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Editorial: Cancer Burden and Control Measures in Africa

Issue: Vol.7, No.4 - October 2008

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Article Type: Editorial

Daniel Asrat (MD, M.Sc, PhD)
Honorary Vice Chairman of IRPC for African Chapter
Department of Microbiology, Immunology & Parasitology
Faculty of Medicine, Addis Ababa University
Addis Ababa, Ethiopia

Both developed and developed countries are suffering from growing and increasingly non-communicable diseases such as cardiovascular diseases, diabetes and cancer. According World Health Organization (WHO), the International Atomic Energy Agency (IAEA), the International Agency for Research on Cancer (IARC), cancer is accounting for 12.5% of all death worldwide and 4% deaths in Africa. By 2020 there are expected to be 15-16million new cases of cancer every year, 70% of which will be in developing countries where governments are least prepared to address the growing cancer burden which are mainly affecting their middle-aged adult population. It is estimated that in the year 2020 there will be 804,000 new cancer cases and 626,400 cancer-related deaths in Africa. Cancer is a hidden epidemic in Africa. The reported commonest cancers seen in Africa are cervical cancer (12%), breast cancer (10%), liver cancer (8%), Kaposi's sarcoma (5%), non-Hodgkin lymphoma (5%) and prostate cancer(5%). Chronic infections with hepatitis B-virus, HIV/AIDS and human papilloma virus increases the risk of developing liver cancer, Kaposi's sarcoma and cervical cancer, respectively. Other risk factors include widespread cigarette smoking, poor environmental sanitation; unhealthy diet, excessive alcohol intake, old age, and lack of physical exercise. Most African countries are unable to handle the cancer problem effectively due to factors like having few cancer care facilities, lack of resources and basic infrastructure which help the people getting access to cancer screening, early diagnosis, treatment or palliative care, limited data on cancer incidence and mortality due to lack of functioning cancer registries and limited death certification, poor referral system, lack of effective anticancer treatment, lack of awareness about cancer among the population and health care workers and lack of funding. Currently the world is working on controlling the spread of HIV, TB and malaria, which are all acknowledged to be major killers in the developing world. Larger amount of money are currently available from donors to help combat these diseases. But not much attention is given for non-communicable diseases and even for neglected diseases in neglected population such as leishmaniasis, schistsomiasis and filariasis.

This is the time to act now!! The only ways to prevent, detect and treat the rising number of cancers in Africa are as follows a) initiating cancer surveillance programs, including cancer registries that provide essential information on the incidence, prevalence, trends, mortality,and survival rates in the country b) launching vaccination programs against Hepatitis B virus, and human papilloma virus. These should be made widely available in cost effective manner. It is already documented one third of cancers in developing are preventable by vaccination. In addition reducing tobacco consumption will also prevent many cancer related deaths mainly due to lung cancer c) developing screening and early diagnosis programs d) provision of adequate anticancer treatment. It is postulated that in developing countries one third of cancer cases are curable by providing effective anticancer treatment e) provision of palliative care, an essential part of the continuous of care of terminal cancer patients with special emphasis in managing pain and total care of patients and family and f) establishing cancer centers having full capacity of handling all cancer related activities and conducting training and research.

In order to achieve the aforementioned goals the African Government should play a leading role with commitment by encouraging their Ministry of Health, Teaching and Research Institutions to establish partnerships with donors such as WHO, IARC, IAEA, the World Bank, Pharmaceutical Industries and other non governmental organizations (NGO's) and Cancer Associations to develop adequate and sustainable cancer care
system for the needy people.

Sincerely,

Daniel Asrat (MD, M.Sc, PhD)
Honorary Vice Chairman of IRPC for African Chapter

REFERENCES
1. Moeti M. Non-communicable Diseases: An overview of Africa's new silent killers. African Health Monitor, January 2008 to June 2008; 1-4

2. WHO, Cancer prevention and control in the WHO African Region (AFR/RC57/RT/1), Brazzaville, World Health Organization, Regional Office for Africa, 2007.

3. Afrox: Building Sustainable Cancer Capacity in Africa: Prevention, Treatment and Palliation. London Declaration, 2007 http://www.afrox.org/docs/Final%20Report.pdf

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