[Ip-health] Notes from Lancet article: Breast and cervical cancer trends for 187 countries, 1980-2010: a systematic analysis.

Jamie Love james.love at keionline.org
Thu Sep 15 16:51:55 PDT 2011


The Lancet just published:  Breast and cervical cancer in 187
countries between 1980 and 2010: a systematic analysis,
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61351-2/fulltext

The authors also put out a press release.  Here are some highlights:

*  “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, Professor of Global
Health at IHME and one of the paper’s co-authors. “We are seeing the
burden of breast and cervical cancer shifting to low-income countries
in Africa and Asia. This is one of the early signs of the emerging
threat of noncommunicable diseases in these countries. Everyone has
been talking about that threat. Now the trend is clear.”

*  In the past, complications from pregnancy and childbirth were among
the leading causes of death in women under age 50. Based on current
trends, breast and cervical cancer are likely to soon approach
maternal causes of death in developing countries. In the Middle East
and North Africa, for example, nearly 40% of all breast cancer deaths
are in women of reproductive age, compared to 10% in much of Europe.
In countries such as Bangladesh, the fraction is higher than 50%.

*   In countries such as the US, 1 in 32 women risked dying from
breast cancer in 1980, and that risk decreased to 1 in 47 by 2010. In
countries such as Rwanda, the opposite happened: 1 in 97 women risked
dying from breast cancer in 1980, and now 1 in 60 women are at risk.


http://www.healthmetricsandevaluation.org/news-events/news-release/more-women-dying-breast-and-cervical-cancer-younger-age-developing-countrie
(Short URL: http://goo.gl/x9yZT)

More women dying from breast and cervical cancer at a younger age in
developing countries
Women in high-income countries benefit from medical advances, while an
increasing number of women are at risk of dying in poor countries.
September 14, 2011 – The number of cases and deaths from breast and
cervical cancer are rising in most countries, especially in the
developing world where more women are dying at younger ages, according
to a new global analysis by the Institute for Health Metrics and
Evaluation (IHME) at the University of Washington.

Breast cancer cases more than doubled around the world in just three
decades, from 641,000 cases in 1980 to 1.6 million cases in 2010, a
pace that far exceeds global population growth. During that same
period, deaths from breast cancer rose from 250,000 to 425,000 in
2010. This much slower increase than the rise in cases indicates that
screening and treatment programs are having an impact.

Cervical cancer cases grew from 378,000 cases in 1980 to 454,000 in
2010. Cervical cancer deaths grew to 200,000 over the same period,
nearly the same pace as cases.

The new study, “Breast and cervical cancer trends for 187 countries,
1980-2010: a systematic analysis,” is published in The Lancet.

“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, Professor of Global Health at
IHME and one of the paper’s co-authors. “We are seeing the burden of
breast and cervical cancer shifting to low-income countries in Africa
and Asia. This is one of the early signs of the emerging threat of
noncommunicable diseases in these countries. Everyone has been talking
about that threat. Now the trend is clear.”
Coinciding with the study release, IHME is publishing a report, The
Challenge Ahead: Progress and Setbacks in Breast and Cervical Cancer,
which provides global, regional, and country data for cases, deaths,
and risks over the past three decades. The work was funded by Susan G.
Komen for the Cure.
“We at Susan G. Komen for the Cure have seen firsthand the growing
burden of breast and cervical cancers in our outreach to low-resource
countries in Africa, the Middle East, Latin America, and central
Europe. This report confirms what we have witnessed, and adds urgency
to calls to world health leaders to make cancer screening, treatment,
and education a priority in the developing world,” said Elizabeth
Thompson, president of Susan G. Komen for the Cure.

Komen on Sept. 13 announced a global partnership with the George W.
Bush Institute, the U.S. State Department, and UNAIDS to support
breast and cervical cancer screening in Africa and Latin America.

In 1980, 65% of all breast cancer cases were in developed countries.
By 2010, the share of breast cancer cases in the developed world
shrank to less than half, with the majority of cases now found in
developing countries. Some developing countries saw a rise in breast
cancer cases of more than 7.5% annually, more than twice the global
rate.

The risk of cervical cancer is much higher in developing countries.
Overall, 76% of new cervical cancer cases occur in developing regions.
Sub-Saharan Africa alone makes up 22% of all cervical cancer cases, or
more than 76,000 in 2010. “If more women are developing breast and
cervical cancer during their reproductive years, this adds more
pressure on families and societies already suffering from high rates
of infectious disease and child mortality,” said Dr. Mohammad
Forouzanfar, the paper’s lead author and an IHME Post-Graduate Fellow.

In the past, complications from pregnancy and childbirth were among
the leading causes of death in women under age 50. Based on current
trends, breast and cervical cancer are likely to soon approach
maternal causes of death in developing countries. In the Middle East
and North Africa, for example, nearly 40% of all breast cancer deaths
are in women of reproductive age, compared to 10% in much of Europe.
In countries such as Bangladesh, the fraction is higher than 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 expand that commitment, breast and cervical cancer
need to become a standard part of the efforts aimed at saving more
mothers’ lives.”

The authors hope researchers and policymakers will be able to build on
these findings and pinpoint some of the reasons for stark differences
between countries. In countries such as the US, 1 in 32 women risked
dying from breast cancer in 1980, and that risk decreased to 1 in 47
by 2010. In countries such as Rwanda, the opposite happened: 1 in 97
women risked dying from breast cancer in 1980, and now 1 in 60 women
are at risk.

Even within regions, the trends can be very different. Women in Peru
have half the risk today of dying from breast cancer that they did in
1980, while the risk has remained nearly the same over 30 years in
nearby Argentina, where 1 in 34 women are at risk of dying. In China,
women had a 1 in 133 risk of dying from cervical cancer in 1980 and
now have a risk of 1 in 342, one of the lowest in the world. Over the
same period, the risk of dying from cervical cancer for women living
in Thailand stayed at about 1 in 100.

“The fact that similar countries with similar populations have very
different trends tells us that all the usual suspects, such as diet
and obesity, are only part of the picture,” said Dr. Christopher
Murray, IHME Director and one of the paper’s co-authors. “This is why
it is critical to build the evidence base in this area, by gathering
data through expanded cancer registries and use of new techniques,
such as verbal autopsies. Then we will be able to answer why the
progress we are seeing in some countries is not shared elsewhere.”

The Institute for Health Metrics and Evaluation (IHME) is an
independent global health research center at the University of
Washington that provides rigorous and comparable measurement of the
world's most important health problems and evaluates the strategies
used to address them. IHME makes this information freely available so
that policymakers have the evidence they need to make informed
decisions about how to allocate resources to best improve population
health.

Media contacts

William Heisel
(206) 897-2886; cell: (206) 612-0739
wheisel at uw.edu

Jill Oviatt
(206) 897-2862; cell: (206) 861-6684
oviattj at uw.edu

--
James Love.  Knowledge Ecology International
http://www.keionline.org, +1.202.332.2670, US Mobile: +1.202.361.3040,
Geneva Mobile: +41.76.413.6584, efax: +1.888.245.3140.
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