Why cancer in developing countries matters, in one graph | 

You already know the world is getting better. It is reason to be optimistic, but some new challenges will replace old ones.

The improving world means that more people will die of non-communicable diseases. That is medical speak for the diseases that cannot be spread from person to person. Topping the list are lifestyle diseases like cancer, diabetes and heart disease. They can be tied to the problem of tobacco use and obesity.

A graph from The Economist shows that developing countries are behind in terms of cancer rates as compared to their Western counterparts, but the mortality rates are in some cases higher.


An estimated 19.3 million people will get cancer in 2025, up from the 14.1 million new cancer cases in 2012. Diabetes killed some 3.4 million people in 2004. By 2030 it is expected to be the seventh leading killer. A similar increase will take place for cardiovascular disease, claiming 23.3 million lives annually by 2030, an increase of 5 million as compared to 2008.

Pneumonia and diarrhea are still the leading killers in developing countries, but that is going to change. In fact it is already happening. Heart disease moved up from the 10th leading killer in developing countries to the 3rd, between 1990 and 2010. The majority of cancer cases and deaths already occur in low and middle income countries.

For a deeper dive into the cancer data, read Katie Leach-Kemon’s post from Friday.

Visualizing the global rise of cancer | 

Guest post by Katie Leach-Kemon, a policy translation specialist from the University of Washington’s Institute for Health Metrics and Evaluation.

World Cancer Cases

The World Health Organization this week released its World Cancer Report, generating headlines such as:

NPR  Cancer Cases Rising At An Alarming Rate Worldwide

CNN WHO: Imminent global cancer ‘disaster’ reflects aging, lifestyle factors

Global cancer cases are rising mostly due to population growth and the fact that more people are living into older ages in low- and middle-income countries.

Experts warn that in countries with few resources, expensive chemotherapy is rarely an option, and stress that cancer prevention is the most cost-effective approach to combat the rising toll of this disease in these settings. Tools to prevent cancer range from reducing tobacco use through tighter regulation, to human papillomavirus (HPV) vaccines to prevent cervical cancer, and hepatitis B and C vaccines to prevent liver cancer.

In today’s post, we will use data visualization tools based on the Global Burden of Disease (GBD) Study 2010 to visualize these changes in greater depth, looking at trends in different types of cancer over time and comparing patterns across age groups and countries. Continue reading

No Controversy Here: Rwanda’s Effort to Beat HPV and Cervical Cancer | 

HPV CouricDaytime television host Katie Couric courted controversy where it does not exist, yesterday. She featured Emily Tarsell a woman who said the HPV vaccine Gardasil is responsible for her her daughter’s death.

Remaining guests, including medical doctors, discussed their support and opposition to the HPV vaccine. Couric builds ‘controversy’ by rising fear of vaccines based on non or pseudo-scientific claims. The ‘balanced’ style of reporting left viewers with few answers and may have caused more confusion than help enlighten misinformed Americans.

“So we’ve obviously heard two different sides about the HPV vaccine and I think for parents watching, it’s probably still rather confusing when you hear these heartbreaking stories that these parents have endured,” closed Couric.

Viwers are left thinking that there is an actual debate over the HPV vaccine when there isn’t.

There is more agreement in the medical community than Couric’s show lets on. The American College of Obstetricians and Gynecologists recommends women both receive the vaccine and are screened regularly for cancer. It is the same recommendation made by the World Health Organization for countries around the world. Continue reading

What’s Killing Us: Infographic Edition | 

Cause of Untimely Death

This awkward infographic comes to us from the Twitter feed of Bill Gates. Ther are some curious choices about the design choices, but it gets the facts across and alerts some things I did not know. For example, deaths caused by typhoid increased between 2005 and 2010. It is not surprising to see that natural disasters are taking more lives too early.

What stood out to you when first looking at the inforgraphic?

The challenge of determining cancer’s burden in Africa | 

Guest post by Katie Leach-Kemon, a policy translation specialist from the University of Washington’s Institute for Health Metrics and Evaluation.

Nurse, Sierra Leone
Nurse, Sierra Leone

In last week’s Humanosphere podcast, former National Public Radio health reporter and current University of Washington journalism educator Joanne Silberner spoke about the stigma surrounding cancer in Uganda. (Yesterday, she also talked to NPR.)

Cancer is a big killer in poor countries as well as in the rich world, but it has not been high on the global health agenda in part because many saw most forms of cancer as either too complex or too expensive to treat in the developing world.

That is not always the case and many advocates are trying to push cancer higher up on the list as part of a broader effort to move from a predominant focus on infectious disease to include non-communicable diseases like heart disease, cancer and diabetes.

