World Cancer Day: The Inequity in Cancer Care

 

1. World Cancer Day
2. Why Cancer
3. Basic Cancer Facts
4. Equity
5. Equity Gap Barriers
6. Inequity in Cancer Statistics
7. Closing the Gap

World Cancer Day

World Cancer Day is celebrated every year on February 4th. This day is about coming together and raising awareness for all types of cancer. Cancer is one of the deadliest diseases and the cause of millions of deaths around the globe every year. This global initiative is led by the Union for International Cancer Control (UICC) in hopes that it will bring higher awareness to this issue. Cancer has affected all our lives, whether directly or indirectly, and it’s finally time to put a stop to it. This year the UICC is focusing on “Closing the Gap” for cancer treatment. We need everyone to act and talk to governments, politicians, and communities to start finding cancer care equity for all.

Why Cancer

Cancer is one of the deadliest diseases, and we still have no cure. Did you know that 10 million people (about half the population of New York) die from cancer every year? That is more than the deaths from HIV/AIDS, malaria, and tuberculosis combined. However, many of these deaths could be preventable. One-third of all cancers can be prevented in the first place and another one-third can be cured if detected early and treated. However, because of the disparities that are present in cancer care, many more people are dying because they are not receiving the medical help that they need to overcome this.

Basic Cancer Facts

There are 3 basic types of cancer tumors: Benign, malignant, and precancerous (also called premalignant). Benign tumors are not cancerous and are not life-threatening. Malignant tumors are fast-growing and can spread and destroy neighboring tissue. Once it starts to spread, it can continue to divide and grow, which can transform into metastatic cancer. Precancerous tumors are the description of abnormal cells that can also develop into cancer.

Cancer can be broken down into 5 distinct categories. The first one is carcinoma, which starts with the cells that make up the lining of your organs. The most common types of cancers like this are breast, prostate, lung, and colon cancer. The second type is sarcoma, which starts in the bone or soft tissue. The most common cancers of this type are leiomyosarcoma, liposarcoma, and osteosarcoma. Then we have Lymphoma and Myeloma, which starts with the cells in the immune system. Since it affects the lymphatic system, it can occur anywhere in the body. Then we have Leukemia, cancer of white blood cells and bone marrow. The most common cancers for this are lymphocytic leukemia and chronic lymphocytic leukemia. Lastly, we have Brain and spinal cord cancers, that affect your nervous system. Some can be benign, but others grow and spread through the body.

Equity

Since the theme for this year’s World Cancer Day is “Closing the Gap” we must address the issue of equity. More than 65% of cancer deaths happen in the least-developed parts of the world. Even in developed countries, there are inequities in various groups. This includes lower-income families, indigenous people, immigrants, refugees, and rural communities. Our fight this year is to bring equitable access to cancer prevention, diagnosis, treatment, and care to save the lives of millions of people around the world.

 Equity Gap Barriers

8 main barriers exist between people and cancer prevention.

1. Gender norms and discrimination.
Women and girls around the world suffer from discrimination from misogyny, stereotypes, and gender roles. There is also stigma and ostracization surrounding cervical and breast cancers, so many do not get screened. Men also suffer from this because of societal and cultural taboos. They are less willing to openly talk about health concerns.

2. Barriers for minority populations.
Racism has a profound effect on access to cancer care with minority populations having the least access. Indigenous people represent 6% of the population, yet they also represent 15% of the intense poverty in these countries.

3. Poverty and socioeconomic status.
Lower socioeconomic status means less access. If you are diagnosed with advanced cancer and are a low-income patient, have only primary education, or lack health insurance, you are more likely to experience financial catastrophe or die within one year of a cancer diagnosis.

4. The rural-urban divide.
People living in rural areas suffer from a lack of prevention, screening, and treatment services. The financial burden of long travels, the need to secure childcare, and time off work, can be overwhelming. As a result, where you live too often determines if you live.

5. Ageism.
Cancer can develop at any age, but the risk of that happening rises dramatically in people 65 or older. Because early cancer symptoms can be mistaken for everyday pain or minor illnesses associated with old age, many cancers in older patients are diagnosed later.

6. Refugee status and forced displacement.
In countries facing political, financial, and social instability – from war, social upheaval, or natural disaster – cancer organizations must deal with shortages of resources or even a complete breakdown in basic health services.

7. Homophobia, transphobia, and related discrimination against LGBTQ+.
Around the world, lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQ+) people face hostility and discrimination, especially in healthcare systems. Also, fear of poor treatment by the medical establishment drives many people away from timely and effective cancer care.

8. Barriers for people with disabilities.
There are more than one billion people with disabilities globally, many of whom face systemic discrimination in health care. People with disabilities are three times more likely to be denied health care, four times more likely to be treated poorly in the health system, and 50% more likely to suffer extreme financial hardship.

Inequity in Cancer Statistics

• In the United States, the survival rate for white women is 71% but for black women, it is just 58%.
• Childhood cancer survivors are 80% in high-income countries but drop to only 20% in low-income countries.
• More than 90% of cervical cancer deaths occur in low- and middle-income countries.
• In refugee populations, cancer is detected in advanced stages, which leads to the worst outcomes possible.
• Because of discrimination in healthcare, transgender people have the lowest cancer screening rates than the rest of the population.
• In New Zealand, indigenous people (Māori) are twice as likely to die from cancer than non-indigenous people.

Closing the Gap

The goal we are focusing on now is health equity for everyone. The cancer care gap can be reduced in many ways, and you can also help. Here are a few ways that we can all do our part in closing the gap:

• Educating the public about cancer prevention
• Equipping healthcare professionals with skills and knowledge including how inequity influences cancer care.
• Strengthening primary healthcare delivered into communities, especially rural communities.
• Increasing resources. We need more money and people who are dedicated to cancer research and who can better effectively shape investments where they are most needed.
• Implementing country-specific cancer prevention and control plans that address each country’s unique needs and resources.
• Addressing negative policies and programs that affect the social and economic factors of healthcare patients.