health, equity, and women’s cancers · cervical cancer: data on 600,000 women in 61 countries...
TRANSCRIPT
Health, equity, and women’s cancers
Every minute a woman dies of breast cancer.
Health, equity, and women’s cancers
Every minute a woman dies of breast cancer.
Every two minutes, a women dies of cervical cancer.
Health, equity, and women’s cancers
Every minute a woman dies of breast cancer.
Every two minutes, a women dies of cervical cancer.
That's around 800 000 women every year.
Health, equity, and women’s cancers
Every minute a woman dies of breast cancer.
Every two minutes, a women dies of cervical cancer.
That's around 800 000 women every year.
Most of these women are living in low-
and middle-income countries.
Health, equity, and women’s cancers
Every minute a woman dies of breast cancer.
Every two minutes, a women dies of cervical cancer.
That's around 800 000 women every year.
Most of these women are living in low-
and middle-income countries.
Most of these deaths are premature…
and preventable.
Health, equity, and women’s cancers
But it doesn’t have to be this way…
Health, equity, and women’s cancers
“This situation is a largely
preventable tragedy for
hundreds of thousands of
women each year”
Health, equity, and women’s cancers
3 papers
43 authors from 18 countries
Editorial & Commentaries:
Chilean President Hon. Michelle Bachelet of Chile
Dr Otis Brawley & Ambassador Sally Cowal, American Cancer Society
Health, equity, and women’s cancers
Health inequity- definitions…
• Differences in health “…that are unnecessary, avoidable, unfair and unjust”1.
• Poor health within countries and inequities between countries reflect an unequal distribution of power, income, goods, and services that result from “ineffective social policies, unfair economic arrangements, and bad politics”2.
1. Whitehead M, Whitehead M. Int J Health Serv. 19922. Marmot M, Friel S, Bell R, Houweling TA, Taylor S. Lancet. 2008
Health, equity, and women’s cancers
Paper 1: The global burden of breast and cervical cancer: a
grand challenge in global health
Health, equity, and women’s cancers
• The global burden
• Incidence, mortality, survival, predicting the future burden
• Social and economic impact- systematic review
• Inequities among women in high income countries: e.g. poor women, ethno-cultural minority and immigrant women, indigenous women…
Photo: CDC
Photo: The Lancet Global Health
These girls and women face higher risks of cancer than their mothers & grandmothers did ….
Photo: CDC
“Women’s Cancers” – why breast & cervical cancer?
•Breast
•Cervix
big #s
“Women’s Cancers” – why breast & cervical cancer?
•Breast
•Cervix
big #s
major cause of premature M&M
“Women’s Cancers” – why breast & cervical cancer?
•Breast
•Cervix
big #s
major cause of premature M&M
“Women’s Cancers” – why breast & cervical cancer?
•Breast
•Cervix
big #s
major cause of premature M&M
effective interventions to reduce mortality
“Women’s Cancers” – why breast & cervical cancer?
•Breast
•Cervix
big #s
major cause of premature M&M
effective interventions to reduce mortality
prevention at relatively low cost
“Women’s Cancers” – why breast & cervical cancer?
•Breast
•Cervix
big #s
major cause of premature M&M
effective interventions to reduce mortality
prevention at relatively low cost
some interventions at primary care
Breast CancerCountry A Country B
61 years old 45 years old
Breast and cervical cancer survivalCONCORD-2 (Allemani et al., The Lancet 2015)*
Breast cancer: data on 5.5 million women in 61 countries • 5-year survival 2005-2009:
80% or higher in 34 countries60-69% in India and Malaysia53% in South Africa and Mongolia
Cervical cancer: data on 600,000 women in 61 countries• 5-year survival 2005-2009:
70% or higher in 6 countries60-69% in 34 countries<60% in 21 countries
*Data from 279 population-based registries in 67 countries for over 25 million adults (15-99 years) diagnosed with one of 10 common cancers during the 15-year period 1995-2009
Cervical Cancer
•85% of all cases
•87% deaths
•Occur in low-income and middle-income countries..
Globocan2012 (IARC)
Globocan2012 (IARC)
Predicting the future burden…
• Breast cancer: predicted to almost double from 1.7 million in 2015 to 3.2 million in 2030
• Cervical cancer is predicted to rise by at least 25% to over 700000 by 2030, most in LMICs
1 676 255 studies*
3% included an economics component.
10% from a low-income or middle-income setting.
* 1990-2015, original quantitative
estimates, 4228 studies, 30 full text
The impact on societies…
Health, equity, and women’s cancers
Key Messages- 1
Where a woman lives, and her socioeconomic, ethno-cultural, or migration status, need not mean the difference between life and death from these
common cancers, for which cost-effective, life-saving interventions exist.
Health, equity, and women’s cancers
Key Messages- 2
It is crucial to understand the social, economic, and financial impact of breast and cervical cancers, which take a disproportionate toll on women in LMIC, and
in the prime of life.
Key Messages- 3
Global efforts, particularly in recent years, have led to significant improvements in maternal health
outcomes. Similar efforts are urgently needed to address breast and cervical cancer, which take the
lives of half a million more women each year.
Health, equity, and women’s cancers