While much progress has been made in the “war” against cancer, a new report, presented at the 2013 European Cancer Congress (ECCO 2013) being held in Amsterdam, The Netherlands, September 27 – October 1, 2013, shows that not everycancerpatient has the opportunity to benefit from the progress made in prevention, diagnosis, treatment.

“The economics of cancer are daunting and the current model of financing is broken,” noted Professor Peter Boyle, Ph.D, President of the International Prevention Research Institute in Lyon, France and Director of the Institute of Global Public Health of the University of Strathclyde in Glasgow, United Kingdom and Lyon, France.

Boyle presented the conclusions from a report called “State of Oncology 2013” about the state of oncology in over 50 countries around the world.

Growing burden
Cancer is only part of the growing burden of chronic disease worldwide, and is set to continue to increase in the future. The report mentions a serious increase in cancer incidence in countries like India, China and Nigeria. The United Nations estimates that the current global population of 7.2 billion will reach 9.6 billion by 2050 and that by 2028 India and China will each have a population of 1.45 billion people. Best estimates are that by 2050, the population of Nigeria will have overtaken that of the United States.

Increasing the global burden
?With this population growth there will be a dramatic rise in the cancer burden in India, China and Nigeria, and these demographic increases, coupled with increases in cancer risk through the adoption of western lifestyle habits by their populations, will drive the numbers of cases of cancer diagnosed in these countries upwards. Increases in these countries, plus the surge in cases expected in populous countries such as Indonesia, Pakistan, Bangladesh and Vietnam, where rapid change is also taking place, will be the driving force behind the expected rise in the global burden of cancer, as well as in other chronic diseases,? Boyle explained.

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[We] need to deal equitably with cancer worldwide, working to improve health? [but to be successful] we really need to overcome — go beyond — our own, selfish, interests…

Advanced disease
?Many parts of the world are already unable to cope with the current situation and are totally unprepared for the future growth of the cancer problem. In lower-resource countries, for many patients the stigma associated with cancer leads them to seek alternative care and if they do present to medical services they do so frequently when the disease is advanced and only palliation is possible,? Boyle continued.

In his presentation Boyle explained that the rights of cancer patients around the globe can be honored by implementing and adhering to what he calls the Four Pillars of Oncology: prevent all cancers that can be prevented, treat all cancers that can be treated, cure all cancers that can be cured, and provide palliation whenever palliation is required.

While progress in oncology has been remarkable in recent decades, and the future looks very encouraging, not every cancer patient is able to benefit from the advances that have been made in treating the disease. The contrast in diagnosis, treatment and its outcome between the high-resource and low-resource countries is dramatic.

?It is bad to have cancer, and worse to have cancer if you are poor. The gap between rich and poor, highly educated and least educated and the north-south divide is substantial and continuing to grow. Radical solutions are urgently needed: the status quo is not an appropriate response to the current situation and philanthropy does not solve this problem either. We need new funding models to cope with and improve this situation.” Boyle said.

Public-private partnership
?If we want to make the required progress, we can’t avoid the conclusion that we need a major public-private partnership, involving a number of sources from different areas. However, such a partnership needs the commitment of the pharmaceutical industry and the wide span of industries involved in diagnostic and treatment technology. And to be really effective, it also needs the commitment of governments and non-governmental organizations. To understand the effectiveness the results need to be measured against the success in delivering the most appropriate treatment and care to every cancer patient around the globe,” he expanded.

No competition
?Given the scale of the need to deal equitably with cancer worldwide, working to improve health cannot be seen as a competition. Public and private organizations are suspicious of each others efforts and goals. But if we want to improve global cancer care and outcomes, we really need to overcome — go beyond — our own, selfish, interests. The situation described in this report, State of Oncology Report 2013 is dramatic and urgent, and all parties should put any deep-rooted suspicion behind them and develop an effective collaboration to improve this key aspect of public health throughout the world,? Boyle concluded.

For more information
[1] Abstract no: 1401: State of Oncology 2013. Public Health and Epidemiology proffered papers session, 09.00 a.m. CEST, Sunday 29 September 2013, Elicium 1

Educational Book
The Educational Book from ECC 2013 is published as a supplement to the European Journal of Cancer. [Download]

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