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More women in poor countries dying from breast cancer

African woman by Joaquin Jara

African woman by Joaquin Jara

The number of young women with breast cancer has more than doubled worldwide since 1980, say researchers at Seattle’s Institute for Health Metrics and Evaluation.

Most of this, say the University of Washington global health number crunchers, is in the developing world where women lack access to screening, prevention and treatment programs that have reduced the overall risk of breast cancer for women in the rich world.

“Women in high-income countries like the United States and the United Kingdom are benefiting from early cancer screenings, drug therapies, and vaccines,” said Dr. Rafael Lozano, a UW professor of global Health at IHME and co-author of the paper published today in The Lancet.

The findings are almost certainly going to be fodder for those advocating giving cancer more attention on the global health agenda at next week’s UN High-Level Meeting on Non-Communicable Diseases.

The study, which reviewed health data of 187 countries from 1980 to 2010, looked at both breast and cervical cancer death rates.

Over three decades, the researchers determined that breast cancer cases increased from 641,000 cases in 1980 to 1.6 million cases in 2010 (which far exceeds what would happen from population growth). Cervical cancer cases increased from 378,000 in 1980 to 425,000 in 2010, not as dramatically as breast cancer cases, and the cervical death rate (though 200,000) actually declined.

Breast cancer rates worldwide, 1980-2010

But it is the shift in the disease burden globally that is of perhaps more interest than the overall numbers.

Breast and cervical cancers have long been thought of mostly as rich-world health problems. As the UW data crunchers have shown, this is no longer the case.

The IHME study notes that in 1980, 65% of all breast cancer cases were in wealthy countries. Today, the majority of cases are in poor or developing countries. Some developing countries, the scientists report, saw a rise in breast cancer cases of more than 7.5% annually, more than twice the global rate.

And the risk of cervical cancer is much higher in developing countries. Overall, 76% of new cervical cancer cases occur in poor countries. Sub-Saharan Africa, they said, accounts for 22% of all cervical cancer cases worldwide — more than 76,000 in 2010.

“We are seeing the burden of breast and cervical cancer shifting to low-income countries in Africa and Asia,” said Lozano. “This is the one of the early signs of the emerging threat of noncommunicable diseases in these countries. Everyone has been talking about it. Now the trend is clear.”

Here are a few other news stories based on the Seattle study:

The Guardian: Cases of breast and cervical cancer on the rise in poor nations

US News and World Report: Breast Cancer Rates Jump Worldwide

Reuters: Breast, cervix cancers growing threats to the poor

One reason this study may be so important, and timely, is the UN meeting next week. The primary purpose of the meeting is to promote an expansion of the global health agenda beyond a primary focus on infectious diseases like AIDS or malaria to include chronic or non-communicable diseases like cancer, diabetes and heart disease.

It’s an ambitious goal, especially in these times of fiscal austerity. But as the IHME study shows, there’s some hard evidence justifying such and expanded agenda based on the disease burden alone.

Much of the attention on women’s health in the global health arena has been on maternal mortality, complications from pregnancy and childbirth. These were assumed — and they had been — among the leading causes of death for women under age 50.

“We have poured an enormous amount of resources into addressing the serious concern of maternal mortality worldwide, and we’ve seen a great deal of progress,” said Alan Lopez, Head of the University of Queensland School of Population Health and one of the report’s co-authors.

To some extent, Lopez said, it is possible that this increased observed mortality from cancer among young women in poor countries is due in part to the reduced risk of death from other causes. But there’s no question, he said, that breast and cervical cancer are now leading causes of death for young women in poor countries — a threat that must be addressed.

The study was funded by the Susan G. Komen for the Cure and the Bill & Melinda Gates Foundation.

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About Author

Tom Paulson

Tom Paulson is founder and lead journalist at Humanosphere. Prior to operating this online news site, he reported on science,  medicine, health policy, aid and development for the Seattle Post-Intelligencer. Contact him at tom[at]humanosphere.org or follow him on Twitter @tompaulson.