science Media Centre. “Growing inequity between countries will increasingly highlight differences in the ability to tackle malignancies. The current situation already represents a global problem; however, with these dynamics, it is inevitable that it will intensify exponentially sooner rather than later.”
Bente Mikkelsen, MD, WHO director of noncommunicable diseases, said that the WHO is working “intensively with more than 75 governments to develop, finance, and implement policies to promote cancer care for all. To expand on this work, major investments are urgently needed to address global inequities in cancer outcomes.”
Source : Medscape