Of the roughly 65 million deaths around the world every year, around 43 million are due to non-communicable diseases such as cancer and diabetes.Chris Young/The Canadian Press
Cancer cases worldwide are projected to nearly double by 2050, to 35 million from 19.5 million annually, according to a new report from the World Health Organization.
That’s not all bad news. One of the main reasons cases are soaring is that people are living longer. Screening and other forms of cancer detection are also becoming more commonplace. Even the fact a greater proportion of deaths are from cancer is the result of other health threats fading.
For centuries, infectious diseases were the scourge of humanity. In the 14th century, the Black Death killed an estimated 25 million people. In the 15th and 16th centuries, an estimated 55 million Indigenous people in the Americas died after the arrival of Old World pathogens such as smallpox and measles.
Some 60 million Europeans died of smallpox in the 18th century, a disease that has now been eradicated. In 1918, the Great Influenza killed at least 50 million people, infecting one in five people around the globe.
We can’t forget the COVID-19 pandemic, with seven million deaths officially, but likely about 20 million in total.
Then there are the persistent and relentless infectious disease killers such as tuberculosis, malaria and HIV-AIDS, which, between them, still account for about 2.5 million deaths a year.
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But the reality today is that, despite the occasional anomaly like COVID, non-communicable diseases account for far more deaths than infectious diseases.
We need to know how people die, not out of morbid curiosity, but to improve the way we live.
There are roughly 65 million deaths globally each year.
About 14 million of those deaths are owing to infectious diseases, while 43 million are because of non-communicable diseases (NCDs) such as cardiovascular disease, cancer, chronic obstructive pulmonary disease and diabetes.
(The balance of deaths, about eight million, are caused by unintentional injuries from motor vehicle crashes, falls, drownings and such, as well as intentional deaths, including homicides and suicides.)
What has changed most in recent decades is a dramatic drop in infectious disease deaths, particularly the “big three.” At their peak, in the early 2000s, tuberculosis, malaria and HIV-AIDS killed about 6.5 million between them. Mortality from those diseases has fallen by two-thirds in this century.
These shifts have allowed people in the developing world to live longer, and develop conditions such as heart disease and cancer.
Seven of the top 10 causes of death in the world are now non-communicable diseases.
We essentially have a silent pandemic of NCDs. But, because these conditions develop slowly over time, we don’t treat them with the same urgency as an infectious disease outbreak.
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As the new WHO cancer report reminds us, as health threats become increasingly similar around the world, inequities are growing.
In developed nations, there have been massive investments in prevention, screening and treatment for all the big NCDs. In developing countries, there has been no such shift.
In wealthy countries like Canada, the five-year survival rate after breast cancer diagnosis is 90 per cent; in lower-income countries it’s less than 30 per cent.
Why? Largely because there is little screening, thus little early detection. Treatment is also hard to access; 23 countries in the world don’t even have radiation facilities, one of the most common cancer treatments.
Two-thirds of the countries worldwide don’t have universal health coverage. In some countries, 90 per cent of cancer patients abandon treatment because it’s unaffordable.
“Whether a person survives cancer should never depend on where they were born or what they earn,” WHO director-general Dr. Tedros Adhanom Ghebreyesus said in response to the new report. “The inequities documented in this report are not inevitable; they are the consequence of choices.”
The greatest potential for impact lies in prevention. About four in 10 cancer cases are related to four underlying causes: smoking, alcohol misuse, excess weight and infections. Those are not just lifestyle choices, but reflections of socio-economic realities.
In Western countries, we are now well on our way to completely eliminating cervical cancer, thanks to vaccination against human papillomavirus. In sub-Saharan Africa, by contrast, it remains the number one cancer killer.
We have done the same with vaccination against hepatitis B (preventing liver cancer) and treating helicobacter pylori bacterium with antibiotics has slashed rates of stomach cancer.
The embrace of GLP-1 weight loss drugs in wealthy countries has the potential to dramatically reduce obesity-related cancer – a more than 40-per-cent drop, according to one study.
New technologies, new treatments, and renewed emphasis on prevention can all provide new hope.
But that hope needs to be more evenly distributed around the world.