Developing nations and cancer
Cancer is a complex group of diseases characterized by the uncontrolled growth of abnormal cells, which can lead to metastasis and significant health consequences. In developing nations, where economic resources are often limited, the burden of cancer is particularly severe. Factors such as inadequate healthcare infrastructure, high rates of poverty, and competing health challenges—like infectious diseases—make access to cancer prevention, early detection, and treatment difficult. The World Health Organization reports that low- and middle-income countries experience a disproportionate burden of cancer diagnoses and deaths, with significant disparities in survival rates compared to wealthier nations.
Risk factors contributing to cancer in these regions include high tobacco use, nutritional deficiencies, and exposure to infectious agents, such as human papillomavirus (HPV) and HIV, which account for a notable percentage of cancer cases. Efforts to reduce the cancer burden focus on prevention, education, and the promotion of healthy lifestyles, recognizing the economic constraints faced by these populations. Despite growing awareness and some initiatives aimed at improving healthcare delivery, challenges remain in building sustainable healthcare systems capable of addressing cancer effectively. Therefore, enhancing global cancer care in developing nations involves a multi-faceted approach that emphasizes education, infrastructure development, and accessible treatment options.
On this Page
Subject Terms
Developing nations and cancer
DEFINITIONS: Cancer describes a group of more than one hundred diseases that are a result of abnormal cells that grow unchecked in the body. These cells can spread, or metastasize, to other sites of the body when the cancer is aggressive or goes untreated. Metastases are the major cause of cancer death.
The least developed or developing countries are those with low incomes, significant poverty, few industries, minimal healthcare, and poor living conditions for the population. In these countries, cancer treatment, which requires sophisticated drugs and equipment, is rarely available, as resources are instead directed to survival, sanitation, nutrition, and other basic needs.
Impact of cancer: The United Nations created a human development index that measures the gross domestic product of a country, life expectancy, per capita income, literacy levels, and other factors, and each country is categorized as Very High Human Development, High, Medium, and Low. Most African, some Central and South American, and some Asian countries are considered low or medium. Newly industrialized countries, such as South Africa, China, and India, face cancer care issues similar to those in developing countries, but they have growing resources to address the health needs of their populations.
Because cancer affects not only the patients but also their families and communities, the economic burden is significant. It includes the cost of care and the impact of lost earnings. Other issues include poor government regulation of public health and industrial issues that increase the risk of cancer among the population.
Incidence, death, and survival statistics: The World Health Organization reports nearly twenty million global cancer diagnoses annually, causing around ten million deaths. Of all global deaths, one of every six is due to cancer. Of those cancer deaths, individuals in low- and middle-income countries experience a disproportionate rate. For example, in countries with a low HDI, women have a one in twenty-seven chance of being diagnosed with breast cancer and a one in forty-eight chance of a breast cancer-related death. In contrast, in high HDI countries, one in twelve women will be diagnosed in their lifetime, and one in seventy-one will die from it. Further, lung cancer health services are between four and seven times more likely to be included in an individual's healthcare plan in a high-income country. Mortality from cancer is generally due to lung, stomach, liver, colon, and breast cancers.
As cancer prevention, screening, and treatment improve in the developed world, incidence and deaths from cancer decrease. Experts predict incidence rates in developing nations will increase as better infrastructure allows access to earlier, more accurate testing and prevention measures. Though diagnoses may increase, experts hope to lower the death rate of cancer patients. Survival rates are bleak in Zimbabwe, Mongolia, Malawi, Serbia, and Papua New Guinea—nearly 176 people per 100,000 die following a cancer diagnosis. These patients are usually diagnosed at a late stage of the disease, presenting with complications that make most treatments futile. Men experience the highest mortality rates from lung, stomach, liver, colorectal, and prostate cancers. Deaths in women occur most frequently with breast, lung, stomach, colorectal, and cervical cancers.
Risk factors:Tobacco use is the most important related to cancer development. Use of all forms of tobacco cigarettes, cigars, pipes, and smokeless tobacco contributes to lung, larynx, esophageal, stomach, bladder, mouth, and other cancers. As per capita income grows, the use of commercial tobacco products often increases with it.
