The burden of cancer in developing countries – a discussion of the challenges of prevention, early
diagnosis and treatment
65 percent of the worldwide cancer burden is from developing countries.^1 This indicates the
challenge of the prevention, early diagnosis and treatment in developing countries. In India for
example, the world’s second fastest developing country (after China), around 2-5 million people are
treated per radiotherapy unit.^2 In comparison, in Britain a single radiotherapy unit treats under
500,000 patients.^3 This demonstrates at least a four – fold difference between the two countries.
Why is this case in developing countries ? Only 5 % of the global spending for cancer care is directed
towards developing countries^4. In addition to this, many African countries lack radiotherapy
facilities all together.
It is estimated that 1 in 5 cancers in the world are caused by infectious agents.^4 Cancers caused
from infectious agents are more common amongst developing countries . Consumption of raw
fish( containing liver fluke ) may be popular due to poverty or lack of education. Liver fluke is
associated with bile duct cancer. Immunization of infants for Hepatitis B coverage various
significantly between developed and developed countries. Amongst the South-East Asian region,
WHO reported a coverage of 13 % compared to 67% for the European Region. Hepatitis B infection
can be a precursor for liver cancer. Infections from the Epstein Barr Virus, can result in Hodgkin’s
Lymphoma.
Vaccination programmes for infectious agents such as HPV have reduced the incidence rate amongst
the general population in developed countries however have yet to be properly implemented in
developing countries. In evidence, while HPV vaccines are implemented in 71 countries as of 2021, a
small number of these are developed countries. ^5
Despite HPV vaccines Gardasil and Ceravix being approved in Kenya, a significant proportion of
Kenyans are unable to afford the vaccine at the cost of 20,000 Kenyan Shillings which is more than
the average annual income for a family.^6 In addition to this, stigmas attached to the HPV vaccine
and women are prevalent in countries such as India. This reflects the lack of education in developing
countries regarding the severity of the association between infectious agents and fatal cancers.
While tobacco smoking was less prevalent among developing countries, the influence of western
countries means that Tobacco smoking is more prevalent amongst developing countries. Poor
regulation of tobacco amongst developing countries means cheaper cigarettes are smoked with
weak filters meaning more carcinogenic compounds such as Benzopyrene and acetlyaldehyde reach
the alveoli. Tobacco chewing is also more common amongst developing countries (associated with
mouth cancer )
WHO reported that only 17 % of countries in Africa had breast screening programmes in 2019.
Introduction of cervical and breast screening programmes has allowed developed nations to
diagnose cancers or “catch” cancers at an early stage. An issue with early diagnosis is the fact that
many cancers may present as asymptomatic or what is referred as delayed latency. In developing
countries, there are not enough funds for both screening and treatment. Many hospitals may not be
able to afford new technologies involved in the treatment and screening of cancers.
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