A: In 2000, seven
types of cancer
accounted for
approximately 60
percent of all newly
diagnosed cancer
cases and cancer
deaths in developing
countries: cervical,
liver, stomach,
esophageal, lung,
colorectal, and breast.
Cancer's Worldwide Impact:

Cancer is another noncommunicable disease long considered a health threat
primarily for high-income countries, but now imposing a considerable disease
burden worldwide.3 In 2001, cancer caused more than 7 million deaths, of which 5
million were in low- and middle-income countries. That year, cancer resulted in the
loss of more than 100 million DALYs, with nearly 75 million lost in low- and middle-
income countries. By 2020, unless cancer prevention and screening interventions
effectively reduce the incidence of cancer, the number of new cancer cases will
increase from an estimated 10 million cases in 2000 to an estimated 15 million
per year, and 9 million of them will occur in developing countries.

While cancer is a problem everywhere, it is not manifested in the same way
worldwide. A substantial portion of cancers in developing countries, up to 25
percent, are associated with chronic infection. Liver cancer is causally associated
with hepatitis B infection, cervical cancer with infection by certain types of human
papillomavirus, and stomach cancer with Helicobacter pylori infection. The
incidence of these cancers is also related to the absence of a well-developed
public health infrastructure for the control of cancer-causing infectious agents.

In 2000, seven types of cancer accounted for approximately 60 percent of all newly
diagnosed cancer cases and cancer deaths in developing countries: cervical,
liver, stomach, esophageal, lung, colorectal, and breast.

The first four exhibit elevated incidence and mortality rates in developing
countries. The last three have a lower but increasing incidence because of
demographic and industrial transitions. Developing regions also exhibit
considerable variation in their cancer burdens.

Deaths from liver cancer are relatively high in East Asia and Africa because of the
high prevalence of chronic hepatitis B infection and inadequate food storage and
preservation in those regions.

Deaths from colorectal and breast cancer are relatively high in Eastern Europe as
people in those regions have adopted less healthy, high-fat diets and more
sedentary lifestyles.

Deaths from oral cancer are particularly high in South Asia, where chewing betel
quid is common. These different types of cancer call for different intervention
strategies.



Risk Factors:

Nine modifiable risk factors are responsible for more than one-third of cancer
deaths worldwide, according to a recent estimate from researchers at the Harvard
School of Public Health and other institutions. Of these, smoking and alcohol
consumption are the most damaging, they reported in The Lancet (2005;366:
1784–1793).
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