An Overview of Cancer Care in Societies in Transition: Global Perspectives—UAE Experience

Abstract

Cancer is not a modern disease but has clearly existed for many centuries. It is however a more common phenomenon nowadays than previously due to the increase of the world’s population and the relatively advanced age to which people now live, since it is a disease that is more common in elderly ages than in younger ages (World Cancer Report 2008).

The burden of cancer worldwide is continuously rising largely because of the age and growth of the world population alongside an increasing adoption of cancer-causing behaviors, particularly smoking, physical inactivity, and “westernized” lifestyle in economically developing countries. Based on the GLOBOCAN 2008 estimates, about 12.7 million cancer cases and 7.6 million cancer deaths are estimated to have occurred in 2008; of these, 56 % of the cases and 64 % of the deaths occurred in the economically developing world. Cancer is the leading cause of death in economically developed countries and the second leading cause of death in developing countries (CA Cancer J Clin 61:69–90. CV2011 American Cancer Society, Inc., 2011). Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females, accounting for 23 % of the total cancer cases and 14 % of the cancer deaths. Lung cancer is the leading cancer site in males, comprising 17 % of the total new cancer cases and 23 % of the total cancer deaths. Breast cancer is now also the leading cause of cancer death among females in economically developing countries, a shift from the previous decade during which the most common cause of cancer death was cervical cancer. Further, the mortality burden for lung cancer among females in developing countries is as high as the burden for cervical cancer, with each accounting for 11 % of the total female cancer deaths. Although overall cancer incidence rates in the developing world are half those seen in the developed world in both sexes, the overall cancer mortality rates are generally similar. Cancer survival tends to be poorer in developing countries, most likely because of a combination of a late stage at diagnosis and limited access to timely and standard treatment. A substantial proportion of the worldwide burden of cancer could be prevented through the application of existing cancer control knowledge and by implementing programs for tobacco control, vaccination (for liver and cervical cancers), and early detection and treatment, as well as public health campaigns promoting physical activity and a healthier dietary intake. Clinicians, public health professionals, and policy makers can play an active role in accelerating the application of such interventions globally (CA Cancer J Clin 61:69–90. CV2011 American Cancer Society, Inc., 2011) (Fig. 19.1).