Cancer: Global rates, prevention and chemotherapy

June 7, 2018

Healthy lifestyle, early detection can prevent up to 50% of cancer; Australia has the highest cancer rates in 2016, according to a study; while, another study finds common breast cancer may nix chemo treatment.

Cancer, the second leading cause of death worldwide, accounted for 8.8 million deaths in 2015, according to the World Health Organisation (WHO). Lung, prostate, colorectal, stomach and liver cancer are the most common types of cancer in men, while breast, colorectal, lung, cervix and stomach cancer are the most common among women. In 2010, the total economic cost of cancer reached US$1.16 trillion. The good news, according to WHO, 30-50% of cancers could be prevented.

Preventing cancer  with lifestyle modification, therapy

According to current evidence, between 30% and 50% of cancer deaths could be prevented by modifying or avoiding key risk factors, including avoiding tobacco products, reducing alcohol consumption, maintaining a healthy body weight, exercising regularly and addressing infection-related risk factors. Moreover, the availability of new treatment modalities is improving cure and recovery rates from the disease.

Prevalence of unhealthy lifestyle, aggravating the risk factors for cancer, trigger the global increase of cancer incidence.  The Cancer Research UK cited that in 2012 alone, an estimated 14.1 million new cases of cancer occurred worldwide; with lung, female breast, bowel and prostate cancer as the four most common cancer types that also account for 4 in 10 of all cancers diagnosed worldwide.  By 2030, there will be an estimated 23.6 million new cancer cases/year, the Cancer Research UK noted.

Meanwhile, in a Global Burden of Disease Cancer Collaboration study from 2006 to 2016, carried out by the University of Washington and recently published online  in Jama Oncology,  it finds that in 2016,  there were 17.2 million incident cancer cases, 8.9 million deaths, and 213.2 million disability-adjusted life-years  (DALY) due to cancer worldwide. During the study period, cases spiked by 28%, with the largest increase occurring in the least developed countries.

Of the 195 countries audited for 29 types of cancer, Australia has the highest number of new cancer diagnoses in the world based on the 2016 figures; while Syria has the lowest levels of cancer, and records the fewest deaths from the disease. Mongolia, meanwhile, accounted for the most deaths from cancer, also based on the 2016 figures.

Cancer therapy, to grow 6.5% to 2023

While the mortality risk from cancer is high, evidences suggest that a significant percentage of cancer is preventable. According to WHO, incidence of disability, suffering and deaths related to cancer can be reduced via early diagnosis, screening, treatment and palliative care. “Treatment options may include surgery, medicines and/or radiotherapy; treatment planning should be guided by tumour type, stage and available resources and informed by the preference of the patient, “ the Geneva-based institution stated. Improvement of cancer care, including access to universal health coverage, boost in government initiatives for cancer awareness, R&D Initiatives from key players, are urged.

That being said, the global cancer therapy market is also growing at a CAGR of 6.5%  from 2018 to 2023, according to a report by market analyst  Mordor Intelligence.

While the market presents upward trajectory, this may not mean that cancer patients are not aware of the surmounting health costs of treatments. Orbis Research stated that the global cost of cancer therapy and drugs went up from US$91 billion to US$ 113 billion in 2016. What constitutes to this increase are the longer duration of cancer therapies, availability of novel agents, and use of combination therapy, the report said. The cost continues to surge and is forecast to grow between 6-9% annually.

No more chemotherapy for common breast cancer type, says study

Chemotherapy is a treatment option for cancer, which involves drugs to “kill” cancer cells that metastasised from the primary tumour to other parts of the body through drugs.

This treatment has side effects, which discourage some patients from choosing this option.  Among the possible side effects, according to the American Cancer Society, are damage to healthy cells (Blood-forming cells in the bone marrow; hair follicle; and/or cells in the mouth, digestive tract, and reproductive system). Moreover,  some of the drugs can also damage cells of major organs including the heart, kidneys, bladder, lungs, and nervous system.  While there are some medications and treatments available to relieve side effects, many patients, , if they can help it,  would rather avoid this treatment.

Hence,  a study published recently in the New England Journal of Medicine, stating that a high percentage of women with a certain type of breast cancer – a hormone-receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer, may no longer need chemotherapy, is a welcome news.

Genomic Health, a US the company specialising in  genomic-based diagnostic tests said in a press statement that the TAILORx (Trial Assigning Individualised Options for Treatment -Rx) study has successfully defined the benefit of chemotherapy in early-stage breast cancer patients with test results of 11 to 25. The breast cancer treatment trial, sponsored by the National Cancer Institute (NCI), and led by the ECOG-ACRIN Cancer Research Group (ECOG-ACRIN), provided definitive evidence that the Oncotype DX test identified 70% of early-stage breast cancer patients who receive no benefit from chemotherapy, including all women older than 50 with scores of 0 to 25, and all women age 50 or younger with scores of 0 to 15,  and can be effectively treated with endocrine therapy alone. Additionally, the trial established that chemotherapy may provide life-saving benefit to 30% of patients.

The TAILORx was participated in by all major cancer clinical research groups with trial sites in the US, Canada, Ireland, Peru, New Zealand and Australia. Investigators used the Oncotype DX Breast Recurrence Score test on every patient to assign treatment or randomization in order to determine whether chemotherapy would be beneficial or not. The four research groups are the Alliance for Clinical Trials in Oncology, Canadian Trials Group, ECOG-ACRIN Cancer Research Group, NRG Oncology and SWOG.


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