Poverty and cancer
Poverty and cancer are intricately linked, particularly in low- and middle-income countries where cancer incidence and mortality rates are significantly higher among impoverished populations. People living in poverty often face numerous barriers to cancer prevention and treatment, including limited access to healthcare, lack of education about cancer, and exposure to environmental toxins. In many cases, cancers are diagnosed at later stages, leading to poorer outcomes and survival rates.
The World Bank defines absolute poverty as living on less than $2.15 per day, a condition that often correlates with inadequate access to essentials such as clean water, nutritious food, and healthcare services. Cancers caused by infectious agents, such as cervical and liver cancers, are particularly prevalent in developing nations, exacerbated by insufficient screening and treatment options. Cultural factors also contribute to the challenges faced by individuals in poverty, including reliance on traditional medicine and social stigmas surrounding cancer, which can delay diagnosis and hinder treatment.
Addressing the intersection of poverty and cancer requires a multifaceted approach, focusing on improving health education, enhancing access to healthcare, and dismantling cultural barriers that prevent timely medical intervention. Vaccination against HPV and better sanitation can play critical roles in reducing cancer risks in these vulnerable populations. Overall, poverty remains the most significant obstacle to effective cancer care globally, underscoring the need for targeted interventions to support disadvantaged communities.
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Poverty and cancer
DEFINITION: Cancer has higher rates of incidence and mortality among people of lower socioeconomic status. Impoverished people in developed or developing countries tend to be poorly educated about cancers and cancer prevention, have little access to screening, have higher rates of exposure to environmental toxins, and have cancers discovered in later stages. Moreover, they are often unable to access and afford adequate medical treatment.
Description of the population: The World Bank defines absolute poverty as living on less than $2.15 per day in developing countries. In addition to economic indicators, poverty may be defined as lacking basic human services such as employment opportunities, safe drinking water, basic sanitation services, and access to food, health, education, and shelter.
Incidence, death, and survival statistics: According to the World Health Organization, globally, the leading causes of cancer death are lung, liver, stomach, colorectal, breast, and esophageal cancer. Approximately two-thirds of cancer deaths occur in low- and middle-income countries, where survival rates for cancer are much lower than in high-income countries, largely due to delays in diagnosis and treatment.
Approximately 30 percent of all malignancies worldwide are caused by infectious agents such as hepatitis B and hepatitis C viruses (HBV and HCV, which cause liver cancer), human papillomaviruses (HPV, which causes cervical cancer), Epstein-Barr virus, and Helicobacter pylori (H. pylori, the bacterial agent that causes stomach cancer) and are preventable with safe health and behavioral practices. These viral infections are higher in low- and middle-income countries than in high-income countries.
Breast and cervical cancer deaths are steady or decreasing in most developed nations because of early detection, proper and timely treatment, and vaccination. However, in many developing countries, the diagnosis rate is much lower than in wealthy nations, but the death rates are much higher. For example, Pakistan is continuing to see an increase in cancer prevalence among women. It has a high prevalence of breast cancer, accounting for about 25 percent of all malignant tumors among Pakistani women. Malaysia also experiences high rates of breast cancer, and 50 to 60 percent of breast cancers were diagnosed late, in Stages III and IV, contributing to low survival rates for breast cancer among Malaysian women.
Cervical cancer, which is preventable through HPV vaccination, routine screenings, and safe sex practices, is highly endemic in Central America, Africa, and India. Approximately 80 percent of all cervical cancer deaths occur in developing nations, where prevention, detection, and treatment strategies are minimal or absent.
Risk statistics: Socioeconomic status, tobacco use, poor nutrition or diet, physical inactivity, and prohibitively expensive healthcare are major risk factors for cancer globally. Environmental factors, such as exposure to pollution, are also risk factors.
The main difference between cancer in developing and developed countries is that developing countries are experiencing cancers largely associated with behavior and environment - cervical, liver, and stomach. These cancers are more often detected in early stages and successfully treated in developed countries. In developed countries, cancers that are preventable through diet and nutrition, physical activity, and avoiding tobacco use are endemic. For example, obesity is a leading cause of death in high- to middle-income countries, and obesity is associated with breast and colon cancers.
Developing countries often lack a stable healthcare system to screen for and treat cancer. If treatment is available, it is often geographically distant or not affordable except by the affluent members of the society. For example, Pakistan has numerous medical facilities that diagnose and treat cancer. However, a majority of Pakistani cancer patients are unable to afford treatment even if the facilities are in their area. Diagnostics are not typically available to socioeconomically disadvantaged groups, while higher-income groups benefit greatly from screening and physical examinations. Poor health education is a contributing risk factor for cancer.
Cultural barriers: Culture also plays a significant role in preventing the early detection and proper treatment of cancer. One cultural barrier is the role of traditional medicine. Physicians in developing countries trained in and practicing Western medicine often incorporate traditional beliefs into their practices. In India, Pakistan, and Malaysia, traditional beliefs interfere with the timely diagnosis of cancer. Social stigmas, such as fear that cancer is contagious and that patients will be abandoned by their spouses and communities, also inhibit timely diagnosis and treatment for cancer in developing nations. Additionally, cultural differences between care providers and their patients create a barrier to cancer screening and prevention. Establishing understanding, trust, and respect between provider and patient is important to treat and prevent cancer effectively.
Perspective and prospects: Poverty is the most significant barrier to early diagnosis and proper treatment for cancer globally. Economically disadvantaged individuals suffer greater mortality from cancer, particularly in developing countries. Financial and cultural barriers prevent socioeconomically disadvantaged people from seeking early diagnosis and treatment for the disease.
Areas to be addressed in solving this problem include improvement of health education, integration of the socioeconomically disadvantaged into health care systems, and the removal of cultural barriers to prevention and timely diagnosis.
Primarily, health education needs to be emphasized. Safe-sex practices can greatly reduce the incidence of cervical and liver cancers by lowering the spread of HPV and hepatitis B and C. Better sanitation may reduce the incidence of H. pylori and reduce stomach cancers resulting from this bacterial agent. Additionally, the dangers of tobacco use need to be emphasized to reduce global lung cancer rates. Proper health education may also help reduce the social stigmas and cultural barriers attached to cancer and enable more timely diagnosis.
Even if people become educated regarding their health, the medical system must be in place and capable of adequately treating cancer. However, because developing countries often deal with a high prevalence of infectious diseases, they usually give a lower priority to the prevention of chronic diseases. The vaccination of people in developing countries against HPV and hepatitis B could help control the increase in the rates of cervical cancer and liver cancer, respectively.
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