Crucial to direct attention towards cancers unique to low, middle-income countries: US-based expert

New Delhi: Low and middle-income countries are grappling with dual burden of non-communicable diseases and infection ailments, and it is crucial to "direct more attention" towards cancers prevalent or unique to such countries, a US-based cancer expert has said.

Citing data, Dr Shobha Krishnan also said that as cancer cases in India are projected to rise by nearly 13 per cent by 2025 compared to 2020, the "urgency to exchange knowledge and best practices is critical".

Krishnan, founder and president of US-based Global Initiative Against HPV and Cervical Cancer (GIAHC), was in India recently to take part in the first-ever US-India cancer dialogue held in Delhi earlier this month.

In June 2023, President Joe Biden and Prime Minister Narendra Modi had reaffirmed the strong health partnership between the US and India by announcing new commitments to accelerate the fight against cancer, including convening a US-India cancer dialogue to advance the prevention, early detection, and treatment of cancer.

According to WHO, cancer is the second leading cause of death globally, accounting for an estimated 9.6 million deaths, or 1 in 6 deaths, in 2018.

As a non-communicable disease (NCD), cancer is a major killer, particularly in low-income and middle-income countries where access to both means of diagnosis and treatment is lesser.

"Low and middle-income countries (LMICs) are grappling with a dual disease burden as non-communicable diseases, such as cancer, increase rapidly alongside persistent infectious diseases. Although numerous collaborations between LMICs and high-income countries (HICs) focus on cutting-edge research and treatment, it is crucial to direct more attention toward cancers prevalent or unique to LMICs," Krishnan told PTI.

Implementing practical solutions is key, particularly for cancers like cervical cancer, which imposes "a significant burden in LMICs".

Cost-effective measures, such as HPV (human papillomavirus) vaccination, screening, and early treatment for positive cases, are available today and should be prioritised, she added.

In India, NCDs, including cancer, are responsible for approximately 63 per cent of all deaths. Addressing this challenge requires a "concerted effort to reduce the burden of cancer effectively and promptly", the cancer expert emphasised.

Lung cancer is the most commonly diagnosed cancer worldwide (12.4 of the total cases) and breast cancer is the most common among women globally, she added.

"The cumulative risk of being diagnosed with female breast cancer by age 75 years is 3 per cent in India, 9 per cent in the US; 10 per cent in the UK; and 5 per cent globally. Lifetime risk of breast cancer among females in high-income countries can be up to three times more that in low-income countries," Krishnan said in a written response to PTI queries sent on email.

Discussions during the two-day cancer dialogue, attended by experts from India and the US, were centered around AI-enabled innovation for cancer care, novel therapeutics -- vaccines, immunotherapy, and other biologicals, among a host of other subjects.

Krishnan made a presentation on, 'Cost Effective Equitable Cancer Therapy and Implementation Science'.

"Being a US citizen with Indian roots, it was profoundly meaningful for me to participate in the US-India cancer dialogue.. This collaboration goes beyond mere scientific efforts to genuinely save lives," she said.

Krishnan said awareness of breast cancer is "significantly higher" compared to cervical cancer.

"This is primarily because breast cancer affects women in developed countries more frequently than those in developing countries, leading to greater funding for awareness, screening, and treatment initiatives. In contrast, cervical cancer is more prevalent in developing countries, largely due to the lack of readily available screening methods that are common in developed countries. Consequently, cervical cancer receives less funding and attention," she said.

According to WHO, globally, cervical cancer is the fourth most common cancer in women, with around 6,60,000 new cases in 2022. In the same year, about 94 per cent of the 3,50,000 deaths caused by cervical cancer occurred in low- and middle-income countries.

"Every two minutes, a woman dies from cervical cancer, underscoring its status as one of the most significant threats to women's health. Without immediate action, such as administering the HPV vaccine to girls between the ages of 9-14 years and screening (with treatment of women with disease) this rate could double, with a woman dying from cervical cancer every minute by 2050," the doctor cautioned.

Having said that, she reiterated that cervical cancer is "completely preventable through HPV vaccination and safe, simple, inexpensive treatment for early cancer that can even be administered in the remote areas of the developing world".

In his address during the event, US Ambassador Eric Garcetti had said this exchange embodies the strength of the "bond between our two great nations", built on a foundation of shared values, mutual respect and a common vision for a healthier future.