New Delhi: Low- and middle-income countries need to improve cancer care and surgery provisions in the next few years to tackle rise in cases and mortality, two new Lancet studies have revealed.
A modelling study, published in The Lancet Oncology journal, noted that the number of cancer cases that will require surgery is set to increase by 5 million procedures between 2018 and 2040 across the world. The greatest relative increase, however, will be seen in 34 low-income countries where the researchers also found widest gaps in the healthcare workforce.
Meanwhile, an observational study in The Lancet, highlighted that patients in low- and middle-income countries are four times more likely to die from colorectal or gastric cancer.
Colorectal cancer refers to any cancer that affects the colon or large intestine and rectum while gastric cancer is a disease where malignant cancer cells form in the lining of the stomach.
Both studies were published Thursday.
According to the modelling study, the estimated cancer surgical case demand in India will rise by 38 per cent between 2018 and 2040.
“Low-income countries currently have the lowest ratios for the actual number of surgeons and anaesthetists per 100 cancer procedures compared with countries at other income levels. The rising demand for cancer surgery could strain the already jeopardised service delivery,” the study warned.
For the study, researchers from Australia, the UK, Canada and Switzerland estimated the proportion of cancer cases with an indication for surgery for 183 countries.
This was then multiplied by age adjusted national estimates of new cancer cases using the International Agency for Research on Cancer’s Global Cancer Observatory database (GLOBOCAN) from 2018.
Moreover, cancer surgical procedures in 44 high-income countries were divided by the number of surgeons and anaesthetists in the countries and used to generate a median benchmark.
Using this data the study found that “to match the median benchmark for high-income countries, the surgical workforce in these countries would need to increase by almost four times and the anaesthesia workforce by nearly 5.5 times”.
The model also found that the number of surgeons would have to be increased by 107 per cent in low-income countries and 67 per cent in middle-income countries.
The second study, conducted by the GlobalSurg Collaborative and National Institute for Health Research Global Health Research Unit on Global Surgery, an international medical research organisation, observed 15,958 patients across 428 hospitals in 82 countries between April 2018 and January 2019.
Of the 15,958 patients, 9,106 were from 31 high-income countries, 2,721 were from 23 upper-middle-income countries and 4,131 belonged to 28 lower-middle-income countries (LMIC).
“Patients in LMICs presented with more advanced disease compared with patients in high-income countries,” the study noted.
According to the study, in low-income or low-middle-income countries, patients suffering from gastric and colorectal cancers were more likely to die within 30 days of surgery due to complications, compared to high-income countries.
“The absence of consistently available postoperative care facilities has been associated with seven to 10 more deaths per 100 major complications” in the low-middle-income-countries, it added.
“Effective surgical care plays a crucial role in the prevention of death from cancer and requires systems of the highest quality throughout the preoperative and postoperative periods,” the study noted.