Bridging the cancer divide: The critical role of early screening and lifestyle changes in developing nations

Cancer is a major health hazard not only to individuals but also to economies as the rising number of patients puts a heavy burden on their health infrastructure and poses a serious threat to human capital.

Its catastrophic effects will be more visible in the low- and middle-income countries as their public health spending is meagre. If we consider India, an emerging economic powerhouse, it spent only 1.9 per cent of its GDP for healthcare in FY24. Naturally, low-income economies lack sufficient medical infrastructure to handle a huge influx of patients. The absence of adequate health cover also makes private healthcare a costly affair for a majority of patients.

According to a World Cancer Research Fund International report, though the overall cancer incidence is high in advanced economies, the highest rate of cancer deaths is seen in developing nations. Mongolia is at the top considering the number of cancer-related deaths, followed by Zimbabwe, Hungary, Poland and Romania. The report says the highest cancer rates were registered in Australia, Denmark, the US, France and Ireland, but these countries were able to raise the survival rate because of their early screening mechanisms and advanced medical facilities.

There are glaring disparities in cancer detection and treatment facilities across the countries. The global estimates, alongside a survey from WHO, also revealed striking inequities in the cancer burden, especially for female breast cancer, according to the Human Development Index (HDI). The HDI measures three factors: life expectancy at birth, education, and standard of living. A survey by International Agency for Research on Cancer (IARC) reveals that 1 in 12 women will be diagnosed with breast cancer in their lifetime, and 1 in 71 women will die of it. In contrast, in countries with a low HDI, only 1 in 27 women will be diagnosed with breast cancer in their lifetime, but 1 in 48 women will die from the disease. The data also revealed global inequities in cancer services, with most countries failing to adequately finance “priority” cancer and palliative care services as part of universal health coverage.

Evidently, the growing burden of cancer creates disastrous results in the low- and middle-income nations. For them, the best strategy to protect people from this danger is prevention rather than treatment as these countries are often marked by inadequate public health infrastructure and low penetration of health insurance. Here, apart from building capable response mechanisms, the urgent step is to sensitise people to follow a healthier lifestyle and go for regular health screenings.

Undoubtedly, cancer prevention is a serious public health challenge. In developing economies, cancer spread is largely due to changes in lifestyle and food habits. Rapid changes in lifestyle and food may incite the causes of this deadly disease. The rising consumption of alcohol, tobacco and high-fat food is leading to an increased risk of cancers. Additionally, air, water and food pollutions are other key drivers of cancer risk. Health experts say that almost 40 per cent of cancer cases can be avoided by addressing the risks associated with food, lifestyle and physical exercises.

Urbanisation and longer life expectancy are two major factors that activate lifestyle changes. According to US’ National Cancer Institute, there were almost 20 million new cases in 2022 and 9.7 million cancer-related deaths worldwide. By 2040, the number of new cases in a year is expected to jump to 29.9 million and the number of cancer deaths to 15.3 million. A majority of these deaths would be occurring in the low-and middle-income countries due to their poor health infrastructure.

Lack of awareness in poorer economies is even more appalling. For example, a global survey by WHO found that cervical cancer is the most common cancer among women in 25 countries, including many sub-Saharan African nations. Though this cancer variety can be effectively eliminated through vaccination among girls, the awareness and initiatives in those countries were shockingly poor.

In many countries, awareness, screening, and early detection mechanisms are so poor that people succumb to the disease at the early stages of life. They often detect cancer only when it is progressed to advanced stages like stage-3 or stage-4, which significantly reduces the survival chance. Apart from building adequate health infrastructure, the developing nations should encourage people to undergo periodic screenings and follow a healthy diet to stem the alarming rate of cancer-related mortality.

Also, promoting a culture of early screening and regular reviews helps people avoid costly treatments at a later stage. Now, technology has made the screening and early detection processes much simpler, especially with the advent of AI-driven diagnostics, which bring more precision and accuracy in cancer detection.

The rising cancer burden and its economic impacts may vary depending on the countries. The poorer countries that have less resources to fight the disease will have to face more of its serious fallouts. Alarmingly, cancer mortality in the low- and medium-HDI countries is estimated to double in the next 25 years. So, these nations should focus more on early screening and detection, which are the most effective, impactful and low-cost ways of preventing the disease. Otherwise, out of the 30 million new cancer cases estimated to come out in 2040, a significant share would be from the low- and middle-income countries.