The Growing C=
ancer
Burden in Developing Countries
Communicable diseases hav=
e for
long been the predominant health problem in developing countries and this
remains the case in the poorest countries (such as A=
frica,
where the AIDS epidemic has further tipped the balance), and the most
vulnerable populations in low and middle income countries. However, although the burden of
infectious disease is high, slightly more people die of cancer in developing
countries each year than die of tuberculosis, AIDS and malaria combined. The incidence of cancer overall is
markedly lower in developing countries than in affluent countries (see Figu=
re 1
for 2002 estimates), largely because of differences in the diet and smoking
rates. However, since over 80=
% of
the world’s people live in developing countries, the latter account f=
or
more than half of the global cancer burden (see Figure 2 for 2002 estimates=
). Smoking rates are at last beginnin=
g to
decline in many affluent countries, but are increasing in the poorer
nations. This, coupled to the=
fact
that population growth is largely confined to developing countries, whose
populations are aging as their socioeconomic circumstances improve, means t=
hat
the global cancer burden will fall progressively upon the countries least a=
ble
to deal with it (Figure 3). Clearly,
the time to act, in order to lessen the impact of this avoidable catastroph=
e,
is now!
![](3D"TheGrowingCancerBurdeninDevelopingCountries_files/image002.gif")
![](3D"TheGrowingCancerBurdeninDevelopingCountries_files/image004.gif")
=
&nb=
sp; =
![](3D"TheGrowingCancerBurdeninDevelopingCountries_files/image006.gif")
Unfortunately, developing
countries have limited human capital, facilities, equipment, and drugs, and
although the design and implementation of cancer control programs has been
advocated by the World Health Organization for some years, and a resolution=
to
this effect is likely to be adopted by the World Health Assembly in 2005, t=
he effective
conduct of such programs will not be possible without major improvements in=
the
available resources for cancer control.&nb=
sp;
Approaches will also need to be developed to counteract the negative
impact on capacity building that results from the loss of the most highly
trained and educated members of such societies to the more economically
privileged countries and to reduce the disparities in health service delive=
ry
that exist throughout the world, but which have a much greater impact in
countries where a high proportion of the population is already living below=
the
poverty line.
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