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New global killers: heart, lung disease and cancer
Question of the Day
“Most countries in Africa are currently overwhelmed with their increasing demand” from cancer patients, and the region also has the highest rates of stroke and high blood pressure in the world, Alwan said.
In Ghana, 23 million people are served by two oncology centers; the country has four cancer doctors and no specialist cancer nurses, said Dr. Allen Lichter, CEO of the American Society of Clinical Oncology, an organization of cancer specialists. The society has trained more than 2,000 doctors in developing countries on cancer care and plans to do more.
Africa also remains the only region in the world where infectious diseases, maternal-infant health problems and poor nutrition still kill more people than noncommunicable diseases do.
Worldwide, stroke and heart-related diseases account for nearly half of all noninfectious disease deaths _ 17 million in 2008 alone, WHO says. Next is cancer (7.6 million deaths), followed by respiratory diseases such as emphysema (4.2 million). Diabetes caused 1.3 million deaths in 2008, but that’s misleading _ most diabetics die of cardiovascular causes.
The U.N. chose to focus on those four diseases and their common risk factors: tobacco use, alcohol abuse, unhealthy diets, physical inactivity and environmental carcinogens.
They have varied impact around the world:
_Europe and North America. These regions are paying the price of too much eating, too little exercise and smoking: heart disease and diabetes dominate. Cancers that are more prevalent with age _ breast and prostate _ reflect long life spans in these regions where treatment is widely available. In Eastern Europe and the former Soviet Union, lung cancer is the dominant cancer in men. Europe has the highest smoking prevalence in the world: 29 percent.
_Asia. Southeast Asia has the lowest rates of obesity in the world, even lower than Africa. Yet in China, where only 6 percent of the population is obese, nearly 4 in 10 people have high blood pressure. China also has three times the death rate from respiratory diseases as the United States. Many areas also have high rates of infection with HPV, a sexually spread virus that can cause cervical cancer.
In India, the government has launched an aggressive diabetes and high blood pressure screening project. There are 51 million diabetics in India, the second-highest incidence in the world after China. Lung cancer is the most common type of cancer in India among men; in women, it’s cervical cancer.
_Central and South America. Cancer prevalence patterns largely resemble North America except that cervical cancer dominates among women in certain areas. Access to care is much poorer in many countries. Dr. Angel Sanchez, an International Cancer Corps volunteer for the American Society of Clinical Oncology, told of conditions at a hospital in Honduras, where there are more than 700 new cancer cases every year for two oncologists to handle.
John Seffrin, CEO of the American Cancer Society, said the U.N. session must lead to specific goals and more money, or a chance to make a difference with these diseases may be lost for decades.
“This is our moment in the sun,” he said. “A resolution alone is insufficient.”
By Andrew P. Napolitano
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