03 Nov 2009

Breast cancer: poor nations hit hard

Breast cancer is becoming an increasingly global epidemic, plaguing more people in developing countries where mortality rates are higher and many lack access to care, US researchers warned.

"We used to think breast cancer was a problem of only wealthy women, but now we know breast cancer shows no favourites: It strikes rich and poor women alike," says Felicia Knaul, Ph.D., who heads the Harvard Global Equity Initiative. "The only difference is that by the time the disease is diagnosed in poor women, it is often too late for effective treatment. "

Behind the bad news about breast cancer: infectious diseases have been losing ground; nutrition plays a role; and people in developing countries are living longer, Knaul said.

About 1.35 million cases of breast cancer will be diagnosed worldwide in 2009, accounting for 10.5% of new cancers in second place behind lung cancer, according to the study by the Harvard School of Public Health.

56% chance of dying from breast cancer in poor countries
Breast cancer cases are expected to surge by 26% by 2020 with some 1.7 million new cases most of which will be in low- and middle-income developing countries, the researchers said.

This year alone more than 55% of the 450 000 reported breast cancer deaths worldwide will be in countries that do not have the resources to deliver early diagnosis and treatment.

That is why the likelihood of dying from breast cancer -- which is highly treatable if caught early on -- hits a high of 56% in the poorest countries, 39% in middle income countries and just 24% in the wealthiest countries.

"To attack the breast cancer global problem, there is not a one-size-fits-all solution," said Dr Lawrence Shulman, head of the Dana Farber Cancer Institute and a conference leader. "What works in rural Mexico is different from what is needed in Malawi or Haiti."

More money, time needed
Key trouble spots include the lack of an adequate infrastructures so patients can be cared for; getting women to come in for screening; and overcoming the social stigma associated with breast cancer, researchers added.

In an effort to counter the challenge, Knaul, one of millions living with breast cancer, will be chairwoman of the upcoming international conference, "Breast Cancer in Developing Countries; Meeting the Unforeseen Challenge to Women, Health and Equity."

A task force first must work at expanding access to cancer education, detection and care in the developing world, the researchers said.

Currently, only 5% of the global resources for cancer are spent in the developing world, they noted. – (Sapa, November 2009)