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Cancer to Surpass Heart Disease as World's Leading Killer
Date:12/9/2008

Biggest rise in cases and deaths coming in developing nations, report says

TUESDAY, Dec. 9 (HealthDay News) -- By 2010, cancer will be the leading killer in the world, surpassing heart disease, causing more deaths than AIDS, malaria and tuberculosis combined.

Unless new treatments are found, there could be 27 million people with cancer by 2030, and 17 million cancer deaths annually. And, there could be 75 million people living with cancer within five years after diagnosis, according to a new report, 2008 World Cancer Report, released Tuesday by the World Health Organization.

"The burden of cancer is shifting from developed countries to developing nations," Dr. Otis Webb Brawley, chief medical officer of the American Cancer Society, said during a teleconference. "And with a growing and aging population, we must take steps to address this problem now."

Last year, there were about 12 million new cases of cancer and 7.6 million cancer deaths reported. Of these, 5.6 million were in developing countries with an estimated 4.7 million cancer deaths.

"The global burden of cancer has more than doubled in the past 30 years," Peter Boyle, director of the International Agency for Research on Cancer and co-author of the report, said during the teleconference. "Right now, there are 25 million people alive with cancer five years after diagnosis."

Cancer rates are growing in developing countries as people adopt western lifestyles, including smoking, high-fat diets, fast food and less physical activity.

These countries typically don't have the resources to cope with this dramatic increase in cancer. Populations in these countries are expected to grow by 38 percent by 2030. And, these countries will have a high number of older people as populations age, increasing the incidence of cancer.

Smoking is the major avoidable risk for cancer and cancer deaths around the world. Currently, some 1.3 billion people smoke. The true burden of cancers and deaths from smoking are yet to seen. This "smoking epidemic" will be influencing cancer in developing countries for many years, according to the report.

In addition to increases in smoking-related cancers such a lung cancer, breast cancer has been increasing up to 5 percent a year in developing countries. Cervical cancer, which is preventable and treatable in developed countries, is a major cause of cancer deaths among women in the developing world. Stomach, liver, oral and cervical cancers also take a heavy toll in developing countries, according to the report.

Cancer treatment in developing nations is out of reach for many people; palliative care is the only therapy offered to more than 80 percent of cancer patients, Boyle said.

"There are currently 30 low-resource countries without a radiotherapy machine. There are 29 countries in Africa where it is legally forbidden to import morphine and opiate drugs for severe pain control," he said. "Every cancer patient has the human right to have access to all aspects of supportive and palliative care and the absolute right to die a pain-free death with dignity."

In developing countries, most cancer is attributable to chronic infections. But, 12 percent of the disease is caused by smoking, and that number is growing, according to the report.

Cancer cases and cancer deaths are expected to grow 1 percent a year, with the biggest increases in China, Russia and India.

There are major differences in cancer rates and types of malignancies around the world. For example:

  • Breast cancer rates have doubled or tripled over the past 40 years in Japan, Singapore and Korea. In China, breast cancer rates have increased 20 percent to 30 percent in the past decade.
  • Lack of refrigeration has caused an increase in stomach cancer in some Asian countries. In the United States, refrigeration and improved hygiene have reduced stomach cancer by 89 percent in men and 92 percent in women since 1930.
  • In Africa, there were an estimated 667,000 cases of cancer and 518,000 cancer deaths in 2008. Cervical cancer is the leading cause of cancer deaths in women. HIV-related cancers are also prevalent.

In the United States, for the first time since such statistics were released in 1998, the number of men and women getting and dying from cancer has dropped, according to a report released earlier this month in the Journal of the National Cancer Institute. The drop was mostly due to fewer cases of lung, prostate and colorectal cancers among men, and fewer cases of breast and colorectal cancer among women. Also, death rates from lung cancer have leveled off among women since 2003, the American Cancer Society report found.

To stem the global tide of increasing cancer rates, the American Cancer Society is recommending several steps, Brawley said.

First, vaccines that prevent cancer-causing infections -- such as human papillomavirus, which causes cervical cancer -- need to be made available to low-income countries. Second, there needs to be greater support for U.S. and international tobacco-control programs. Third, health officials and governments must promote culturally sensitive risk-reduction programs and invest in cancer research and early detection.

More information

For more on cancer, visit the American Cancer Society.



SOURCES: Dec. 9, 2008, teleconference with Otis Webb Brawley, M.D., chief medical officer, American Cancer Society, Atlanta; Peter Boyle, B.Sc., Ph.D., D.Sc., director, International Agency for Research on Cancer; Dec. 9, 2008, World Health Organization report, 2008 World Cancer Report; Dec. 3, 2008, Journal of the National Cancer Institute


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