Closing the cancer care gap
Dear Editor,
Recently the world was informed that King Charles III was diagnosed with an unspecified form of cancer. The cancer was discovered as doctors treated the monarch for an enlarged prostate.
Cancers are a leading cause of death worldwide, causing 10.0 million deaths in 2019. We all have lost a family member or friend to cancer. In some families multiple members have succumbed to this dreaded disease. About one in five people develop cancer in their lifetime: approximately one in nine men and one in 12 women will die from the disease.
World Cancer Day is an international day marked on February 4 to raise awareness of cancer and to encourage its prevention, detection, and treatment. This year’s theme is ‘Close the care gap’. Everyone deserves access to cancer treatment.
Cancer is a large group of diseases that can affect any organ or tissue of the body. It refers to the abnormal growth of cells that divide uncontrollably and has the ability to spread from one body part/organ/tissue to another.
The global World Health Organization (WHO) survey on Universal Health Coverage (UHC) and cancer shows that only 39 per cent of participating countries covered the basics of cancer management as part of their financed core health services for all citizens’ health benefit packages. Only 28 per cent of participating countries additionally covered care for people who require palliative care, including pain relief in general, not just linked to cancer.
This is problematic, especially for Caribbean societies. For men, prostate and colorectal cancers were the second and third most commonly occurring cancers, while liver and colorectal cancers were the second and third most common causes of cancer death. For women, lung and colorectal cancer were second and third for both the number of new cases and deaths.
The WHO stated that cervical cancer was the eighth most commonly occurring cancer globally and the ninth leading cause of cancer death, accounting for 661,044 new cases and 348,186 deaths. It is the most common cancer in women in 25 countries, many of which are in sub-Saharan Africa. Even while recognising varying incidence levels, cervical cancer can be eliminated as a public health problem through the scale-up of the WHO Cervical Cancer Elimination Initiative.
According to data from the European Society for Medical Oncology, the health burden of cancers is distributed unevenly across countries, with high-income countries facing a greater per-population burden in terms of disability-adjusted life years than low- and middle-income countries (LMICs).
Cancers impose a marked toll on the economy through reduced productivity, unemployment, labour loss, and capital investment reductions. Accordingly, investment in cancer screening, diagnosis, and treatment could yield substantial health and economic benefits, especially in LMICs, which have lower levels of cancer survival compared to high-income countries.
Global estimates reveal striking inequities in the cancer burden, according to the human development index (HDI). This is particularly true for breast cancer. In countries with a very high HDI, one in 12 women will be diagnosed with breast cancer in their lifetime and one in 71 women die of it. By contrast, in countries with a low HDI, while only one in 27 women is diagnosed with breast cancer in their lifetime, one in 48 women will die from it.
The rapidly growing global cancer burden reflects both population ageing and growth as well as changes to people’s exposure to risk factors, several of which are associated with socio-economic development. Tobacco, alcohol, and obesity are key factors behind the increasing incidence of cancer, with air pollution still a key driver of environmental risk factors.
Let us lobby the Government to invest more funds to support the diagnosis and treatment of cancer. Alarmingly, the
JAMA Oncology publication estimates that the total cost of cancer to the global economy will reach US$25.2-trillion between 2020 and 2050. It is clear that the global community must unite both in terms of collective voices and resources in order to spread the message that early detection provides the best possible outcome for a diagnosis of cancer.
The time to show more kindness and to be supportive to those who are going through their journey with cancer is now. Is it possible to close the care gap as it relates to cancer? Yes, it is; however, a conscious and collective effort must be made at both the governmental and community levels in order to close the care gap regarding cancer.
Wayne Campbell
waykam@yahoo.com