- Globally, breast cancer is the most common cause of cancer-related death in women, with some 327 000 deaths each year. There are 1·35 million new cases every year, and about 4·4 million women are believed to be living with breast cancer. An estimated 1·7 million women will be diagnosed with breast cancer in 2020—a 26% increase from current levels—mostly in the developing world. Breast cancer is already the leading cause of cancer in southeast Asian women, and is second only to gastric cancer in east Asian women, and to cervical cancer in women in south-central Asia. In India, almost 100 000 women are diagnosed with breast cancer every year, and a rise to 131 000 cases is predicted by 2020. To meet this important and growing health challenge, a team of researchers has established a Global Task Force and hosted an international conference, entitled Breast Cancer in Developing Countries; Meeting the Unforeseen Challenge to Women, Health and Equity at Harvard School of Public Health (Nov 3—5).
- The aims of this new initiative are to emulate what has been accomplished for patients with HIV/AIDS, tuberculosis, poliomyelitis, trachoma, and malaria, for which support from developed countries, the pharmaceutical industry, the World Bank, the Clinton and Bill & Melinda Gates Foundations, and others has expanded access to early detection and treatment of these diseases, provided a sustainable supply of affordable drugs, and led to improved health and survival.
- Currently, only 5% of global spending on cancer is aimed at developing countries. New cases of cancer diagnosed in 2009 alone will cost an alarming US$286 billion, factoring in the costs of treatment, patients' income lost to illness, and investment in research. Breast cancer accounts for nearly $28 billion, $16 billion of which is in the USA. For breast cancer about $26 billion would be needed in the developing world to bring spending in countries with low breast-cancer survival up to that of high-survival countries. Major obstacles include the lack of adequate health-care infrastructure, getting women to attend for screening, and overcoming the social stigma associated with breast cancer. There is also a crippling lack of appropriate resources and expertise that are needed for diagnosis and treatment of breast cancer in developing countries, such as diagnostic mammography, the ability to carry out surgery safely and effectively, and chemotherapy drugs and radiation therapy.
The Lancet, Volume 374, Issue 9701, Page 1567, 7 November 2009
doi:10.1016/S0140-6736(09)61930-9
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