The Lynx Group

The State of Cancer Globally in 2013

October 2013, Vol 4, No 8

Amsterdam, The Netherlands—Although much progress has been made in cancer care over the past couple of decades, a report presented at the 2013 European Cancer Congress emphasizes that on a global scale, the impact is far from equitable.
“Many parts of the world are already unable to cope with the current situation and are totally unprepared for the future growth of the cancer problem,” said Peter Boyle, PhD, DSc, President, International Prevention Research Institute, and Director, Strathclyde Institute for Global Public Health, Lyon, France.

A report called “The State of Oncology 2013,” spearheaded by Dr Boyle, with an educational grant from Roche, intends to inform the scientific and lay communities and their political representatives about the status of oncology around the world.

Dr Boyle called for a “radical solution” to the problem—asking the private sector, primarily the pharmaceutical and medical device industry, to lead the charge.

Global Burden Increasing
Dr Boyle and colleagues estimate that by 2030, the global incidence of cancer will reach 26.4 million, and cancer deaths will be 17 million. More than 50% of cases and 66% of cancer deaths will increase in low- and medium-income countries, with 30% increase over time compared with only 4% increase in high-income countries, Dr Boyle said.

The steady rise in population, the aging of the population around the world, and the increase in smoking among the poor will influence the burden of care. All will combine to increase the cancer burden, with low- and medium-income countries most affected.
“It is bad to have cancer, and worse to have cancer if you are poor. The gap between rich and poor, highly educated and little educated…is substantial and is set to continue to grow. Steady progress continues to be made in oncology, but not all patients have had the benefit of this progress,” Dr Boyle said at a press briefing.

Resources Lacking
In lower-resource countries, the high mortality rate from cancer is largely due to advanced disease at presentation and the lack of appropriate diagnostic and treatment modalities and facilities.

“For instance, there is often just 1 radiotherapy machine for an entire country, and it is usually outdated and even broken,” Dr Boyle said. In Africa, the actual supply of radiotherapy machines is 20% of the country’s need, and in the Asia-Pacific region, there is a need for 4000 radiotherapy machines, although just 1200 or so exist. “It is clear that accessible, affordable, and suitable radiotherapy technologies are needed,” he said.

Beyond clinical services, the availability of basic medications for symptom control remains an enormous challenge. “Patients in the final stages of cancer are frequently in terrible pain, with only paracetamol (a mild analgesic) available in many places,” Dr Boyle noted.

Need for Radical Solutions
Radical solutions are the only reasonable response to these dire predictions, Dr Boyle and colleagues maintain. “Current models are broken. We need a new model of financing to cope with this situation and those to come,” he said.

The estimated cost of achieving parity around the world for patients with cancer is $250 billion. Since “no source of philanthropy, government, or institution can afford this investment,” Dr Boyle said, the report is proposing a private–public partnership. “Global funds, such as those funding HIV/AIDs efforts, are totally inadequate for dealing with cancer. We need a new model and, to my mind, this should be driven by the private sector.”

Dr Boyle acknowledged that the pivotal question will be “what’s in this for industry,” but he believes that industry will see the need to seek “the greater good.”

“I think there may be enough support to make this work,” he said, adding that his group is in “serious discussions” with some members of that community “and we hope to make a big announcement in the fall of 2014.”

The commitment should have as its “metric” the right of every patient with cancer to have the most appropriate treatment and care, Dr Boyle said.

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