The global burden of women’s cancers: an unmet grand challenge in global health

Abstract

Each year, more than 2 million women are diagnosed with breast or cervical cancer, yet where a woman lives largely determines whether she will develop one of these cancers, have access to timely and effective diagnostic and treatment services, and ultimately survive. Premature death and disability from cancer is a preventable tragedy for hundreds of thousands of women and their families every year. In regions with limited resources, and a fragile or fragmented health system, cancer contributes to the cycle of poverty. This is most striking for cervical cancer, as more than eight in ten women diagnosed and nine in ten women who die from cervical cancer live in a low- or middle-income country. There are proven and cost-effective approaches to reduce these disparities, yet for most women there are few opportunities to access life-saving interventions such as HPV vaccination, and cervical cancer screening with timely treatment of pre-cancerous lesions. These longstanding inequities highlight the urgent need for substantive and sustainable investments in cancer control more broadly, including prevention and early detection programs, capacity building for health service infrastructure and human resources for cancer management including all disciplines: pathology, surgery, radiotherapy, systemic therapy as well as palliative care. Equally vital is the development of high-quality population-based cancer registries, particularly in low- and middle-income countries. In this first Series paper we describe the burden of breast and cervical cancer, with an emphasis on global and regional trends in incidence, mortality and survival; the social and economic impact on women and their families; and the disparities in cancer survival among socioeconomically disadvantaged women in different settings.