The Cancer Dilemma

| September 22, 2013 | 0 Comments

 

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Map of China’s “Cancer Villages”

According to a study released by Washington National Institute for Wellness Solutions, cancer is the top health concern among Middle-income Americans—ranking higher than concern for heart disease, stroke, or Alzheimer’s disease1. That cancer is a major health concern in the U.S. is not surprising, as age-related diseases are the cause of most deaths in industrialized nations2. What may be surprising is that cancer will soon become a major global health concern among countries across all developmental statuses. A new analysis in Lancet Oncology projected that worldwide rates of cancer are expected to jump more than 75% by 2030, with developing countries experiencing a 90% increase. This translates to 22.2 million cancer cases diagnosed in 2030, as compared to the 12.7 million cases diagnosed in 20083. At the World Cancer Declaration in 2008, the predicted upsurge in cancer rates was described as an “impeding disaster” for developing and newly industrialized countries4.

 

As life expectancies increase, an increase in age-related diseases, such as cancer, often follows. In countries where the life expectancy is low, efforts are usually focused on communicable diseases. However, among newly industrialized countries, such as China, India, and Brazil, the medical infrastructure will have to keep up with the persistence of communicable diseases as well as a dramatic increase in age-related diseases. Rates of age-related diseases within these countries are expected increase dramatically—possibly too quickly for medical infrastructure to adequately address the population’s shifting health concerns.

 

 

This double burden of disease is already present in China as cancer rates are steadily rising. Compared to the 580,350 people expected to die in the United States this year, China’s cancer death rate was about 2.5 million people in 2012. These cancer rates have shot up as China experiences high amounts of pollution, greater tobacco use, and changing diet and lifestyle, all in addition to an aging population. As a result, medical infrastructure is already inadequately prepared to handle the massive increase in cancer rates. Many villages in China have already been dubbed “cancer villages” because the cancer rates in these areas have sky-rocketed in recent years due to pollution from poorly regulated industries. In the Chinese medical system, there are often limited resources available for those diagnosed with cancer, and doctors are often blamed for “bad outcomes,” which makes willingness to diagnose and treat cancer extremely difficult to come by5.

 

 

Developing countries will also face a significant increase in cancer rates, although not as immediate or detrimental as newly industrialized countries. What type of cancer and how rates will differ depends on the country’s developmental status. In developing countries, cancer rates related to infection will be predominant, such as cervical, liver, and stomach cancer. In developed countries, cancer rates due to the environment will peak, caused by factors like an unhealthy diet, a lack of exercise, obesity, pollution, and tobacco use. Among these countries, breast, prostate, lung, and colon cancer are expected to increase6.

 

 

While industrialized countries are already including cancer prevention and treatment in their medical infrastructure, newly industrialized countries are just now beginning to adjust. Medical infrastructure needs to be updated and prepared to handle the projected rise in cancer rates. However, here in lies the dilemma: should these countries use some of their limited resources to prepare for the future cancer rates, or should they continue to focus on communicable diseases? As of now, the more prevalent communicable diseases are most likely the immediate focus. However, there may be some affordable preventive steps that newly industrialized countries can adopt. Some steps could include incorporating low cost screening to detect breast and cervical cancers as well as administering HPV vaccination to prevent cervical cancers. Efforts to control and reduce tobacco use by raising tobacco taxes and curbing public smoking may also help stem the rise of lung and throat cancer rates, as well as other respiratory diseases. By taking steps to incorporate some low-cost prevention and screening methods, newly industrialized nations may be more prepared for the oncoming storm.

 

 

[1] Middle-Income America’s Perspectives on Critical Illness and Financial Security. Washington National Institute for Wellness Solutions. 2013. (Accessed June 5, 2013 at http://www.washingtonnational.com/about-us/news-center/company-news/cancer-tops-list-of-health-concerns-among-middle-income-americans,-new-study-says/#sthash.zk1XcaRH.dpuf).

 

[2] Deaths: Preliminary Data for 2011. National Vital Statistics Report. 2011. (Accessed June 5, 2013 at  http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_06.pdf).

 

[3] Global cancer transitions according to the Human Development Index (2008—2030): a population-based study. Lancet Oncology. 2012. (Accessed June 1, 2013 at http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(12)70211-5/fulltext).

 

[4] Chan, Margaret. Cancer in developing countries: facing the challenge. World Health Organization. 2010. (Accessed June 1, 2013 at http://www.who.int/dg/speeches/2010/iaea_forum_20100921/en/index.html).

 

[5] Tatlow, Didi Kirsten.  As Cancer Rates Rise in China, Trust Remains Low. New York Times. 2013. (Accessed June 1, 2013 at http://www.nytimes.com/2013/04/18/world/asia/18iht-letter18.html?_r=1& ).

 

[6] Global cancer incidence predicted to increase by 75 per cent by 2030. Cancer Research UK. 2012. (Accessed June 1, 2013 at http://www.cancerresearchuk.org/cancer-info/news/archive/cancernews/2012-05-31-Global-cancer-incidence-predicted-to-increase-by-75-per-cent-by-2030 ). 

 

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