Disparities in Cancer Care: An Urgent Global Need
When it is detected early and treated effectively, cervical cancer—the fourth most common cancer in women—is one of the most highly curable cancers. In the United States (U.S.), the rate of infection and death from cervical cancer has decreased significantly in the past 40 years, due to increased screening, including for the human papillomavirus (HPV), which causes the cancer; the HPV vaccine; and access to radiation therapy—which is the foundation for curative treatment for advanced cancers.
In low- and middle-income countries (LMICs), where access to radiation therapy is scarce or non-existent, the story is starkly different. For a young woman in Tanzania or Ethiopia, for example, a diagnosis of cervical cancer is likely to be a death sentence. Left untreated, she will suffer a long and painful illness. She can lose bladder and bowel function and be ostracized from her family and community—sent away to die alone.
The impact of her death is devastating in other ways: since cervical cancer is most often diagnosed in women under 50, children of these women are often left as orphans and neglected resulting in additional needless deaths.
Women are especially impacted by the lack of radiotherapy access. When a woman dies from cancer, her young children often die from neglect, and the death toll rises.
In LMICs, successfully treating breast cancer also depends on the availability of radiation therapy. The BBC reported last summer from Zimbabwe on 44-year-old Tendayi, who began a course of radiation therapy after undergoing breast conserving surgery and chemotherapy for stage III breast cancer. When the machine broke down, she was told the only way to fix it was to fly in an engineer from South Africa and this took months. Without timely radiation treatment, her oncologist told her that she should start thinking about having a mastectomy as her only remaining option.
Unfortunately, Tendayi’s story is all too common among women in LMICs where radiation therapy technology breakdowns and long servicing delays are the norm or where it is not available at all. The lack of access to cancer care contributes to staggering outcomes, with nine of 10 cervical cancer deaths and seven of 10 breast cancer deaths occurring in LMICs. Overall, LMICs bear the burden of 70 percent of cancer deaths.
With more than 18 million new diagnoses of cancer worldwide in 2018 and more than nine million cancer deaths, and with new cancer cases expected to reach 27 million by 2040, the need to improve access to treatment, especially radiation therapy, that can extend and save millions of lives has never been more critical.
