Epidemiology of Cancer in EMR

1. Epidemiology of Cancer in EMR

2. Contents Marrakech, Morocco, 18-19 June 2010 Global burden of cancer 1 Regional burden of cancer 2 3 Regional challenges in cancer prevention and control 4 Cancer control strategy and framework for country action 5 Recommendations

3. Contents Marrakech, Morocco, 18-19 June 2010 ✓ Global burden of cancer 1 Regional burden of cancer 2 3 Regional challenges in cancer prevention and control 4 Cancer control strategy and framework for country action 5 Recommendations

4. Cancer projected global deaths (2004-2030) • Cancer is the second most common killer today, 13% of death worldwide are currently caused by it. • By 2030, cancer will become the leading cause of death, ahead of ischemic heart disease & stroke. • The estimated number of cases of cancer is expected to rise each year from 11 million in 2002 to 27 million by 2030 . • The majority of new cases are expected to occur in less developed countries.

5. Cancer projected global deaths Recent IARC Report , June 2010. • In 2008, best estimates: 12.7 million new cancer cases and 7.6 million cancer deaths. • Over half (56%) of new cancer cases and 63% of deaths in developing regions of the World. • Approx. 21.4 million new cases will be diagnosed and 13.2 million deaths from cancer will occur in 2030. Cancers Stroke

6. Cancer projected global deaths (2004-2030) Cancers Ischaemic heart disease Stroke Acute respiratory infections Road traffic accidents Perinatal HIV/AIDS TB Malaria

7. Contents Marrakech, Morocco, 18-19 June 2010 Global burden of cancer 1 ✓ Regional burden of cancer 2 3 Regional challenges in cancer prevention and control 4 Cancer control strategy and framework for country action 5 Recommendations

8. Regional burden of cancer • Cancer is the 4th ranked cause of death in the Eastern Mediterranean Region, following cardiovascular diseases, infectious diseases and injuries; • It is estimated that cancer kills 272,000 people each year in the Region; • Half of the cancer occur before age 55 years; • The majority of cancer cases diagnosed at relatively advanced stage.

9. Summary Statistics Regional Statistics Reference: Globocan 2008 (IARC), Country Fast Statehttp://globocan.iarc.fr/factsheets/populations/factsheet.asp?uno=993

10. Most common cancers in the Region Eastern Mediterranean countries, incidence (all ages) GLOBOCAN 2002 estimates: http://www-dep.iarc.fr/

11. 5 Most common cancers in the Region Reference: Globocan 2008 (IARC), Country Fast Statehttp://globocan.iarc.fr/factsheets/populations/factsheet.asp?uno=993

12. Most frequent cancers (Incidence & Mortality) in MEN ♂ Reference: Globocan 2008 (IARC), Country Fast State http://globocan.iarc.fr/factsheets/populations/factsheet.asp?uno=993

13. Most frequent cancers (Incidence & Mortality) in WOMEN ♀ Reference: Globocan 2008 (IARC), Country Fast Statehttp://globocan.iarc.fr/factsheets/populations/factsheet.asp?uno=993

14. Most frequent cancers (Incidence & Mortality) in BOTH SEXES ♀ ♂ Reference: Globocan 2008 (IARC), Country Fast Statehttp://globocan.iarc.fr/factsheets/populations/factsheet.asp?uno=993

15. Childhood cancers Regional burden of cancer EMR countries All sites In the Region, the most common childhood cancers are cancers of the blood. Incidence of childhood cancer in the Region is comparable to that in industrialized countries, but mortality is much higher.

16. Lessons learned From international experiences • 40% of cancers can be prevented. • 40% of cancers can be detected early and cured. • Suffering from the remaining 20% of cancers can be reduced by palliative therapy.

17. Prevalence of tobacco smoking Among adults in the Region

18. Prevalence of overweight & obesity in the Region

19. World cancer burden caused by infection in 2002 Total caused by infection, 17.8% • The major infections are: • Schistosomiasis(bladder cancer) • Helicobacter pylori(stomach cancer) • Hepatitis B and C (liver cancer) • Human papillomavirus (cervical cancer) • Source: Parkin DM. International journal of cancer, 2006, 118(12):3030–44.

20. Cancer related to infection and corresponding burdenInEMR Source: The cancer atlas. American Cancer Society, 2006.

21. Contents Marrakech, Morocco, 18-19 June 2010 Global burden of cancer 1 Regional burden of cancer 2 ✓ 3 Regional challenges in cancer prevention and control 4 Cancer control strategy and framework for country action 5 Recommendations

22. 1. Screening and early detection Regional challenges in cancer prevention • In the Region, the vast majority of cancers are diagnosed at an advanced stage when cure is improbable even with the best treatment.

23. 2. Cancer management in the Region Regional challenges in cancer prevention • Human resources (oncologists, nurses) are insufficient in the majority of countries; • Medicine availability and affordability for patients in the majority of countries (out-of-pocket expense); • Radiotherapy machines, radio-oncologists and radio-technicians are not sufficient to cover the needs in many countries; • Multidisciplinary management of cases is not instituted in all referral centres.

24. 3. Palliative care Regional challenges in cancer prevention • Misconceptionsabout pain relief use; • Training Gaps; • Lack of awareness; • Inadequate policies restricting access to pain relief medications; • Accessibility & affordability of medication for pain relief

25. 4. Cancer data Regional challenges in cancer prevention • 11 countries have hospital-based cancer registry and published reports, but the quality of the data and reports from these registries is very heterogeneous. • Cancer registry is not exist in 8 Member States have no cancer registry. • Data about stage at presentation, mortality and survival are lacking in almost all Member States.