Low income countries to continue reporting higher cases of cancer, new WHO report says

Dr Victor Oria

February 8, 2024

A new report by the World Health Organization’s International Agency for Research on Cancer shows that there were 20 million new cancer cases and 9.7 million deaths in 2022.

The report projects that new cancer diagnoses will reach 35 million by 2050, an increase of 77 percent from the 20 million cases reported in 2022. According to the report, about 1 in 5 people will develop cancer in their lifetime.

Low-and-middle-income countries will continue reporting the highest incidences of cancer. This projected growing burden of cancer presents a stronger case for concerted efforts to tackle the disease.

Factors such as air pollution, obesity, alcohol, and tobacco consumption are still some of the major risk factors associated with this increased burden. In 2024, the theme for World Cancer Day celebrated on February 4, was Together, we challenge those in power. This theme aimed to pressure global leaders to prioritize and invest adequate resources toward cancer prevention, care, and research.

In Africa, the cancer situation is overwhelming. In 2022, there were 1.173 million new cancer cases, slightly increasing from the 1.1 million cases reported in 2020. During the same period, cancer mortality cases rose from 700,000 to 756,531.

Cancer mortality cases  projected to rise

About 49.3 percent of new cancer cases in Africa are attributed to breast (16.8 percent), cervix uteri (10.6 percent), prostate (8.7 percent), liver (6.2 percent), and colorectal (6.0 percent) cancers.

If the continent does not prioritize preventive measures, cancer mortality cases are projected to rise to about one million by 2030. While the cancer survival rate in high-income countries is about 80 percent, the survival rates in Africa currently average at 12 percent.

In Africa, cervical cancer poses one of the greatest threats to women’s survival. While it is the eighth most common cancer globally, in Africa, it is the second most common cancer, accounting for 10.6 percent of all cancer cases in the continent.

In 2022, Africa had about 19 percent of global cervical cases, and 23 percent of cervical cancer deaths reported globally. This high rate of cervical cancer incidence and mortality in Africa is related to health inequities linked to screening services, low HPV vaccination rates, socioeconomic determinants like poverty, and the high prevalence of HIV on the continent.

Cervical cancer is a preventable disease, and Africa’s cancer burden will be manageable if measures are taken to protect women against this disease.

HPV vaccination program

According to one public health study, about 74 percent of cervical cancer cases in Africa can be prevented through HPV vaccination. Yet Africa is still lagging in implementing this preventive measure. As of 2022, only 22 out of 54 countries (40 percent) had included HPV vaccination in their national immunization programs. Nonetheless, the HPV vaccine coverage in Africa is still low, with first-dose and last-dose coverage at 33 percent and 25 percent, respectively.

Rwanda was the first country in sub-Saharan Africa to implement the HPV vaccination program in 2011, covering about 76 percent of the eligible population. Longitudinal studies following these vaccinated girls are essential to track the evolution of this disease in the country.

While cervical cancer is still a leading cause of death in Rwanda, this is likely contributed by women born before the HPV vaccination program began. Countries like the United Kingdom that introduced routine HPV immunization earlier demonstrate that vaccination works.

Preventing cervical cancer

Based on 2022 statistics, cervical cancer was the 20th most common cancer in the UK, accounting for 0.71 percent of all new cancer cases and 0.6% of cancer-related mortality. This is not by chance but because of the high coverage of HPV vaccination in the United Kingdom.

In addition, we must also commend the United Kingdom for proposing and implementing HPV vaccination for boys aged 12-13, a program that began in 2019.

January is the cervical cancer awareness month, and many events were held in many African countries to sensitize the public about screening and HPV vaccination. While this is commendable, the best lesson can be adopted from Scotland, where routine HPV immunization was introduced in 2008.

A longitudinal study by Public Health Scotland and the Universities of Edinburgh and Strathclyde showed no cervical cancer cases in women who were fully vaccinated at age 12-13.

This study concluded that the HPV vaccine is highly effective in preventing cervical cancer. Further, it noted that vaccination should be combined with regular screening for early detection and treatment to protect against cervical cancer.

Even as Africa raises awareness about cervical cancer, the best way to combat this disease is to improve HPV vaccination rates. The African Union and public health stakeholders must collaborate to ensure all countries incorporate HPV vaccination in their national immunization programs. Preventing cervical cancer is the best way to reduce the burden of this disease.

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Dr Oria (PhD) is LEAD Fellow, Prof Janine Erler Research Group, Biotech Research and Innovation Centre – University of Copenhagen, Denmark.


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