GLOBOCAN 2024: Looking Beyond the Numbers to Understand Global Cancer Disparities

GLOBOCAN 2024: Looking Beyond the Numbers to Understand Global Cancer Disparities

GLOBOCAN 2024 has recently been released. For those unfamiliar with it, it is a document that provides estimates of the global cancer burden, such as the most common types of cancer, incidence, mortality, and stratifies these data according to pre-defined regions of the world and/or countries. The importance of the information it reveals is enormous, since it helps countries, policy makers, health professionals and civil society shape their policies and priorities on how to better tackle the problems they face or to reinforce policies that already show promising results.

Although the graphs and statistics presented in GLOBOCAN 2024 are important, the most valuable insights emerge when we look beyond the numbers themselves. The stratification of cancer burden across regions may raise important questions about inequity, inequality, data accuracy and other relevant information. We may not be able to accurately identify every problem, but GLOBOCAN provides the tools to ask the right questions rather than simply provide the answers—and it is by asking those questions that we can begin to find solutions.

The GLOBOCAN 2024 data clearly show a rising trend in cancer incidence, prevalence, and mortality worldwide. That itself is important information, since it shows policy makers that public health directives towards cancer care must be widely implemented. Screening strategies, investment in research, increase in the number of treatment facilities, awareness of palliative care, among other policies are needed in every region. The difference lies in the specificities of each country, regarding not only the numbers themselves, but also characteristics of population, age, environmental differences and type of health assistance provided. It is in those differences that one can recognize disparities in several points of the collected data.

This article aims to look beyond the GLOBOCAN 2024 data and explore what they reveal about global cancer care, in the hopes that, by doing so, we may assist the interpretation of the numbers, thus shedding some light on the problems that need solving and the successes that might be shared with others.

The document starts with the higher incidence and mortality of cancer among males and females. It shows that prostate cancer is the most prevalent in males and breast cancer the one in females, which does not come as a surprise. However, there is a subset of countries that this pattern is not observed. When looking at it, we see that cervical cancer is the most prevalent and has the highest mortality among females in some countries in Sub Saharan Africa and one Latin American country; among males, lung cancer is the most prevalent in some Asian countries and the leading cause of cancer deaths in North America, Northern and Western Europe, China and Australia. It is also noticeable that one country in Africa has Kaposi Sarcoma as its most prevalent cancer.

From the GLOBOCAN 2024 data alone we can make some assumptions about the state of public health. Cervical cancer is a disease mostly linked to HPV infection, which can be prevented with proper vaccination and safe sexual behaviors, and early identification of premalignant lesions through population screening. Thus, this suggests that in countries where its incidence is highest, that public health policies are failing in preventing the infection and performing the screening of suspicious and premalignant lesions.

Kaposi Sarcoma is most common in people living with HIV without proper treatment, which shows that the country faces challenges in both preventing the infection with safe sexual behavior awareness, as well as controlling it. It highlights an important gap in the public health system, since there are many medications that successfully control the virus, preventing the occurrence of HIV related diseases. The data described reveals the gap between countries when it comes to preventable and/or manageable diseases that rely on public health policies for prevention. This also presents itself as a financial burden, since prevention strategies cost much less than the treatments, either curative or palliative.

Interestingly, another graph shows correlation between high-very high IDH and lung cancer incidence. Although there has been mounting evidence of growing incidence of adenocarcinoma lung cancer in people who have never smoked¹, in countries where tobacco smoking is still common, it remains as one the leading causes of lung cancers². Regardless of IDH, lung cancer is usually diagnosed at stage IV, with advanced disease, without curative intent³. Also, lung cancer is usually very aggressive and requires access to high technology imaging (such as PET CT scans, CT, MRI) to start the investigation, as well as high technology techniques and specialized doctors to biopsy and provide a definitive diagnosis (such as bronchoscopists, interventional radiologists and pathologists)4. Considering the aggressiveness of the disease and the need for specialized health care for diagnosis, it is possible that low-income countries present higher incidence of lung cancer, but underdiagnosed. Many people might pass away before ever receiving proper diagnosis5. In addition to the later stage diagnosis, there is also significant treatment disparities among high- and low-income countries6, making lung cancer mortality rate highest among people from low-income countries, according to GLOBOCAN 2024 data, despite the likely underdiagnosis. This suggests that the reality might be even worse than the numbers show.

Although there are clear differences that low- and high-income countries face when it comes to proper prevention, screening, diagnosing and treating cancer, not all is lost. Gathering information such as the ones presented by GLOBOCAN 2024 is essential for recognizing where the problems lie so we can tackle them and move forward towards better care. Drawing attention to global disparities can motivate policy makers, government and society to demand the implementation of measures to mitigate the cancer burden in each country.

Not too long ago, the HIV epidemic drove the world into chaos, and by joining forces, governments, the pharmaceutical industry, medical societies and patients’ advocacy groups drove development, awareness and, later, broader access to treatment to a disease that was once considered a death sentence. If we want, we can work together once again to overcome one of the greatest public health challenges of our century.

Written by Dr. Helena Kremer, MD

Clinical Oncologist | Brazil Hub Lead, OncoDaily

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