Singapore/Tokyo: Asia’s cancer rate may jump by almost 60% to 7.1 million new cases a year by 2020, straining the region’s ill-prepared health systems, said Richard Horton, editor of the British medical journal Lancet.
Aging populations, tobacco use and increasing rates of obesity are fuelling the incidence of deadly tumors in Asian patients too poor to afford the most advanced treatments including Herceptin and Avastin, sold by Roche Holding AG, the drugmaker based in Basel, Switzerland, Horton said 21 April at an international cancer meeting in Singapore.
Asia’s prevalence of cancer deaths may climb 45% to 163 per 100,000 people by 2030 from about 112 per 100,000 in 2005, according to the World Health Organization. At that rate it would overtake the Americas, where cancer-related mortalities are expected to rise to 156 per 100,000 from 136 over the same period. Europe, which has the highest prevalence at 215 per 100,000, may increase about 9% to 234 per 100,000.
“There really is going to be an incredible pandemic of cancer like we’ve not seen — we couldn’t have imagined it — over the next 20 years,” Horton said in an interview in Singapore, where he spoke at the Lancet Asia Medical Forum. “We barely have the health systems to handle infectious diseases, so how on earth are we going to deal with this?”
Cancer already kills more people worldwide than AIDS, tuberculosis and malaria combined. Spending to prevent and treat chronic diseases such as cancer and diabetes may slow the expansion of China and India, the world’s two fastest-growing major economies, researchers said at the meeting in Singapore.
“It is going to cost them a fortune in terms of health care expenditure,” Horton said, adding that it will “eliminate a huge number of people from the labour market. We think AIDS is a disaster to the world now. You have seen nothing yet.”
It costs close to $50,000 (Rs20,81,160) in Great Britain to treat a breast cancer patient using Herceptin, which generated $3.2 billion in sales last year for Roche and its partner South San Francisco, California-based Genentech Inc. In comparison, per capita government expenditure on health was $4 in Bangladesh, $7 in India, $11 in Indonesia and $22 in China in 2003, according to data compiled by the WHO.
Asia accounted for about half the 7 million cancer deaths worldwide in 2002, with 23 percent in China alone, D. Maxwell Parkin, a visiting research fellow at the University of Oxford’s clinical trial service unit, told the two-day forum.
“Historically in developing countries, people died before they could get cancer,” said You-Lin Qiao, a professor of cancer epidemiology at the Chinese Academy of Medical Sciences in Beijing. “Now they are living longer, we’re seeing more cancer and degenerative diseases of the brain,” he said.
The majority of China’s rural dwellers don’t have health insurance, Qiao said in an interview. The cost of treatment, therefore, is borne by the entire family.
Attacks on China’s medical personnel almost doubled last year to 9.83 million cases, with 5,519 staff injured, causing 200 million yuan ($26 million) in costs, the official Xinhua News Agency reported last week, citing Vice Minister of Health Chen Xiaohong.
The violence reflects the growing frustration in China over a health system struggling to provide affordable medical care, said Tony Mok, professor of clinical oncology in Hong Kong’s Prince of Wales Hospital, who consults in the southern Chinese city of Guangzhou.
“The doctor treats the patient,” Mok said. “The family thinks it is going to work. They get all their money, sell their cow, sell their house, and then the patient dies. They get very angry.”
About 1.1 million doctors and nurses are urgently needed in Southeast Asia alone, where shortages of health-care workers exist in six of the region’s 11 countries, according to the WHO’s 2006 World Health Report. Developing countries make up 85% of the world’s population, but have a third of the world’s radiotherapy machines, which are used to treat cancer.
“If nothing happens, there will be a disaster,” said Franco Cavalli, president of the Geneva-based International Union Against Cancer. “For the time being, governments don’t realize, or do not want to realize, that this is a bomb which is going to explode.”
Developing nations in Asia have little access to anti-cancer drugs now, with the U.S., Europe and Japan absorbing 95% of the global supply, Cavalli said.
‘Westernization’ of Diets
Lung cancer, Asia’s biggest cancer-killer and driven by tobacco-smoking, may increase 42% to almost 1 million deaths a year between 2005 and 2015, the Geneva-based agency reports. Stomach cancer, the second-biggest type of the disease in Asia, may grow 25% to 1.2 million deaths a year over the same period, the WHO says.
Still the “Westernization” of Asian diets, including rising consumption of alcohol and red meat, is causing higher rates of breast, colon and rectum cancer, Oxford’s Parkin said.
Pursuing sophisticated drugs and technologies for treating cancer patients “is incredibly high-cost and probably beyond the bounds of most countries” in Asia, the Lancet’s Horton said. Instead, priority should be given to a campaign to stop smoking, increase exercise and consumption of fruit and vegetables, prevent obesity and reduce salt.
“These seem simple things, but they would eradicate a vast proportion of the potential cancer burden,” he said.
Simeon Bennett and Kanoko Matsuyama, Bloomberg