Cancer is a Global Problem

Tomorrow is World Cancer Day. We think we have a cancer problem in the US, and we do. But other countries, especially the poorer ones, are truly suffering. Two publications by the American Cancer Society - Cancer Atlas and The Global Economic Cost of Cancer (which I quote extensively) - soberingly detail the scope of the problem.

For example, 6 out of 10 cancer patients would benefit from radiation therapy (my specialty) in the course of their cancer treatment. However, about 20 countries in Africa do not have a single radiation treatment facility. And even when radiation facilities are available, as is the case in several countries in Africa and Asia, coverage is woefully inadequate. Ethiopia, a country of around 90 million people, is served by a single radiation treatment center located in the capital city.

Similarly, although morphine to treat cancer pain is plentiful, safe, and easy to use, millions of terminally ill cancer patients in Africa and Asia die in pain because of regulatory restrictions, cultural misperceptions about pain, and concerns about addiction. Eighty-five percent of the global population lives in low- and middle-income countries, but consumes just 7% of the medicinal opioids, like morphine.          

For the first time, research has shown that cancer has the most devastating economic impact of any disease in the world. The total economic impact of premature death and disability from cancer worldwide was $895 billion in 2008, nearly 19 percent higher than heart disease. And, that figure does not include direct medical costs.

Cancers of the lung, bronchus, and trachea account for the largest drain - nearly $180 billion - on the global economy. That's not surprising, given that smokers die an average of 15 years earlier than nonsmokers. Tobacco is predicted to kill seven million people annually by 2020 and eight million per year by 2030, with more than 80 percent of the deaths taking place in low- to middle-income countries. One-third of those deaths are the result of cancers. This is almost entirely preventable.

And it isn't just lung cancer. Despite the fact that most cases of cervical cancer can be prevented or treated effectively, 274,000 women die from the disease yearly. Approximately 241,000 of these deaths are among women in low- and middle-income nations. And then there's breast cancer, colorectal cancer, and on and on.

It seems like all we hear about on the global stage is HIV/AIDS and malaria (and, more recently, Ebola) - the so-called communicable diseases. But the economic loss from HIV/AIDS ($193.3 billion) TB (45.4 $billion) and malaria ($24.8 billion) combined is not even 30 percent of the economic loss of cancer.

Why should you care?

Put simply, the global cancer epidemic is huge and is set to rise, according to World Cancer Day planners. Cancer treatment and pain management for those dying of cancer are not political issues. They are global health issues which we in the United States, with our expertise and yes, wealth, can tackle better than any other country. They are also the type of moral issues which donors and politicians of every stripe can come together to address. 

This will require effort on the part of organizations like the American Cancer Society and other NGOs, but it will to an even larger degree depend on the leadership of the United States in organizations like the United Nations and the World Health Organization, whatever you think of them. And it will depend on you. Support the American Cancer Society and ACS CAN - the American Cancer Society Cancer Action Network - so that we can create a world with less cancer and more birthdays.