February 6, 2024
Cancer represents one of the most significant global health threats of our time, affecting millions of people worldwide irrespective of age, gender, or socioeconomic status. Its impact is felt, not just in terms of the physical suffering of patients, but also through the emotional and financial strain on families and societies.
According to the National Cancer Registry, around 75000 new cancers were registered in South Africa in 2020. The magnitude of the threat cannot be underestimated. Cancer is a leading cause of death worldwide, with estimates from the World Health Organization (WHO) indicating that nearly 10 million deaths occurred from cancer in 2020 alone. The most common cancers diagnosed globally and in SA, are breast, cervical, lung, colon, and prostate cancer, which collectively account for millions of new cases each year.
Causes of Cancer
The causes of cancer are multifaceted, involving genetic, environmental, and lifestyle factors. Genetic mutations play a critical role, with some individuals inheriting genes that increase their cancer risk. Environmental factors, such as exposure to toxic chemicals or radiation, also contribute significantly. However, lifestyle choices, such as obesity, tobacco use, unhealthy diets, physical inactivity, and excessive alcohol consumption, remain among the most preventable risk factors. Often, there is not one factor that directly contributes to cancer development, but usually it’s an accumulation of risk factors over ones’ lifetime that predisposes an individual to oncogenesis.
Disparities in Cancer Care
A striking feature of the global threat of cancer is the significant disparity in cancer care across different regions and countries. High-income countries (HICs) often have better cancer detection, treatment, and palliative care facilities compared to low- and middle-income countries (LMICs). This disparity is due to several factors, including differences in healthcare infrastructure, availability of trained healthcare professionals, and access to cancer treatments. As a result, survival rates for many cancers are significantly higher in HICs than in LMICs.
Prevention and Control Strategies
Given the complexity of cancer, its prevention and control require a multifaceted approach. Primary prevention strategies focus on reducing exposure to known risk factors. This includes public health campaigns, promote healthy diets and physical activity, and reduce exposure to carcinogens. Vaccination against cancer-causing viruses like HPV and hepatitis B can also prevent certain types of cancer.
Early detection through screening programs is crucial for improving cancer outcomes, as it can lead to earlier stage at diagnosis and prompt treatment, which is associated with an increase in survival rates. This includes mammography for breast cancer, pap smears for cervical cancer, and colonoscopies for colon cancer, and urological assessments for prostate cancer.
Access to effective treatment is essential for controlling the outcomes of cancer. This includes surgery, chemotherapy, radiation therapy, and newer targeted therapies and immunotherapies. Palliative care is also crucial for improving the quality of life for those with advanced cancer, and especially for those in LMIC’s. This is due to the complex interplay between economic limitations, social structures, and environmental challenges, in which resource restricted countries such as South Africa, face significant hurdles in just meeting the basic needs of their populations.
The global threat of cancer is a complex challenge that requires a coordinated global response. Addressing disparities in cancer care is crucial for ensuring that progress in the fight against cancer benefits people worldwide. By working together, governments, non-governmental organizations, healthcare providers, and communities can make significant strides in reducing the impact of cancer on individuals and societies around the globe.
Dr Pramod Reddy
Director of the Surgical Screening Clinic and the Durban Breast Clinic, based at Busamed Gateway Private Hospital.