Cancer is an emerging public health problem in Africa. According to the International Agency for Research on Cancer (IARC), about 715,000 new cancer cases and 542,000 cancer deaths occurred in 2008 in Africa. These numbers are projected to nearly double (1.28 million new cancer cases and 970,000 cancer deaths) by 2030 simply due to the aging and growth of the population, with the potential to be even higher because of the adoption of behaviors and lifestyles associated with economic development, such as smoking, unhealthy diet, and physical inactivity.
Despite this growing burden, cancer continues to receive low public health priority in Africa, largely because of limited resources and other pressing public health problems, including communicable diseases such as acquired immune deficiency syndrome (AIDS)/human immunodeficiency virus (HIV) infection, malaria, and tuberculosis. It may also be in part due to a lack of awareness about the magnitude of the current and future cancer burden among policy makers, the general public, and international private or public health agencies.
Sub-Saharan Africa provides several contrasts with other world regions. Among women, this is the only region where cervical cancer is equivalent to breast cancer in terms of incidence (each constitutes approximately a quarter of the total burden) and is the most common cause of cancer death in women (23.2% of the total). The incidence and mortality rates for cervical cancer are 34.8 and 22.5 per 100 000 respectively, the highest of any world region. Among men, prostate and liver cancers are the most common forms of incident cancer and causes of cancer death. Although the leading role of prostate cancer in the cancer incidence pattern in men is shared with most other world regions, this regions also has mortality rates comparable to incidence rates. The rates of 27.9 and 20.9 per 100 000 for prostate cancer incidence and mortality, respectively, stand in marked contrast to those in Europe (64.0 and 11.3 per 100 000, respectively) or North America (97.2 and 9.8 per 100 000, respectively), where incidence much higher but mortality is much lower. The importance of liver cancer in this region should be emphasized; it is the second most common cancer in men and the third most common cancer in women. Cervical and breast cancers in women and prostate and liver cancers in men are the only cancers with sex-specific incidence or mortality rates of more than 10 per 100 000, but the high rates of Kaposi Sarcoma is the third most common cancer in men and represents 9.2% incidence rate of 7.2% of all cancer diagnoses, with an incidence rate of 7.2 per 100 000. This reflects the very high regional level of HIV infection and associated cancer sequelae before the advent of highly active antiretroviral therapy. Cervical cancer and Kaposi sarcoma also make important contributions to the pattern of 5-year prevalence in the region.
References
American Cancer Society (2011), Cancer in Africa. Atlanta: American Cancer Society.
B.W. Stewart, C.P. Wild (2014), World Cancer Report 2014. Lyon: World Health Organization/ International Agency for Research on Cancer.