Study examines ways to reduce growing cancer burden in developing world

Aug 17 2010

"The growing burden of cancer in developing countries could be reduced without expensive drugs and equipment, scientists said on Monday, but it requires a global effort similar to the fight against HIV/AIDS," Reuters reports in an article that examines a study published in the Lancet by a group of American scientists who have created the Global Task Force on Expanded Access to Cancer Care and Control in Developing Countries (GTF.CCC).

In the study, scientists "said cancer is now a leading cause of death in poor nations but is often neglected in health authorities' prevention and treatment plans." They said many cancers that burden developing countries can be treated with drugs, including breast cancer drug tamoxifen, "that are off-patent and can be manufactured generically at affordable prices." Current estimates indicated that "about 5 percent of global resources for cancer are spent in developing countries," the news service writes (Kelland, 8/16).

According to Inter Press Service, cancer in developing countries accounted for 56 percent of all reported cancers in 2008, and "is predicted to reach the 70 percent mark by 2030," the news service reports. "The rising proportion is due to population growth, ageing and reduced mortality from infectious diseases. And survival rates for certain cancers, such as cervical, breast and testicular, are directly related to country income," IPS reports (De Fazio, 8/15).

In the study, the researchers write that "the world faces a huge and largely unperceived cost of inaction around cancer in developing regions, which merits an immediate and large-scale global response." The study presents "reasons for rapid scale-up of cancer treatment," such as a need to strengthen primary health care and an examination of cancers that are preventable and/or treatable.

The authors also discuss "evidence for the feasibility and effectiveness of cancer control and care in countries of low or middle income," including examples of programs in Malawi, Rwanda and Haiti, "extremely resource-poor settings," that have shown "that absence of oncological specialists need not delay the implementation of mutually reinforcing efforts to prevent, screen, treat, and palliate cancer." The paper also looks at cancer treatment programs in Mexico, Colombia, and Jordan (Farmer et al., 8/16).

"Despite the success of these programmes, 'the reach of these pilot initiatives has been dwarfed by the burden of the disease,' the paper says," according to IPS (8/15).

Reuters continues: "The group criticised what it described as 'the public health community's assumption' that cancer could not be treated in poor countries and compared it to 'similarly unfounded arguments from more than a decade ago'" about HIV/AIDS treatment. They also wrote: "The time has come to challenge and disprove the widespread assumption that cancer will remain untreated in poor countries" (8/16).

IPS also discusses the cost of bringing cancer treatment to developing countries, including comments from study co-author Felicia Knaul of the Harvard Global Equity Initiative. "'Many of the treatments for cancer are not that expensive, including palliation and pain control,' Knaul says. However, reducing the costs of treatments is precisely one of GTF.CCC's goals" (8/15).

In the study, the authors "propose three changes" in global cancer care: implementing demonstration programs to determine the "most effective measures to alleviate the burden of cancer and expand the volume of health services in developing countries"; enabling countries to "participate in collective, multicountry negotiation to secure reduced prices for essential services, drugs, and vaccines"; and implementing "innovative financing mechanisms, which should decisively expand the financial resources available for prevention, treatment, and palliation of cancer in the developing world" (8/16).

Reuters also published a related factbox on cancer in developing countries (Kelland, 8/15).