Abstract
With cancer accounting for 19% of deaths and projected to rise in the coming years, Ecuador’s inequities in healthcare coverage remain a major concern for the rural, indigenous populations. While the cancer burden among this vulnerable population has been much publicized in the context of the controversial oil extraction in the Amazon, there is contradictory evidence on its occurrence and determinants. This review critically discusses the available literature on cancer among indigenous people in Ecuador and explores the link between oil exploitation and cancer occurrence among indigenous people using a scoping review approach. The results of this review show there is a clear but inconsistent association between oil exposure and cancer risk in indigenous populations of Ecuador. While the environmental magnitude of oil extraction in this region is a topic of debate, our findings point to the interplay with social determinants and other sources of carcinogenic compounds, which exacerbates the risks faced by indigenous communities. Based on these findings, this study puts forward three arguments to contextualize the occurrence of cancer related to oil exploitation in the Amazon, and puts forth key recommendations for public health initiatives embedded within the local community.
Highlights
Non-Communicable Diseases (NCDs) like cancer, diabetes, cardiovascular diseases, and chronic respiratory diseases, which account for 71% of total deaths worldwide, are increasingly posing a major health challenge [1]
The research question at the centre of our study was the following: What is the occurrence of cancer in the indigenous Ecuadorian population and what are the social and environmental determinants linked to oil exploitation
After screening the 16 full-text articles, two were excluded because they investigated precancerous lesions rather than actual cancer burden and one was excluded as it is a phenomenological understanding of oil extraction in the Amazon with a broader focus on economic, social, political, and health impact
Summary
Non-Communicable Diseases (NCDs) like cancer, diabetes, cardiovascular diseases, and chronic respiratory diseases, which account for 71% of total deaths worldwide, are increasingly posing a major health challenge [1]. While once only considered a burden for High-IncomeCountries (HICs), developing countries are rapidly closing this gap. They experience a change in lifestyle patterns similar to the developed world, with increased exposure to carcinogens, bad dietary practices, and sedentary occupations [3]. This shift in disease ecologies proves to be a significant concern, with Low- and Middle-Income Countries (LMICs) accounting for approximately 78% of the global deaths due to NCDs, and 65%. Alarming statistics on the inadequate coverage of cancer screening and diagnostic and treatment services in most LMICs demonstrate that these countries are ill-equipped to cope with the mounting health challenge [5,6]
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