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.
Ageing populations, tobacco use and increasing rates of obesity are fuelling the incidence of deadly tumours in Asian patients too poor to afford the most advanced treatments including Herceptin and Avastin, sold by Roche Holding AG, the drug maker based in Basel, Switzerland, Horton said at an international cancer meeting here.
Asia’s prevalence of cancer deaths may climb 45% to 163 per one lakh people by 2030 from about 112 per lakh in 2005, according to the World Health Organization (WHO). At that rate it would overtake the Americas, where cancer-related mortalities are expected to rise to 156 per lakh from 136 over the same period.
“There is going to be a pandemic of cancer like we’ve not seen—we couldn’t have imagined—over the next 20 years,” Horton said in an interview after 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’ve seen nothing yet.”
It costs close to $50,000 (Rs21 lakh) in Britain to treat a breast cancer patient using Herceptin, which generated $3.2 billion in sales last year for Roche and its partner, the 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 WHO.
Asia accounted for about half the seven million cancer deaths worldwide in 2002, with 23% 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 cancer epidemiology professor at Beijing’s Chinese Academy of Medical Sciences. “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 treatment, said Tony Mok, professor of clinical oncology at Hong Kong’s Prince of Wales Hospital, who consults in the Chinese city of Guangzhou.
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 nations, according to WHO’s 2006 World Health Report. Developing nations are home to 85% of the world’s population, but have just 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 US, Europe and Japan absorbing 95% of the global supply, Cavalli said.
Lung cancer, Asia’s biggest cancer-killer, may increase 42% to almost one million deaths a year between 2005 and 2015, the 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, WHO says.
Pursuing sophisticated drugs and technologies for treating cancer patients “is incredibly high-cost and probably beyond the bounds of most countries” in Asia, 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.