Cancer survival rates low and varied in some developing countries

There was wide variation in cancer survival among areas in Africa, Asia and Central America, demonstrating the need for improvement in awareness, population-based cancer registration, early detection programs, health services infrastructure and human resources.

“A key message for oncologists and health planners must be that cancer survival in many developing countries is abysmally low,” Michel P. Coleman, MD, a professor of epidemiology and vital statistics at the London School of Hygiene and Tropical Medicine, said in an accompanying editorial. “Substantial investment in wide public access to effective health services for early diagnosis, screening and treatment is crucial.”

Researchers analyzed data from 341,658 patients diagnosed with various cancers from 1990 to 2001. Patients were from 25 population-based cancer registries in 12 countries in sub-Saharan Africa, including The Gambia and Uganda; Central America, including Costa Rica; and Asia, including China, India, Pakistan, Philippines, Saudi Arabia, Singapore, South Korea, Thailand and Turkey. Five-year age-standardized relative survival was calculated for these regions.

For five-year age-standardized relative survival, the median rates ranged from 76% to 82% for breast cancer, 63% to 79% for cervical cancer, 71% to 78% for bladder cancer and 44% to 60% for large-bowel cancer in China, Singapore, South Korea and Turkey.

In contrast, survival was lowest in The Gambia, where it did not exceed 22% for any cancer site, and in Uganda, where it did not exceed 13% for any cancer with the exception of breast cancer, which had a survival rate of 46%.

Survival was highest among areas having well-developed health services with advanced diagnostic and treatment facilities and high per head gross national income. Conversely, survival was lowest among areas having poorly developed health services with limited availability of cancer diagnostic and treatment facilities and very low per head gross national income, according to the researchers.

Sankaranarayanan R. Lancet Oncol. 2009;doi:10.1016/S1470-2045(09)70335-3.