Press. voanews.com
The World Health Organization says about half a
million Africans die of cancer each year, or six percent of global cancer
deaths annually. The leading cancers in Africa affect the breast, cervix and
prostate, according to WHO.
Dr. Andre Ilbawi, the technical officer for cancer
control at WHO headquarters in Geneva, says the cause of the illness in Africa
is not always clear, though factors that may contribute to breast cancer
include alcohol use, obesity and lack of physical activity.
Weakened immune systems also play a role, making
people susceptible to many infections and diseases, including the human
papilloma virus, or HPV, which can cause cervical cancer.
"Women in Africa have a higher rate of HIV, which
makes worse the effect of HPV," Ilbawi said, "so we see the
combination of infectious causes really can explain the majority of cervical
cancer cases in Africa and elsewhere."
Ilbawi says other infections, besides HPV, also can
lead to cancer.
"We know the immune system plays a very important
role in fighting cancer. And in some situations, infections can cause cancer
themselves," he said. "It's not always as easy as saying malaria
triggers cancer years down the line for someone exposed to malaria, but we do
know there are some cause and effects for infectious causes of cancer in
Africa. Some include hepatitis B and C, [which] contribute to liver cancer. …
There are infections in the stomach that can contribute to gastric cancer … so
infections both directly and by weakening the immune system can contribute to
cancer cases."
Early detection
Not all cancers are fatal, especially if detected
early. The WHO is working to encourage governments to adopt measures that are
low cost, but high impact, especially on the local, or primary care, level.
"Early diagnosis has a strategic position in
health expenditures because if we are able to detect cancer early, then the
costs of treatment are lower," Ilbawi said. "We know from high-income
countries that detecting cancer at stage one or two [out of four] reduces the
cost of treatment between two- to four-fold in some settings."
He also says earlier detection makes it likely that
less toxic medications can be used. WHO guidelines suggest inexpensive ways to
improve cancer detection, beginning by educating the public and health workers
on how to recognize potential symptoms.
"We need that provider to identify high-risk
symptoms and say to a patient, 'I understand you are having bleeding in your
stool or a lump or mass that may be concerning to you. It could be many
possible diseases. But what you need to do is get from the primary care level
to the diagnostic facilities, where you can access biopsy and pathology to
confirm whether it's cancer,'" Ilbawi said.
"The first-level provider is critical because
that's where most patients go first. And we have to bring those providers into
the health system for cancer — not just focus on high-cost treatment at a
centralized facility when most people can't get there, can't afford those
treatments or get there far too late," he added.
Low-cost options
Other low-cost options include providing social
workers and patient navigators who can help direct patients to facilities that
provide blood and tissue testing — and treatment. Ilbawi says therapies for
cancer patients do not have to be costly. They might involve surgery,
chemotherapy, and oral and hormonal treatments.
The WHO advises countries on how to improve cancer
care, including insurance and other mechanisms that make treatment more
affordable. Ibawi says it's a coordinated effort that includes governments,
advocacy groups, the U.N. and donors. Together, they help identify where
strategic investments can help improve health services and extend the lives of
hundreds of thousands of people.