A nurse prepares a chemotherapy machine at the Cancer
Institute of Singapore at the National University Hospital in Singapore,
Wednesday April 18, 2007. Smoking, drinking and eating unhealthy foods ,
all linked to various cancers, will combine with larger populations and
fewer deaths from infectious diseases to drive Asian cancer rates up 60
percent by 2020, some experts predict. [AP]
|
SINGAPORE - Asia is bracing for a
dramatic surge in cancer rates over the next decade as people in the developing
world live longer and adopt bad Western habits that greatly increase the risk of
the disease.
Smoking, drinking and eating unhealthy foods -- all linked to various cancers
-- will combine with larger populations and fewer deaths from infectious
diseases to drive Asian cancer rates up 60 percent by 2020, some experts
predict.
But unlike in wealthy countries where the world's top medical care is found,
there will likely be no prevention or treatment for many living in poor
countries.
"What happened in the Western world in the '60s or '70s will happen here in
the next 10 to 20 years as life expectancy gets longer and we get better control
on more common causes of deaths," said Dr. Jatin P. Shah, a professor of surgery
at Memorial Sloan-Kettering Cancer Center in New York, who attended a cancer
conference last month in Singapore.
"The habit of alcohol consumption, smoking and dietary changes will increase
the risk of Western world cancers to the Eastern world," Shah said.
An estimated 40 percent of cancers worldwide can be prevented by exercise,
eating healthy foods and not using tobacco, according to the World Health
Organization.
But more people in Asia are moving into cities and becoming overweight and
obese from inactivity. They are replacing fruits and vegetables with fatty meals
full of meat and salt, which is leading to increases in stomach and colon
cancers. Meanwhile, traditional diseases like malaria are killing fewer people
-- building an aging population that's a prime target for cancer.
The effect is already startling, with the Asia-Pacific making up about half
of the world's cancer deaths and logging 4.9 million new cases, or 45 percent,
of the global toll in 2002.
That number is projected to leap to 7.8 million by 2020 if nothing changes,
according to Dr. Donald Max Parkin, a research fellow at the University of
Oxford who is a leading authority on global cancer patterns and trends.
China alone, with its booming economy and 1.3 billion people, is home to
about one-fifth of the world's new cases, compared to about 13 percent in the
U.S. and 26 percent in Europe, Parkin said. Heart disease remains the top killer
in China, but cancer is a close second.
Cancer deaths are slowly dropping in the United States, with slight declines
recorded in 2003 and 2004. A decrease in smoking, coupled with early detection
and better treatment of tumors is credited with the positive results -- the
first U.S. decline in cancer deaths since 1930.
Smoking is on the rise in Asia, where it's common to see people lighting up
in airports, restaurants and even hospitals. Lung cancer makes up the bulk of
all cases regionwide, followed by stomach and liver cancers. It also remains the
biggest cancer killer worldwide.
"Lung cancer is the big one because of cigarette smoking. There are many
tobacco advertisements -- everywhere," said Dr. You-Lin Qiao from the Cancer
Institute and Hospital in Beijing, who added that the odds are stacked against
those diagnosed in China. "No matter if you're rich or poor, if you get lung
cancer you die. There's no treatment at all."
While Americans and Europeans have been abandoning smoking, an estimated 300
million men are puffing away in China -- equal to the entire U.S. population. If
nothing changes, a third of Chinese men under age 30 are predicted to die from
tobacco, with lung cancer already the biggest cancer killer there.
Smokeless tobacco is also a big problem in Asia's other giant, India, where
many men and women chew some form of tobacco. Mouth cancer makes up half of all
new cases in parts of the country.
A lack of vaccines that prevent cancer-causing viruses is another obstacle
for Asia, which is home to about three-quarters of the world's liver cancers,
caused largely by Hepatitis B infections.
A vaccine guarding against the virus has been available since the early 1980s
and is routinely given to children in Western countries, but it is still not
reaching large swaths of the Asia-Pacific.
Some experts worry it could take years before the new vaccine for the
sexually transmitted human papillomavirus, or HPV, is available to women in
developing countries. The three shots currently cost about $350 in the U.S. and
are 70 percent effective against preventing HPV, the main cause of cervical
cancer. It is already the No. 2 cause of cancer among women in Asia, after
breast cancer.
"The problem is so huge that it's very difficult for us to know where to
start," said Dr. Franco Cavalli, president of the nonprofit International Union
Against Cancer. "All the new cancer treatments are so expensive, that already in
the affluent countries we are not able to pay for them. ... So imagine what that
means for low-income countries where you have $20 a year per person for health
expenditures."
Regular screening, such as Pap smears and mammograms, is too costly for many
poor countries. Treatment with radiation or chemotherapy is unfathomable for
most. And in Asia, many patients seek help from hospitals in the late stages of
disease after traditional medicine has failed to cure them.
Monika Bardhan of Malaysia's NCI Cancer Hospital has seen a dramatic increase
in cancer patients over the past four years. "It's staggering. Every day I see a
patient with breast cancer -- I just hold my own and say a prayer."