Other behavioral risk factors include excessive alcohol use, which contributes to breast, esophageal, liver, and other cancers according to the World Health Organization; nutritional deficiencies, such as a lack of fruits and vegetables in the diet; obesity; and unprotected exposure to ultraviolet (UV) light from the sun. Infectious agents and viruses, sometimes the result of unsafe sex practices, contribute to the development of cancer. In low-income countries, cancer-causing infections cause around 30 percent of cancer diagnoses. Cervical cancer, caused by human papillomaviruses (HPV), and Kaposi's sarcoma, caused by the human immunodeficiency virus (HIV), are prevalent in developing nations despite their preventable nature. The WHO Cervical Cancer Elimination Initiative aims to eliminate cervical cancer as a public health problem, particularly in the twenty-five countries where it is the most common cancer among women.
Environmental factors like air pollution and food contaminated with chemicals and mycotoxins contribute to cancer development. Agriculture is a common field of employment in developing countries, and the chemicals used can raise the workers’ risk of cancer. Mining and other nonregulated industries may also expose workers to risks. Because of fewer government regulations, chemicals banned as hazardous in developed countries are often used in developing countries.
Reducing the global cancer burden: Up to 40 percent of cancers can be prevented by controlling risk factors and promoting a healthy lifestyle, while recognizing the economic constraints of the population. The single most important factor in reducing the global cancer burden is to stop tobacco use. Education that takes into consideration economic issues and culture is the key to cancer control.
The World Health Organization and the United Nations outlined recommendations for cancer control programs worldwide, identifying critical parts of any program—prevention, early detection, prompt treatment, and appropriate care. For patients diagnosed with advanced cancers, appropriate care should be provided when there is a chance of cure or prolonged survival with an acceptable quality of life. For advanced cancers with no chance of cure, pain relief and palliative care for patients, along with support for families, are important as part of any program.
The problem with any cancer control plan is that it requires a level of healthcare knowledge and sophistication to implement. However, when developing countries are struggling to provide sanitary living conditions and sufficient food for their populations, their priorities may not include cancer control. Infant mortality, communicable diseases, tuberculosis, HIV/AIDS, and malaria compete for scarce healthcare resources.
Improving global cancer care: Public and private donations to organizations dealing with health problems in developing countries are at an all-time high. Governments, individuals, and humanitarian groups are raising billions of dollars to improve healthcare in developing countries. The International Finance Corporation of the World Bank has a public-private partnership initiative aimed at developing countries to enlist healthcare entrepreneurs to provide health-related services such as hospitals, dialysis centers, and cancer centers. Both the World Health Organization and the United Nations are involved in global healthcare efforts.
However, the lack of infrastructure to support improvement efforts presents challenges. Developing nations may have limited hospitals, doctors, nurses, and other healthcare workers. Most have little government support and regulation to support a sustained healthcare effort. The most important step in improving global cancer care is to develop a strategy to use available money to develop a healthcare infrastructure that allows ongoing diagnosis, treatment, and care of disease. The focus of cancer programs should be education and lifestyle changes to lower the prevalence of preventable cancers like those caused by HPV.
Early cancer detection with appropriate treatment in developing countries would reduce global mortality. Increasing the availability of immunizations like the HPV vaccine and resources such as radiation therapy and chemotherapy are essential steps, as are pain control and symptom management.
Bibliography
“Cancer in the Developing World: Worse than AIDS.” Economist, 1 Mar. 2014, www.economist.com/international/2014/03/01/worse-than-aids. Accessed 20 June 2024.
"Cancer Fact Sheet." World Health Organization, Feb. 2022, www.who.int/news-room/fact-sheets/detail/cancer. Accessed 20 June 2024.
"Endocrine Disruptors." National Institute of Environmental Health Sciences, www.niehs.nih.gov/health/topics/agents/endocrine. Accessed 20 June 2024.
"Global Cancer Burden Growing, amidst Mounting Need for Services." World Health Organization, 1 Feb. 2024, www.who.int/news/item/01-02-2024-global-cancer-burden-growing--amidst-mounting-need-for-services. Accessed 20 June 2024.
MacDonald, T. H. Third World Health: Hostage to First World Health. CRC Press, 2018.
Ramanakumar, A. V. “Need for Epidemiological Evidence from the Developing World to Know the Cancer-Related Risk Factors.” Journal of Cancer Research and Therapeutics, vol. 3, 2007, pp. 29–33.
Wild, C. P., Weiderpass E., and Stewart, B. W., eds. World Cancer Report. World Health Organization International Agency for Research on Cancer, 2020.