Global Cancer Deaths to Double by 2030

Cancer deaths are projected to more than double
worldwide over the next two decades, largely from a dramatic increase in cancer
incidence in low- and middle-income countries driven by tobacco use and
increasingly Westernized lifestyles.

A new report from the International Agency for Research on Cancer (IARC)
explores the global burden of cancer, which is poised to become the leading
cause of death worldwide by 2010.

The report predicts that:

• By 2030, 27 million new cancer cases and 17 million cancer deaths will
  occur each year worldwide. That compares to 12 million new cancers and slightly
  less than 8 million cancer deaths in 2007.


• Based on current trends, the rate at which new cancers are diagnosed is
  expected to grow by 1% annually, as are deaths from the disease.


• China, Russia, and India are projected to have the biggest increases in
  cancers and cancer deaths.


• Smoking and other lifestyle factors like obesity will overtake chronic infection as the leading
  cause of cancer in poor and middle-income countries.

A report released earlier this month showed a decline in both cancer
incidence and cancer deaths for the first time in a decade.

This highlights the point that the burden of cancer is shifting to less
industrialized regions, IARC Director Peter Boyle, MD, tells WebMD.

"Forty years ago, cancer was primarily a disease of high-resource,
industrialized countries," Boyle says. "That isn't true anymore. When
we think of low-resource countries, we think of communicable diseases as the
big killers. But each year more people across the globe die of cancer than die
of AIDS ,
tuberculosis , and malaria combined."

Cancer Burden Will Double

Around the world, the burden of cancer doubled between 1975 and 2000, and it
is predicted to double again by 2020 and triple by 2030.

Boyle notes that in 1970, just 15% of cancers occurred in poor and
medium-resource countries.

Today, more than half of cancer cases and two-thirds of cancer deaths occur
in these underserved countries, and the disparity is expected to rise.

The dramatic increase in smoking in low- and medium-income countries, which
began in the mid-1980s and early 1990s, is the biggest single cause of the
projected increase, which is expected to peak in 2030.

It takes about 40 years for big increases in smoking rates to be reflected
in smoking-related diseases like lung cancer and emphysema , Boyle says.

"The big tobacco companies started to move pretty strongly into these
low- and medium-resource countries in the early 1990s at about the same time
that we were working very aggressively to reduce tobacco use in Western
countries," he says.

According to the report:

• About 1.3 billion people smoke worldwide.


• About 12% of cancers in low-income countries can be attributed to tobacco
  use, but this figure is expected to rise substantially.


• Lung cancer kills more people than any other cancer worldwide.

And cervical cancer , which is largely preventable and
treatable in the industrialized world, is a leading cause of cancer deaths
among women living in poor regions, including many areas of Africa.

Regional Differences Persist

The report highlighted regional differences in cancer incidence and
death.

Among the findings:

• Breast
  cancer rates in Japan, Singapore, and Korea have doubled or tripled over
  the last four decades.


• Across Asia, the rate of stomach
  cancer is high because of a lack of refrigeration. Since the 1930s,
  when rfrigerators became popular, mortality rates from stomach cancer in the
  U.S. have declined by about 90%.


• Chewing tobacco is an important cancer risk factor in India.


• Roughly one in three cancers in low-income countries are caused by chronic
  infections like hepatitis B, human papilloma virus (HPV), and HIV. These
  cancers are increasingly preventable or treatable, but vaccination, screening,
  and treatment are not widely available in these countries.


• In Africa, pain medication for terminal cancer
  is generally limited or nonexistent because narcotics are illegal.

ACS Issues Call to Action

In response to the report, the American Cancer Society (ACS ) joined with
other cancer groups in the U.S. today to issue a call to action to the incoming
Obama administration and the new Congress.

ACS Chief Medical Officer Otis Brawley, MD, tells WebMD that the new report
highlights the need to make vaccines that prevent cancer available to low- and
middle-income nations, to promote smoking cessation programs
worldwide, and to invest in cancer research aimed at reducing the global burden
of cancer.

"People ask, 'Why should the federal government fund research into
cancer in other countries?'" Brawley says. "The answer is that we can
learn a great deal from this research and it is the right thing to do."

By Salynn Boyles
Reviewed by Louise Chang
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