giovedì, Febbraio 22, 2024

Dopamina: il mediatore carente nel Parkinson che ha un ruolo più complesso di quanto creduto

Camminare è qualcosa che la maggior parte delle persone...

I fattori socioeconomici e relazionali come influenti sul benessere e la salute mentale

La salute mentale è fondamentale per il benessere individuale,...

Autoimmune condition under training: how exercise impacts on most common clinical conditions

The global rise in autoimmune diseases, driven by environmental...

Public health and life expectance: cancer numbers worldwide and the efforts for preventable deaths

The Organisation for Economic Co-operation and Development (OECD) estimates that ~1.9 million preventable and >1 million treatable premature deaths occurred across 38 OECD member countries in 2017. Of these, ~31% of preventable and 27% of treatable premature deaths occurred due to cancers. The global burden of cancer incurs significant societal and financial costs. For instance, in Brazil, Russia, India, China and South Africa, estimated productivity losses due to premature cancer deaths are 46.3 billion USD. While timely public health interventions could prevent premature deaths from some cancers, it isn’t a feasible approach for many cancer types. Cancer is an umbrella term encompassing many diseased states arising from genetic mutations, environmental factors or lifestyle choices. Moreover, growth rate, the likelihood of metastasis, and response to treatment vary for different cancers, raising the need for a personalized approach to manage cancer.

In the present study, researchers extended the OECD work to a global scale to explore the multifaceted variations in premature cancer deaths. They presented the burden of preventable and treatable premature deaths and estimated crude and age- and cancer-type-adjusted years of life lost (YLLs) for 36 cancer types in 2020 for 185 countries. Further, they stratified their findings by country (world region) and their Human Development Index (HDI), sex, and age groups. Results are as follow. In 2020, over 50% of 9.96 million cancer deaths occurred prematurely, i.e., before the age of 70, equating to 182.8 million YLLs. The proportion of premature YLLs in low HDI countries was higher compared to high HDI countries (68.8% vs. 57.7%). Moreover, women in low HDI countries had to bear a higher burden of premature cancer deaths than men, most of which were due to cervical cancer caused by the human papillomavirus (HPV).

Thus, increasing HPV vaccination coverage and cancer screening in low HDI countries could potentially eliminate cervical cancer. Owing to high levels of tobacco use among men in many middle-income countries, they bear a higher burden of premature deaths from lung cancer. The prevalence of lung cancer in women is also high in high HDI countries, indicating changing cancer profiles among women. Higher smokeless tobacco use among men in medium HDI countries, such as India, Bangladesh and Nepal, has led to increased dominance of head and neck cancers in men, both of which are preventable. Other preventable cancers are attributable to alcohol use, such as liver and esophagus cancers, common in Central-eastern Europe and Eastern Asia.  Together, tobacco and alcohol use, as well as environmental (air pollution) and occupational risks (asbestos exposure), impact the variability in premature, preventable cancer deaths.

Moreover, people in each country experience varying cancer risk factors; thus, the preventable proportion of premature YLLs due to cancer varies by country.Furthermore, the study estimates suggested that nearly one-third of premature YLLs from cancer(s) were preventable with equitable access to effective treatment. In high HDI countries, the quality of cancer care systems and therapeutic capacities are superior to middle- and low-income countries. Moreover, they have better infrastructure for providing essential cancer care services, such as radiotherapy, chemotherapy, and surgery.The inequities in the distribution of radiotherapy machines across low-income and high-income countries are enormous, with the former having an average of 0.06 machines per million inhabitants compared to more than seven per million in the latter, contributing to a substantial variation in premature cancer mortality.

Surprisingly, treatable premature cancer deaths due to colorectal and breast cancer remained comparable across all countries. In high-income countries, screening programs have also helped reduce premature deaths by treatment of colorectal and breast cancers in their early stages. In low- and middle-income countries, these screening programs have remained ineffective. Thus, these countries need screening guidelines customized to their specific situations to give people more access to effective cancer treatments.The right combination of primary and secondary prevention measures and more accessible and cost-effective treatments translate into multimodal quality cancer care. Low HDI countries have a larger population in premature age groups (30-69 years) and a lower life expectancy in general, resulting in a higher proportion of premature YLLs. In addition, they have weaker and fragmented health systems.

