Burden of Breast, Cervical Cancer Falls Mostly to Low-, Middle-Income Countries

A new paper highlights the global inequities in access to prevention, early detection and treatment for breast cancer and cervical cancer. Where a woman lives, and how she lives will play a large part in whether or not she develops one of these cancers, when she gets health care services, and her access to treatment services, according to the paper published in Lancet.

“In low-resource settings, breast and cervical cancer disproportionately affect women in the prime of life, resulting in substantial economic and societal effects,” wrote Ophira Ginsburg, MD, of the University of Toronto in Canada. “A woman’s country, region of residence, income level, socioeconomic status, ethnocultural status, or migration status should no longer affect the likelihood of dying from these common cancers.”

According to the paper about 1.7 million women are diagnosed with breast cancer each year and breast cancer is the most commonly diagnosed cancer in women in 140 countries. Breast cancer survival in low- and middle-income countries is lower than in high-income countries. For example, the 5-year survival rates for breast cancer ranges from 50% in countries such as South Africa, Mongolia, and India to more than 80% in countries like Australia, France, and the United States. Mortality rates are highest in the Pacific Islands, the Caribbean, sub-Saharan Africa, and southern Asia.

Cervical cancer is less common, diagnosed in more than half a million women worldwide in 2012. However, in countries like sub-Saharan Africa it is the most common cancer diagnosed in women. Cervical cancer screening is more common in high-income countries like Canada, the United States, and the United Kingdom resulting in lower age-standardized cervical cancer rates (less than 7.9 per 100,000 women) compared with countries in sub-Saharan Africa and central and South American (40 per 100,000 women).

“Disability and premature death from breast or cervical cancer is a preventable tragedy for hundreds of thousands of women and their families every year,” the researchers wrote. “In 2012, breast and cervical cancer were responsible for the deaths of 522,000 and 266,000 women worldwide respectively; as such, around half a million more women died from these two cancers alone than from complications of pregnancy or childbirth.”

The researchers used data from long-standing high-quality population-based cancer registries to estimate the predicted future global burden of breast and cervical cancer in 2030. If rates are maintained at the level of 2012, the number of women with breast cancer will increase to 2.4 million cases per year based on demographic changes; however, if average changes continue it will increase to almost 3.2 million per year.

If cervical cancer rates remained unchanged, they estimated that as many as 700,000 women per year could be diagnosed by 2030. Even if cervical cancer rates decrease in all countries worldwide the same number of women diagnosed today would be diagnosed in 2030, around 510,000.

“International efforts have recently led to major improvements in maternal health outcomes: a similar global drive is urgently needed to reduce the effects of breast and cervical cancer, which currently take the lives of around 800,000 women every year,” the researchers wrote.