Remarkable scientific progress against cancer has changed very little for millions of patients globally, who face devastating physical, emotional and financial consequences after diagnosis, a new World Health Organization report has warned.
One person in five will develop cancer, according to WHO estimates, and the disease will touch 92% of people, either through their own diagnosis or that of a close family member.
Dr Andre Ilbawi, team lead for cancer control at the WHO, said: “For years, the story told about cancer has been about scientific progress, new technologies, new treatment, new hope. That story is true, and it deserves to be told, but it’s not the whole story.”
This year’s WHO global status report on cancer found “persistent and widening” inequities in access to prevention, diagnosis, treatment and care.
There are an estimated 20.6m cases, and 10m deaths, from cancer every year. Figures are projected to rise to nearly 35m cases by 2050.
In richer countries, 85% of those diagnosed with breast or childhood cancers will survive at least five years but the figure drops to less than 30% in poorer countries.
In low- and lower-middle income countries, between 9% and 54% of the WHO’s top-20 priority cancer drugs are available, compared with between 68% and 94% in high-income countries, the report found. In 23 countries there are no radiation facilities.
Diagnosis rates were lower in sub-Saharan Africa than in wealthier regions, but deaths from cancer were disproportionately high.
Two-thirds of countries do not cover cancer in universal health coverage packages, and high costs mean up to 90% of patients in some settings abandon treatment, the report said.
A global survey of patients and their families found widespread financial hardship, mental health challenges and strain on caregivers.
Abigail Simon-Hart, a breast cancer survivor and patient advocate from Nigeria, said she had “seen parents choose between paying for treatment and keeping a child in school, and children forced to abandon their education because every single available resource was spent on cancer care”.
Simon-Hart added that in some places the stigma surrounding a cancer diagnosis could be deadly. In the course of her work, she said, she had met women who chose to die rather than lose a breast to life-saving mastectomies.
The report also highlights successes including a credible path to elimination of cervical cancer, and a downward trend in tobacco use. Most countries now have national cancer action plans.
Dr Isabelle Soerjomataram, deputy head of the International Agency for Research on Cancer’s surveillance unit, which worked with the WHO on the report, said a further positive message was that “four in 10 new cancer cases are linked to risk factors which we already know how to address. This includes tobacco use, infections, alcohol use and excess body weight.”
The WHO experts called on the global community to “value care as highly as cure”, and on governments to fund cancer services from prevention to diagnosis to treatment.