On the contrary, high HDI countries, through the cost-effective implementation of public health programs and high-quality cancer screening programs with high population coverage, have ensured that their citizens have equitable access to quality cancer care, including care for cancer survivors. In conclusion, global and national efforts for higher investments in cancer risk factor(s) reduction and vaccination [for prevention of specific cancers (e.g., cervical cancer)] are needed. Moreover, in global initiatives advocating universal health coverage, nations should appeal to address disparities in access to cancer care. Furthermore, since premature cancer death rates vary by cancer type and gender, there is a need for monitoring cancer-specific deaths in a sex-disaggregated manner.

Overall, the study data could help implement, monitor and tailor national health policies concerning cancer prevention and treatment to minimize premature deaths worldwide.

  • Edited by Dr. Gianfrancesco Cormaci, PhD, specialist in Clinical Biochemistry.

Scientific references

Frick C et al. Lancet Global Health 2023 Sep 27.

Eyre HA et. Amer J Geriatr Psych. 2023 Sep 26.

Horgan D et al. Healthcare (Basel). 2022; 10(8):1594.

Latest

Dopamina: il mediatore carente nel Parkinson che ha un ruolo più complesso di quanto creduto

Camminare è qualcosa che la maggior parte delle persone...

I fattori socioeconomici e relazionali come influenti sul benessere e la salute mentale

La salute mentale è fondamentale per il benessere individuale,...

Autoimmune condition under training: how exercise impacts on most common clinical conditions

The global rise in autoimmune diseases, driven by environmental...

Newsletter

Don't miss

Dopamina: il mediatore carente nel Parkinson che ha un ruolo più complesso di quanto creduto

Camminare è qualcosa che la maggior parte delle persone...

I fattori socioeconomici e relazionali come influenti sul benessere e la salute mentale

La salute mentale è fondamentale per il benessere individuale,...

Autoimmune condition under training: how exercise impacts on most common clinical conditions

The global rise in autoimmune diseases, driven by environmental...

Prevenzione con l’avocado per la salute del cuore: il punto fatto dalle recensioni scientifiche più recenti

L’avocado nella prevenzione delle cardiopatie L’eccesso di peso e la...
Dott. Gianfrancesco Cormaci
Dott. Gianfrancesco Cormaci
Laurea in Medicina e Chirurgia nel 1998, specialista in Biochimica Clinica dal 2002, ha conseguito dottorato in Neurobiologia nel 2006. Ex-ricercatore, ha trascorso 5 anni negli USA alle dipendenze dell' NIH/NIDA e poi della Johns Hopkins University. Guardia medica presso la casa di Cura Sant'Agata a Catania. In libera professione, si occupa di Medicina Preventiva personalizzata e intolleranze alimentari. Detentore di un brevetto per la fabbricazione di sfarinati gluten-free a partire da regolare farina di grano. Responsabile della sezione R&D della CoFood s.r.l. per la ricerca e sviluppo di nuovi prodotti alimentari, inclusi quelli a fini medici speciali.

Ernia inguinale: compare nell’anziano per colpa degli estrogeni

Un aumento correlato all'età in estrogeni può essere il colpevole dietro le ernie inguinali, una condizione comune tra gli uomini anziani che spesso richiede...

Autism spectrum disorder: DNA hunt shifts on RNA editing

More than 24 million people worldwide are estimated to have autism. In developed countries, about 1.5% of children have been diagnosed with autism spectrum...

Sclerosi multipla: l’herpes virus non è responsabile ma impedisce il riparo dei danni

L'herpesvirus umano 6 (HHV-6) può giocare un ruolo fondamentale nell'impedire la capacità del cervello di riparare se stesso in malattie come la sclerosi multipla. I...