Many Ugandan women who find lumps in their breast see it as a death sentence, Silberner reports, in part because of lack of access to many therapies we take for granted in the West. But Ugandan women with breast cancer are also unlikely to seek medical care partly for fear that their husbands will leave them if they have a mastectomy.

Another challenge to building the case for cancer care in the developing world is getting accurate information about the disease burden.  Continue reading

Cancer kills an awful lot of poor people, but they’re fighting back | 

Silberner interviewing a doctor who treats breast cancer in Haiti.
Silberner interviewing a doctor who treats breast cancer in Haiti.

I’m sick with a cold, so I suppose it’s fitting that we discuss disease on this week’s Humanosphere podcast. Who better to talk to than Joanne Silberner, who reported on health for National Public Radio for 18 years?

Silberner now teaches journalism at the University of Washington, but over the past few years, she’s also been reporting for PRI’s The World and other media on non-communicable diseases in the developing world. She points out that even though malaria, tuberculosis, and HIV are usually considered “the big three” killers in global health, cancer kills more people in low- and middle-income countries than all of those combined, according to the Fred Hutchinson Cancer Research Center.

Traveling and reporting from Cambodia, India, Uganda, and Haiti (where I joined and worked for her), Silberner’s been up close and personal with impoverished patients afflicted by cancer, as well as fledgling but growing treatment efforts. These solutions are often amazingly simple, but getting people to overcome stigmas and use them is a challenge. Some treatments are exceedingly expensive – chemotherapy, for example – but health workers are trying to bring them to low-resource settings anyway.

I also ask her about getting journalism students interested in global health, whether Seattle really is the epicenter for the field, and about other neglected diseases, including diabetes, high blood pressure, hypertension, and mental ailments. In the headlines portion, I chat with East Coast correspondent Tom Murphy about his just-finished reporting trip to Kenya and challenges facing the widely-heralded One Acre Fund.

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Stigma faced by Ugandan women with breast cancer | 

Stigma, misinformation and poverty all conspire against women suffering from breast cancer, reports Denise Grady for the New York Times.

Her excellent story profiles some of the women in Uganda who are suffering from breast cancer and are trying to seek treatment. One of the people is Jessy Acen, a thirty year-old mother of two whose husband abandoned her after she was diagnosed.

Cancer had caused immense, painful swelling on the left side of her face, and in her left arm and hand. The disease had also spread through her skin from one breast to the other and erupted into oozing sores that she treated by wrapping her chest in bandages. She often sat with the swollen arm cradled in her lap, a position one comes to recognize among women here with advanced breast cancer.

The disease was diagnosed in 2008 when she was only 25. She had a mastectomy at a hospital near home and began chemotherapy, but could not afford the full course of drugs. Within a year, the cancer sprang back, invading her armpit, blocking lymph nodes and causing the swelling in her face and arm.

“When she made contact with us, she had advanced disease,” said Dr. Fred Okuku, an oncologist at the cancer institute. “Straight to the lung, straight to the liver. And what we’ve been doing is to try to prolong her life, and also give her treatment with the aim of reducing the pain.”

Watch Jessy’s story above, read more about it here and read another article about stigma and poverty’s affect on cancer in Uganda here. It is worth your time to read both.

Scientists identify China’s mysteriously massive cancer burden | 

Tai Chi in the park

Flickr, PTorrodellas

Tai Chi in the park

Scientists in Seattle, Australia and China report in The Lancet today on the leading causes of death and disability – as well as the many positive health trends – in a rapidly modernizing China.

Perhaps unsurprisingly, the study, based on Global Burden of Disease data compiled at the University of Washington’s Institute for Health Metrics and Evaluation (IHME), found that China’s rapid economic development over the past few decades has been accompanied by a decline in ‘diseases of poverty’ like malaria, vaccine-preventable infectious diseases and child malnutrition.

The world’s largest nation and new emerging superpower also has seen remarkable progress at lowering childhood and maternal mortality, along with an equally unsurprising rise in the burden of diseases and disorders familiar to wealthier countries such as heart disease, stroke and dementia. Air pollution gets special attention as well.

NPR reported As China Gets Richer, First World Diseases Take Hold, which was the primary theme of the The Lancet special report on China. Similarly, Forbes reported that China’s health problems mirror wealthy nations.

Not quite.

One surprising – and not completely understood or explained – finding out of the study is that China appears to be the undisputed world leader for certain cancers: Liver, stomach and esophageal.

I asked a policy translation specialist at IHME, Katie Leach-Kemon, to dig into this a little deeper using one of IHME’s data visualization tools known as a ’cause pattern’ analysis. Leach-Kemon compiled this graphic below showing age-standardized rates of years-of-life-lost due to different cancers around the world. Here’s a link to the active chart online. Notice my red highlights:

China Cancer GBD CompareMarked


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