The next biggest killer ...

Cancer, accounting for 8.2 million deaths globally in 2012, is recognized as the second most prevalent NCD worldwide.¹

 

Despite the scale of this disease, cancers frequently arise from mutations in a single or a small group of cells. These mutations affect either the cell’s DNA or the cellular mechanisms regulating its DNA sequence, resulting in abnormal growth, duplication and eventual tumour formation.^2,3 Notably, the severity of cancer depends greatly on its metastatic potential – whether or not it has the ability to spread too and infect other distant body regions.  For further explanation click here.³

Cancer infographic accessed at
http://www.infographicszone.com/health/top-10-cancer-infographics

Cancer causing mutations may be inherited, however they frequently arise from exposure to physical (UV light or ionizing radiation), chemical (asbestos, tobacco smoke and arsenic) or biological (infection with certain viruses or bacteria) carcinogens.^2,3,4  Various lifestyle factors also have a huge impact on an individual’s risk of cancer development.  Notably, 30% of cancers are preventable.⁴ These are cancers arising from a single or combination of factors including; a poor diet, tobacco use, physical inactivity and harmful use of alcohol or exposure to cancer-related infections such as helicobacter pylori (stomach cancer), HBV (liver cancer) and HPV (cervical cancer).⁴

Notably, cancer remains the leading cause of death in developing countries and is predicted to cause 2/3 of the deaths in these regions by 2020.^4-7  The growing rates of cancer within these lower socioeconomic regions are partly due to the increase in life expectancy due to gains made against infectious diseases, which have subsequently increase child survival beyond the age of 5.^5-7 However, now there exists a high incidence of malignant (metastatic) tumours arising from communicable diseases. These 2 million deaths are almost solely due to a lack of disease control and screening services within low- resource communities.  Urbanisation has also been a major contributor to the increase in lung, breast and colorectal cancers, as it has lead to increased tobacco consumption, calorie intake and alcohol abuse within low socioeconomic communities. Of all those listed above, tobacco causes 20% of both cancer related deaths within these communities, making it the highest contributing factor in cancer development within these communities.^5,6

Cancer incidence worldwide in 2012
Avalible at http://www.cancerresearchuk.org/cancer-info/cancerstats/world/

So what is being done to help?

Lack of access to both screening and treatment is responsible for the majority of cancer related deaths within low-socioeconomic communities.^5,6,8 In many middle and low income countries, access to trained professionals, palliative care, oral morphine and medication is limited. Furthermore the majority of those living in low socioeconomic communities do not have access to the screening facilities required to make an early cancer diagnosis. In the past, the global health agenda has focused solely on the treatment of infectious diseases and disease outbreak control. As the health burdens associated with commutable diseases diminishes, attention is hoped to turn towards treatment of NCDs.  With this in mind, WHO, in their 2008 report proposed that cost effective cancer interventions need to be designed which stretch across four broad categories; primary prevention and control, early detection, treatment and palliative care. It is hoped that in implementing these plans there will be a marked reduction in the number of cancer associated deaths within middle and low socioeconomic communities over the next 10 years.⁸

References

1.The NCD Alliance. Cancer [Internet] 2014 [updated  2012; cited 2015 Mar 18]. Available From: http://www.ncdalliance.org/node/40.

2. National Cancer Institute. What Is Cancer? [Internet] 2015 [updated  2015 Feb; cited 2015 Mar 19]. Available From: http://www.cancer.gov/cancertopics.

3.Biodigital. What is Cancer? New York City; Biodigital: 2008 

4. World Health Organisation. Cancer Fact Sheet [Internet] 2015 [updated  2015 Feb; cited 2015 Mar 19]. Available From: http://www.who.int/mediacentre/factsheets/fs297/en /

5. World Health Organisation. Cancer Mortality and morbidity [Internet] 2012 [updated  2012; cited 2015 Mar 20]. Available From: http://www.who.int/gho/ncd/mortality_morbidity/cancer/en/.

6. Koh H, Massin-Short S, Elqura L, Judge C. Poverty, Socioeconomic Position, and Cancer Disparities: Global Challenges and Opportunities. Geo. J. on Poverty L. & Pol’y. 2008; 15: 663

7. World Health Organisation. Cancer Mortality; age-standardised death rate per 100 000 population, both sexes 2012 [Internet] 2012 [updated  2012; cited 2015 Mar 19]. Available From: http://gamapserver.who.int/mapLibrary/Files/Maps/Global_NCD_mortality_cancer_2012.png

8.World Health Organisation. Global action plan for the prevention and control of noncommunicable diseases 2013-2020. Switzerland: WHO press; 2013. 91p.