Developing World Faces Growing Cancer Burden

With new cancer cases expected to rise from 14 million to 22 million per year worldwide over the next two decades, the International Agency for Research on Cancer (IARC), an arm of the World Health Organization, has issued a report calling for an expanded global focus on prevention.

Despite treatment advances, “we cannot treat our way out of the cancer problem,” says Christopher Wild, PhD, director of IARC and coauthor of the agency's World Cancer Report 2014. “More commitment to prevention and early detection is desperately needed in order to complement improved treatments and address the alarming rise in cancer burden globally.”

The weight of those 8 million additional cases per year will fall disproportionately on the developing world, where more than 60% of the world's cancer cases and 70% of cancer deaths are already concentrated.

“The burden of cancer, whether you measure it by deaths, disability, or years of potential life lost, is going to get worse in the developing world,” says Edward L. Trimble, MD, MPH, director of the Center for Global Health at the National Cancer Institute, who was not involved in the report.

Early detection and treatment of cancers like cervical cancer have already made a difference in countries such as India and Costa Rica, the report found. Yet about half of all cancers could be avoided entirely, it said, largely by stopping smoking, limiting alcohol use, preventing obesity, and increasing vaccination rates against infection-related cancers.

Experience has proven that preventive steps are viable, even in countries with few resources. “There are now examples of successful tobacco-control programs from many countries, showing that the combination of education, changes in packaging, pricing, marketing restrictions, and limitations on where smoking is allowed can bring down rates of young people starting to smoke cigarettes and adults who continue to smoke,” says Trimble.

Lawrence N. Shulman, MD, chief medical officer at Dana-Farber Cancer Institute, an oncologist at Brigham and Women's Hospital, and an associate professor of medicine at Harvard Medical School, all in Boston, MA, applauded IARC's attention to cancer prevention in the developing world. However, he says he hopes the agency will continue to focus on treatment in addition to prevention, as the two approaches strengthen each other.

“We believe that cancer care can be effective and affordable in resource-poor settings,” he emphasizes.

For example, although cancer medications are costly in the developed world, they can still be made available in places with few resources, says Shulman. He and others are currently collaborating with large generic drug suppliers to create the kind of cost reductions for cancer drugs that worked so well for HIV medications.