By Bruno de Freitas Moura (Photo by Fabio Rodrigues-Pozzebom)
A recent international study estimates that over four in ten cancer deaths in Brazil – 43.2% – could be preventable through improved prevention strategies, earlier diagnosis, and better access to treatment. The research, published in the March edition of the prestigious medical journal The Lancet, suggests that of the approximately 253,200 cancer cases diagnosed in Brazil in 2022, roughly 109,400 could have been avoided. This finding underscores the potential for significant public health gains through targeted interventions.
The study, titled “Avoidable deaths from primary prevention, early detection, and curative treatment of cancer worldwide,” involved 12 researchers, eight of whom are affiliated with the International Agency for Research on Cancer (IARC), a World Health Organization (WHO) body based in Lyon, France.
Researchers categorized the nearly 110,000 avoidable cancer deaths in Brazil into two groups: 65,200 cases considered preventable – meaning the disease might not have developed at all – and another 44,200 potentially avoidable through earlier detection and appropriate treatment.
Global Impact
The study provides a global overview of cancer deaths, analyzing 35 types of cancer across 185 countries. Globally, 47.6% of cancer deaths are considered preventable, meaning that nearly 4.5 million of the 9.4 million cancer deaths worldwide could potentially have been avoided.
The research identified five key risk factors contributing to preventable cancer deaths: tobacco use, alcohol consumption, excess weight, exposure to ultraviolet radiation, and infections caused by viruses like HPV and hepatitis, and the bacterium Helicobacter pylori.
Disparities in Preventability
The analysis revealed significant disparities in cancer death rates between countries and regions. Nations in Northern Europe demonstrated some of the lowest rates of preventable deaths, with Sweden at 28.1%, followed by Norway (29.9%) and Finland (32%). This indicates that in these countries, fewer than three in ten cancer deaths might have been avoided.
Conversely, the ten highest proportions of avoidable cancer deaths were found in African countries, with Sierra Leone reporting the highest rate at 72.8%, followed by Gambia (70%) and Malawi (69.6%). In these nations, seven out of ten cancer deaths could potentially be prevented with improved prevention, diagnosis, and treatment access.
Countries with lower rates of avoidable deaths include Australia and New Zealand (35.5%), Northern Europe (37.4%), and North America (38.2%).
The highest proportions of avoidable deaths were observed in Eastern Africa (62%), Western Africa (62%), and Central Africa (60.7%). South America had a rate of 43.8%, similar to Brazil’s.
Human Development Index (HDI) and Cancer Outcomes
The study also examined the relationship between the Human Development Index (HDI), a UN measure of health, education, and income, and cancer mortality. Countries with low HDI scores – indicating lower quality of life – had the highest rates of preventable cancer deaths, with six in ten (60.8%) potentially avoidable.
In contrast, countries with high (57.7%), medium (49.6%), and incredibly high (40.5%) HDI scores had progressively lower rates of preventable deaths. Brazil is considered a country with a high HDI. The research also noted that in countries with low and medium HDI scores, cervical cancer was the leading cause of preventable death.
The study also highlighted disparities in cervical cancer mortality rates, with countries with very high HDI scores reporting 3.3 cases per 100,000 women, compared to 16.3 per 100,000 women in countries with low HDI scores.
Specific Cancer Types
The research published in The Lancet estimates that 59.1% of avoidable deaths are linked to lung, liver, stomach, colorectal, and cervical cancers. When focusing solely on cancers preventable through preventative measures, lung cancer was the leading cause of death, accounting for 1.1 million deaths – 34.6% of all preventable cancer deaths.
Breast cancer in women had the most treatable deaths, meaning cases where survival was possible with timely diagnosis and access to appropriate treatment. There were 200,000 such deaths, representing 14.8% of all treatable cancer deaths.
Strategies for Reduction
Researchers suggest several strategies to reduce preventable cancer deaths, including public health campaigns to reduce tobacco and alcohol use, and policies to discourage consumption through increased pricing.
The study also addresses the growing issue of excess weight, stating, “The increasing number of people with excess weight poses considerable challenges to global health.” Researchers suggest interventions such as regulations on advertising, food labeling, and taxes on unhealthy foods and beverages.
The researchers emphasized the importance of preventing infections associated with cancer, such as HPV, which is preventable through vaccination. They also highlighted the need to focus on meeting WHO goals for early breast cancer detection, aiming for at least 60% of cases diagnosed at stages one or two and ensuring more than 80% of patients receive a diagnosis within 60 days of their initial consultation.
“Global efforts are needed to adapt cancer prevention, early detection, and treatment to address inequalities in avoidable deaths, particularly in countries with low and medium HDI,” the study concludes.
In Brazil, the Ministry of Health and the National Cancer Institute (INCA) regularly conduct prevention and early diagnosis campaigns.
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