Collaborative efforts needed to reduce cancer burden in Africa
MedWire News: Collaborative efforts among private and government health agencies, and the health industries are required to reduce the growing burden of cancer in Africa, say researchers.
"The burden of cancer is increasing in Africa because of the aging and growth of the population as well as increased prevalence of risk factors associated with economic transition, including smoking, obesity, physical inactivity, and reproductive behaviors," write Ahmedin Jemal (American Cancer Society, Atlanta, Georgia, USA) and colleagues in Cancer.
"Despite this growing cancer burden, cancer continues to receive a relatively low public health priority in Africa, largely because of limited resources and other pressing public health problems," they add.
The team reviewed the current burden of common cancers in Africa, based on GLOBOCAN 2008 estimates, and assessed the opportunities for cancer prevention and control in the region.
They report that, overall, 715,000 new cancer cases and 542,000 cancer deaths were estimated to have occurred in Africa in 2008.
Breast cancer was the most commonly diagnosed cancer and the second leading cause of cancer death among women, with age-adjusted incidence and mortality rates of 28.0 and 16.0 per 100,000, respectively.
Cervical cancer was the second most frequently diagnosed cancer in women (25.2 per 100,000), but was the leading cause of cancer death (17.6 per 100,000). The researchers note that some countries in East Africa had among the highest cervical cancer rates (50 cases per 100,000) worldwide, probably due to a lack of screening services, they say.
Prostate cancer was the most commonly diagnosed cancer in men (17.5 cases per 100,000), as well as the most common cause of cancer death (12.5 per 100,000), while liver cancer was the second most common male cancer (11.7 per 100,000), and the second most common cause of cancer death in men (11.7 per 100,000). Liver cancer was also the third leading cause of cancer death in women in Africa in 2008 (5.5 per 100,000).
Other commonly diagnosed cancers included Kaposi sarcoma, which is declining because of a reduction in prevalence of HIV and wider availability of highly active antiretroviral therapy, non-Hodgkin lymphoma, and nasopharyngeal, esophageal, lung, and bladder cancers.
Jemal et al observed that the incidence and mortality rates for specific cancers varied by geographic location. For example, Kaposi sarcoma was the most commonly diagnosed cancer in men in Eastern Africa (14.9 cases per 100,000) but was rare in Northern Africa (0.4 cases per 100,000). By contrast, lung cancer was the most common male cancer in Northern Africa (14.9 cases per 100,000) but was much less common in Eastern Africa (4.1 cases per 100,000).
The researchers comment that "prevention of exposure to cancer-causing agents or risk factors, including infections, tobacco use, and obesity, is by far the most feasible and cost-effective approach to cancer control in Africa."
They continue: "There are opportunities for substantially reducing the growing burden through the application of resource level interventions, including vaccination for liver and cervical cancers, tobacco control policies, [and] low-tech early detection methods for cervical cancers."
"Achieving this requires collaborative efforts among private and government public health agencies, the health industries, and donors," Jemal and co-authors conclude.
By Laura Cowen