Registries needed to track cancer deaths in poor countries, says report

Registration schemes for deaths and cancers are urgently needed in poor countries, which bear most of the global cancer burden, says a report published this week.

The report, the 2007 Annual World Cancer Data Update, estimates that there were 10.4 million new cases of cancer, 6.5 million cancer deaths, and 25 million people with cancer in 2000. It predicts that new cases will more than double to 26.4 million by 2030, with 16.4 million deaths from cancer and 75 million people living with the disease. Most of this increase will be in less developed countries.

The report has been developed by the International Agency for Research on Cancer, part of the World Health Organization. It warns, “The majority of the global cancer burden has now shifted from Westernised, developed countries several decades ago to medium and low resource countries.

“WHO regions with a large proportion of countries of low or medium resource are hardest hit, and the impact in such countries, still faced with the burden of infectious disease and a low budget for health, will be considerable in terms of the treatment needs and costs of treatment.”

Less than 20% of the world’s population is covered by cancer registration and only 30% by mortality registration schemes, according to the figures for 2000. This is not spread equally around the globe. Less than 0.1% of the population in Africa was covered by schemes that record medically certified cause of death, and only 8.5% of the population in Asia was covered.

Systems to collect data on the incidence of cancer were also less common in poor countries. The report found that 8% of the population of Africa was covered by systems for reporting incidence of cancer. In Latin America this figure reached 10%, and in Asia 7% of people were covered. In the absence of data from large portions of these populations, the agency used available data to estimate the total burden of cancer incidence and mortality.

“To move towards cancer prevention and control worldwide, we must first understand the magnitude and nature of the cancer burden in different regions of the world,” the agency said. It said that the priorities for cancer control in countries with low resources should be realistic and achievable and include a focus on the identification, delivery, and assessment of effective measures to control cancer.

The agency suggested that action against tobacco should be a priority because it will be the main cause of increasing cancer rates in low and medium resourced countries for years to come. With the delay approaching 40 years between major changes in smoking rates and disease rates, the peak in deaths from cancer related to smoking in developing countries has still to materialise, it warned. It also called for concerted, global action against breast cancer and cancer of the cervix.