CANCER: A growing but neglected epidemic in sub-Saharan Africa

Among the most concerning findings:

• Cancer deaths in sub-Saharan Africa are expected to double to 1 million deaths per year by 2030;
• the incidence of cancer is expected to rise to 1.4 million (new) cases per year, in the absence of rapid interventions;
• 1 in 7 women – 14% of women in sub-Saharan Africa – risk developing cancer before the age of 75, with cervical cancer and breast cancer being the leading causes of death from cancer;
• By 2050, half of the world’s childhood cancer cases might occur in Africa;
• 38% of African women abandon breast cancer treatment.

It is first of all on the lack of observance of treatments that this alert concerns

and this review, conducted at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University (Baltimore). The study calls more broadly for improved access to cancer care, prevention, screening and diagnosis and proposes a national control plan for each country in sub-Saharan Africa.

A more than worrying result:

• annual cancer deaths in sub-Saharan Africa might reach 1 million by 2030 vs 520,000 cancer deaths in 2020;
• the incidence of cancer is expected to reach more than 1.4 million cases per year;
• 4.2% of new cancer cases worldwide were in sub-Saharan Africa in 2020;
• unlike the United States and Europe, women are more affected by cancer than men in sub-Saharan Africa (139 vs 119 cases per 100,000);
• breast and cervical cancers are the most common types of cancer in the region;
• the prevalence of childhood cancers in the region exceeds 56 cases per million and by 2050 half of the world’s childhood cancers might occur in Africa.

What factors should be tackled first? Drivers of this cancer “epidemic” in sub-Saharan Africa include infections, environmental exposures, aging population, increasing adoption of western lifestyles, infrastructure issues, shortage of skilled personnel, laboratories and equipment for diagnosis, treatment and prevention. In addition to these structural deficiencies, there is insufficient compliance by patients treated for advanced-stage cancer, as well as a general lack of knowledge of the risk factors for cancer.

“The COVID-19 pandemic has exacerbated these factors, making an already dire situation worse.”

A roadmap to follow: the consortium of national and international experts, made up of researchers and clinicians, proposes a roadmap for governments and non-governmental organizations to increase access to care, accelerate prevention and increase cancer survival in sub-Saharan Africa .

“Inaction has dramatic consequences

on cancer incidence and mortality rates in sub-Saharan Africa. Although the list of obstacles to effective cancer control in the region is long, the implementation and maintenance of cancer registries, cancer control plans, screening and early detection programs, the integrating palliative care into the cancer care pathway are particularly critical interventions. The implementation of telemedicine and new technologies might improve the training of personnel specializing in oncology and accelerate cancer research.

There are solutions for the fight once morest cancer in Africa”.

The urgency of fighting women’s cancers: another study by the International Agency for Research on Cancer (IARC) confirms breast and cervical cancer as the most common forms of cancer in Africa. Cervical cancer is thus responsible for most cancer deaths (1 in 100 deaths) and remains the leading cause of cancer death among women in 27 African countries.

Virtual absence of cancer prevention programs in the region contributes to the high burden of disease, and when such programs are implemented, participation rates remain below 50% or as low as 10%, in these sub-Saharan African countries. Thus, sensitization and education come up once morest socio-cultural factors, in particular traditional beliefs. Finally, infectious diseases including HPV infection, but also smoking, alcohol consumption, excessive caloric intake can help explain this cancer burden. In particular, obesity rates, which have increased dramatically over the past 30 years. But also smoking, which is expected to increase by 41%, from 12.8% in 2010 to 18.1% in 2025 across the entire African continent.

However, some progress is noted, for example, the implementation by Rwanda of the national vaccination program once morest HPV.

Awareness and education remain a priority: Population knowledge and attitudes regarding cancer risk factors are key to reducing the cancer burden in sub-Saharan Africa. Public health campaigns will therefore be necessary to raise awareness of the risk factors and to dispel erroneous beliefs.

Finally, the abandonment of treatments remains a major cause of poor survival results.. For example, in patients with non-metastatic breast cancer requiring chemotherapy, treatment was initiated within 3 months in 66% of patients diagnosed but was only completed by 35% of patients treated. Treatment dropout is also a key factor in low survival rates for childhood cancers.

High treatment costs and poverty are major barriers to treatment access in sub-Saharan Africa and there is an urgent need for policies to ensure patients have faster and more equitable access to cancer drugs.

This broad assessment thus documents with precision the urgency of the fight once morest cancer in Africa and provides a roadmap for decision-makers to bend the curve and meet the United Nations’ sustainable development objectives: i.e. a reduction of one third of deaths of non-communicable diseases by 2030.