Cancer Care Gap: Examining Cancer Mortality-Incidence Rate Ratio in Sub-Saharan Africa

Abstract

PURPOSE The 2022 global burden of cancer estimate released by the International Agency for Research on Cancer (IARC) showed a huge burden of 20million new cancer cases and 9.7 million cancer deaths, a threat to the achievement of the 2030 Sustainable Development Goals target on Non-Communicable Diseases (NCDs). Africa accounts for only 5.9% of new global cases and 7.8% of cancer mortalities; however, these figures belie the enormous premature death that has made cancer a death sentence in Africa. A five-year survival rate measures cancer survival. However, due to the scarcity of follow-up data in Africa, the Mortality-Incidence Rate Ratio (MIR) which has an inverse relationship with survival has become a useful substitute for making comparisons on a global scale. The study's purpose is to compare the cancer MIR in Africa with other continents and disaggregate MIR in Sub-Saharan Africa across gender and major cancer sites. METHODS Data on Age Standardized Incidence Rate (World)-ASIR and Age Standardized Mortality Rate (World)-ASMR for six continents and the top five cancer sites in Africa (Breast, Prostrate, Cervix, Liver, and Colorectal) were extracted from the IARC Global Cancer Observatory (Cancer Today). MIR (calculated as the ratio of ASIR/ASMR) comparisons were done using Microsoft Excel 2021. RESULTS The average global cancer MIR is0.47. Africa has an estimated MIR of 0.67, which is more than double those of North America (0.23) and Oceania (0.23), and far above those of Europe (0.38), Latin America and the Caribbean (0.46). The high figure of Asia, 0.54, is well below the African Cancer MIR. Among the top five cancer sites in Sub-Sahara Africa, the liver has the highest MIR (0.95 compared to global MIR of 0.86) followed by the cervix (0.75 compared to global MIR of 0.50), Colorectal (0.73 compared to global MIR 0.44), prostrate (0.60 compare global MIR 0.38) and Breast (0.52 compare global MIR0.25). Disaggregated by gender, cancer MIR is higher in Sub-Saharan Africa for both sexes above the global average (Male 0.72 compared global MIR0.52; Female 0.67 compared global MIR 0.41). CONCLUSION The Mortality-Incidence rate ratio in Sub-Sahara Africa is alarmingly high compared to the global figure, reflecting a huge disparity in cancer care outcomes. A concerted effort to bridge the care gap in Sub-Sahara Africa is required to achieve the SDGs' NCD target, which aims to reduce premature death by a third.