Health Care UpdatesPerspective

WHO projects ‘alarming rise’ in cancer worldwide

Cancer will become a significantly larger global health care burden in the next 2 decades, with incidence expected to rise by 57% and deaths projected to increase by 63%, according to WHO’s World Cancer Report 2014.

“Despite exciting advances, this report shows that we cannot treat our way out of the cancer problem,” Christopher P. Wild, MD, director of the International Agency for Research on Cancer, said in a press release. “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.”

 

Christopher P. Wild

The number of new cancer cases worldwide, estimated at 14 million in 2012, will increase to 22 million within the next 20 years, according to the report. The number of cancer deaths is projected to increase from 8.2 million in 2012 to 13 million per year in the next 2 decades.

The most common diagnosed cancers globally are lung cancer (1.8 million cases, or 13% of all cancers), breast cancer (1.7 million; 11.9%) and large bowel cancer (1.4 million; 9. 7%). The types of cancers that most frequently contribute to mortality are lung cancer (1.6 million deaths, or 19.4% of all cancer deaths), liver (745,000, or 9.1% of all cancer deaths) and stomach (723,000, or 8.8% of all cancer deaths).

Developing countries have been disproportionately affected by increasing cancer incidence and mortality due to rapidly growing and aging populations, according to the report. More than 60% of all cancer cases worldwide occur in Asia, Africa, Central America and South America, and those regions account for about 70% of all cancer deaths.

“The rise of cancer worldwide is a major obstacle to human development and well-being,” Wild said. “These new figures and projections send a strong signal that immediate action is needed to confront this human disaster, which touches every community worldwide, without exception.”

Although the report cites lack of early detection and treatment access as significant obstacles to cancer control in developing countries, these regions are disproportionately affected by the double burden of high infection-related cancers — including cancers of the cervix, liver and stomach — and the increasing incidence of cancers associated with industrialized lifestyles, such as lung, breast and large bowel cancers.

Implementation of effective vaccination against hepatitis B virus and human papilloma virus could noticeably reduce cancers of the liver and cervix, according to the report’s authors. In addition, preventing the spread of tobacco use in low- and middle-income countries could have significant benefits.

The report’s authors noted that adequate legislation also could play an important role in reducing exposure and risk behaviors. For example, the Framework Convention on Tobacco Control — the first international treaty sponsored by WHO — has been instrumental in reducing tobacco consumption through taxes, advertising restrictions, and other regulations and measures that control and discourage tobacco use.

Similar interventions — such as those that target the consumption of alcohol and sugar-sweetened beverages, and limiting exposure to occupational and environmental carcinogenic risks such as air pollution — could be employed.

“Adequate legislation can encourage healthier behavior, as well as having its recognized role in protecting people from workplace hazards and environmental pollutants,” Bernard W. Stewart, PhD, co-editor of World Cancer Report 2014, said in a press release. “In low- and middle-income countries, it is critical that governments commit to enforcing regulatory measures to protect their populations and implement cancer prevention plans.”

Cancer will become a significantly larger global health care burden in the next 2 decades, with incidence expected to rise by 57% and deaths projected to increase by 63%, according to WHO’s World Cancer Report 2014.

“Despite exciting advances, this report shows that we cannot treat our way out of the cancer problem,” Christopher P. Wild, MD, director of the International Agency for Research on Cancer, said in a press release. “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.”

 

Christopher P. Wild

The number of new cancer cases worldwide, estimated at 14 million in 2012, will increase to 22 million within the next 20 years, according to the report. The number of cancer deaths is projected to increase from 8.2 million in 2012 to 13 million per year in the next 2 decades.

The most common diagnosed cancers globally are lung cancer (1.8 million cases, or 13% of all cancers), breast cancer (1.7 million; 11.9%) and large bowel cancer (1.4 million; 9. 7%). The types of cancers that most frequently contribute to mortality are lung cancer (1.6 million deaths, or 19.4% of all cancer deaths), liver (745,000, or 9.1% of all cancer deaths) and stomach (723,000, or 8.8% of all cancer deaths).

Developing countries have been disproportionately affected by increasing cancer incidence and mortality due to rapidly growing and aging populations, according to the report. More than 60% of all cancer cases worldwide occur in Asia, Africa, Central America and South America, and those regions account for about 70% of all cancer deaths.

“The rise of cancer worldwide is a major obstacle to human development and well-being,” Wild said. “These new figures and projections send a strong signal that immediate action is needed to confront this human disaster, which touches every community worldwide, without exception.”

Although the report cites lack of early detection and treatment access as significant obstacles to cancer control in developing countries, these regions are disproportionately affected by the double burden of high infection-related cancers — including cancers of the cervix, liver and stomach — and the increasing incidence of cancers associated with industrialized lifestyles, such as lung, breast and large bowel cancers.

Implementation of effective vaccination against hepatitis B virus and human papilloma virus could noticeably reduce cancers of the liver and cervix, according to the report’s authors. In addition, preventing the spread of tobacco use in low- and middle-income countries could have significant benefits.

The report’s authors noted that adequate legislation also could play an important role in reducing exposure and risk behaviors. For example, the Framework Convention on Tobacco Control — the first international treaty sponsored by WHO — has been instrumental in reducing tobacco consumption through taxes, advertising restrictions, and other regulations and measures that control and discourage tobacco use.

Similar interventions — such as those that target the consumption of alcohol and sugar-sweetened beverages, and limiting exposure to occupational and environmental carcinogenic risks such as air pollution — could be employed.

“Adequate legislation can encourage healthier behavior, as well as having its recognized role in protecting people from workplace hazards and environmental pollutants,” Bernard W. Stewart, PhD, co-editor of World Cancer Report 2014, said in a press release. “In low- and middle-income countries, it is critical that governments commit to enforcing regulatory measures to protect their populations and implement cancer prevention plans.”

    Perspective
    Clifford A. Hudis

    Clifford A. Hudis

    This year’s World Cancer Day focused on dispelling myths — and perhaps the greatest myth is to think there is nothing we can do about the growing number of people affected by cancer worldwide.

    Progress in cancer treatment has already prolonged and improved countless lives. Our parallel tasks are to ensure that everyone can benefit from these advances, no matter who they are or where they live, while continuing to accelerate the pace of progress. Given the growing global burden of these diseases, it is simply unacceptable that millions of people in developing countries still go without even the most basic forms of cancer prevention and care. Their suffering is unnecessary and avoidable.

    As we increase the efficacy of treatment, we also need to deepen the global commitment to cancer prevention. Decades of research have shown that cutting tobacco use is the single most powerful way to prevent many deadly cancers, especially in developing countries where smoking is most widespread. Tackling obesity, a key modifiable risk factor for many cancers, is another top prevention priority. In the United States, one in three cancer deaths is related to obesity, poor nutrition or physical inactivity, and the problem will only increase as more countries and regions adopt the diet and lifestyles of more economically developed economies.

    We can take action, in part by making healthier choices in our own lives and helping our patients and their families do the same. But we also need to hold national and global leaders accountable for curbing tobacco use and encouraging and ensuring access to cancer treatment and prevention resources for everyone in need.

    • Clifford A. Hudis, MD, PhD
    • ASCO President Chief, Breast Cancer Medicine Service Memorial Sloan-Kettering Cancer Center

    Disclosures: Hudis reports no relevant financial disclosures.