There’s been a surplus of encouraging news for cancer patients in the United States.
In his State of the Union address last week, President Barack Obama’s introduction of a new initiative to find a cure for cancer and his naming of Vice President Joe Biden as the leader of this effort elicited enthusiastic applause.
Earlier this month, a study released by the American Cancer Society (ACS) showed declining death rates in the U.S. for many types of cancer.
The report concluded that advances in prevention and early detection, development of new and better treatments, and steady reductions in smoking have resulted in a 23 percent drop in the cancer death rate in the U.S. since its peak in 1991.
The study, Cancer Statistics, 2016 showed that over the past decade the mortality rate dropped by 1.8 percent per year in men and 1.4 percent per year in women.
The study said the decline is driven by continued decreases in lung, breast, prostate, and colon/rectum cancer.
The results were widely reported by a variety of news organizations.
However, these reports neglected to point out that the study only looked at cancer death rates in the U.S., not the rest of the world.
Cancer is Increasing Worldwide
While rates for some cancers in the U.S. and other higher-income nations are descending, the global picture looks much bleaker.
A study authored by American Cancer Society epidemiologist Lindsey Torre that was released in December concluded that cancer death rates are in fact alarmingly on the rise in low- and middle-income countries.
Torre told Healthline there is an ongoing cancer crisis in many of the less wealthy nations of the world and the media could have done a better job of explaining that the ACS study this month was only referring to the U.S.
According to Torre’s study, there were an estimated 8.2 million cancer deaths worldwide in 2012. Of those, 5.3 million were in poorer, economically developing countries.
That number is expected to grow rapidly, reaching 13 million cancer deaths by 2030, as the population in developing countries increases, and people in those nations live longer and adopt lifestyles that raise the risk for cancer.
Torre’s study showed that the death rates of colorectal, lung, and breast cancers, which have all been more prevalent in wealthier nations, are rising in low- and middle-income countries.
These poorer countries are already burdened with high rates of infection-related cancers such as stomach, liver, and cervical cancer.
Changing Lifestyles a Factor
It seems counterintuitive, but money can indeed cause cancer.
Ruth E. Patterson, a professor in family medicine and public health at the University of California San Diego and program leader for cancer prevention at U.C. San Diego Moores Cancer Center, summed up the global cancer situation.
“As the low- and middle-income nations modernize, they're being hit with one of the curses of wealth: cancer,” Patterson said. “According to the World Health Organization [WHO], the global burden of cancer will grow by 70 percent over the next two decades.”
Patterson said much of this increase in less developed countries results from longer life spans.
“However,” she added, “around one-third of cancer deaths are due to adoption of Western lifestyles, such as poor diet, lack of physical activity, tobacco use, and alcohol consumption.”
Torre added that as countries get wealthier, people are less active, and there is less manual labor and more use of transportation. There is also more access to tasty but less healthy foods.
This all leads to the greater possibility of getting cancer.
Access to Cancer Tests, Treatments
The countries most adversely affected by Westernization and rising cancer death rates are in Asia, South America, and Africa, said Torre.
She is particularly concerned with the disparity in cervical cancer in wealthy countries versus poor countries.
“Cervical cancer today is highly preventable, thanks in large part to the recent HPV vaccine, but also because of Pap smear screening which has been around since the 1950s,” Torre said. “These things have had a huge impact.
A Pap smear can detect cancer and also detect precancerous legions and remove them. Cervical cancer is very preventable if there is access to screening.”
But cervical cancer patients in poorer nations have limited or no access to testing, or treatments, Torre added, especially in Sub-Saharan Africa.
“A Pap smear requires expertise and infrastructure, and some countries, including those in sub-Saharan African, just don’t have that,” Torre said.
Torre said there are numerous initiatives to introduce HPV vaccine in lower-income countries, in spite of the cost. HPV can be prohibitively expensive, Torre noted, but projects “are being rolled out around the world.”
“There are also some alternative screening methods being used where you don’t need as much lab equipment, it’s a more visual method,” she said.
Torre said many people still find the trends in worldwide cancer rates unexpected.
“People are surprised to learn about the high rates of death in infection-related cancers, for example, including liver cancer, which is caused by chronic infection with hepatitis C and B virus,” she said. “Stomach cancer and cervical cancer, too, are caused by infection.”
In the United States, liver cancer is also still on the rise, Torre noted, but that increase is driven by the hepatitis C virus in the baby boomer generation.
“The thought is that it could be because wide use of injection drugs in the 1960s and 1970s, and that is also related to the increase in obesity,” she said. “Liver cancer is increasing quite rapidly in the U.S. as the baby boomers age.”
This is also seen in developed countries in Australia and parts of Europe, Torre said, perhaps for the same reasons.
Cancer Rising in China, Hong Kong
Meanwhile, in China, there has been a marked increase in cancer death rates as a result of exposure to occupational carcinogens and environmental pollution associated with rapid industrialization, as well as lifestyle factors such as cigarette smoking and the adoption of a Western diet.
According to the 2014 World Cancer Report from the International Agency for Research on Cancer in Lyon, France, China accounts for more than 3 million newly diagnosed cancer cases every year. That’s more than 21 percent of the world’s total.
In the report “Comparison of Cancer Incidence between China and the USA by Cancer Biology & Medicine” in 2012, it was revealed that while the most common forms of cancer in China include lung, breast, liver, and stomach, the rates of lymphoma are rapidly rising.
Dr. Zhu Jun, director of the Beijing Cancer Hospital's lymphoma department, told the South China Morning Postnewspaper that his institute's research showed that the afflicted population of lymphoma patients is rising by more than 6 percent each year.
The Beijing Municipal Health Bureau in 2012 stated that the population of lymphoma patients in the capital more than doubled from 4.37 per 100,000 in 2001 to 9.13 for every 100,000 people in 2010. Statistics are not available on a national level.
In Hong Kong, the numbers are even more dramatic. A report released in 2011 showed a 15 percent increase in lymphoma cases over the previous decade.
But China appears to be addressing both its cancer and pollution crises more than ever before. There are efforts to reduce emissions as well as increase solar initiatives. There are also multiple biotech companies in China that are looking at new lymphoma and other cancer treatments in clinical trials.
And there is an increasing number of existing cancer treatments making their way into China as more China and U.S. pharmaceutical and biotech companies seek partnerships.
There is still a large-scale problem with access to treatments in China. But China and U.S. health observers both insist that new environmental and healthcare efforts will mean cleaner air and water, and more access to treatment for China’s in-need cancer patients.