With the Political Declaration of the UN High-Level Meeting on the Prevention on the Prevention and Control of Non-communicable Diseases (document no. A/66/L1), the fight against cancer has been officially recognized by the International community as a health challenge of epidemic proportions that requires a long-term strategy and coordination on a global scale.
After this Declaration, in May 2012, the World Health Organization has set the new objective to reduce at 25% the premature deaths due to chronic disease by 2025. The fight against cancer is now considered a global priority from the United Nations and the entire International Community.
An Alarming Situation
According to data collected by the Foundation's doctors between 2008 and 2013, in Fianarantsoa and Mahajanga the situation of women’s cancers is alarming:
Out of 4589 women, 596 were result positive to the Pap test (13%).
The HPV positivity test rate is 23% (199 positive cases out of 883
Out of 85 biopsies performed, in 27% of cases (23 women) malignant tumors were found.
14.1 million new cancer cases, 8.2 million deaths every year and 32.6 million people living with the disease after five years from the time of diagnosis: these are the alarming statistics of cancer in 2012 at the global level and according to estimates, they are increasing. At the global level, breast cancer is the second most common cancer in the world and the most common cancer in women with about 1.67 million new cases diagnosed in 2012 (25% of all cancers).
This is the most common cancer among women in both the most developed (794,000 cases) and the least developed regions (883,000 cases).
It is the fourth most common cancer in women, with approximately 528,000 new cases in 2012. Like liver cancer, a large majority (about 85%) of the cases occurs in less developed regions, where it represents nearly 12% of all women’s cancers. The high-risk areas include East Africa (42.7), Melanesia (33.3), South Africa (31.5) and Central Africa (30.6).
In terms of mortality, the statistics show that we are still far from overcoming the disease: 14% of deaths from breast cancer and more than 10% for cervical cancer worldwide.
Why women's cancers?
In the less developed regions of the world, the incidence of breast and uterine cancer is striking: almost 900 thousand cases of breast cancer (23%) and more than 500 thousand cases of uterine cancer (15.6%). If we add to these figures the lack of any system of early diagnosis, as well as the lack of any treatment for the disease, it is easy to discover why mortality rates are so high (respectively 14.3 % and 12%).
The fact that more than half of the patients are younger than 45 at the moment of cancer diagnosis, is impressive. This is an age in which women are still young, productive and have children that still depend entirely from them.
As already mentioned, if women’s cancers are very common and have a high mortality rate in Africa, in Madagascar the situation is particularly serious. In 2012, 35% of the 9466 new cases of women’s cancers (3371 identified cases), was uterus cancer (corpus and cervix), with a mortality rate equal to 55.47%.
For breast cancer, the situation is not different: 1799 cases reported, (19%) with a mortality rate of 49.14%.
If we consider that in the whole country only three departments of oncology are active and that there is no data collection, the abovementioned numbers become more alarming. This means that the numbers are much higher than those reported by the World Health Organization. The only available data are those collected by the public Andrianavalona Joseph Ravoahangy Hospital (HJRA) of Antananarivo.
According to those data in 2008 cervical and breast cancers represented 50% of all cancer cases and 75% of the cases diagnosed in 2010.