Your Odds Of Surviving Cancer Depend Very Much On Where You Live

Dec 1, 2014
Originally published on December 3, 2014 7:18 pm

In the United States, 9 out of 10 kids diagnosed with acute lymphoblastic leukemia will live. In Jordan, the survival rate is 16 percent.

And while cervical cancer patients have a five-year survival rate of over 70 percent in countries like Mauritius and Norway, the rate in Libya is under 40 percent.

That's the sobering news from the largest cancer study ever published. It surveyed more than 25.7 million patients and reveals a huge gulf in cancer survival worldwide.

But there's good news as well. "In most countries, survival from some of the commonest cancers has been improving," says Dr. Michel Coleman from the London School of Hygiene and Tropical Medicine, one of the study's authors.

More people are surviving breast cancer, colon cancer and stomach cancer than ever before, especially in the U.S. and Europe. The survival rate for breast cancer in France and Finland, for example, is 87 percent. The data from other regions are also encouraging. Brazil's breast cancer survival rate has gone up from 78 percent in 1995-99 to 87 percent in 2005-09.

The reason that some countries lag behind is not surprising; it's a matter of how much is invested in cancer care. Dr. Corey Casper, head of global oncology at the Fred Hutchinson Cancer Research Center in Seattle, met a doctor in Uganda a few years ago who was then seeing 10,000 patients a year "in a facility that had ... no roof, inconsistent electricity and no meds." What's more, says Casper, he was the only cancer doctor in Uganda and four surrounding countries.

Cultural barriers can also interfere with the diagnosis and treatment of cancer. Uganda has 57 tribes, each with a different language. Many tribes don't even have a word for cancer, Casper says. So people may go a very long time before they realize they have a problem. When they do seek care, it's usually too late.

"More than 75 percent of the patients who come to the cancer institute in Uganda come with stage 3 or stage 4 cancer," Casper says.

But it's not all doom and gloom. Uganda is opening a $10 million cancer center next month in the capital, Kampala, with help from USAID and the Fred Hutchinson center. Smaller centers have sprung up elsewhere in Africa, in Latin America and in southeast Asia.

Yet as the study makes clear, there is still much work to be done — and the scope isn't fully known. There are countries where we have no idea how many people die from a certain cancer because there just aren't good data.

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AUDIE CORNISH, HOST:

The largest ever global cancer study has now been published - a survey of more than 27 million cancer patients. And it yields this statistic. In the developing world, more people die of cancer than HIV, malaria and tuberculosis combined. As NPR's Anders Kelto reports, it also reveals a huge gulf in cancer survival rates worldwide.

ANDERS KELTO, BYLINE: So basically, there's some good news and some bad news. Here's Dr. Michael Coleman from the London School of Hygiene and Tropical Medicine - one of the authors of the study.

MICHAEL COLEMAN: The good news is that in most countries survival from some of the commonest cancers have been improving.

KELTO: Breast cancer, colon cancer, stomach cancer - more people are surviving these diseases than ever before, especially in the U.S. and Europe. Some low-income and middle-income countries are making progress, too.

COLEMAN: There are many countries in Latin America, for example, and Southeast Asia where survival has improved quite markedly. Even in Mongolia there have been quite sizable increases in survival from some cancers.

KELTO: But then, there's the bad news. The study published in The Lancet shows that there's still a huge gap between rich countries and poor ones. Take childhood leukemia. In the U.S., 9 out of 10 kids who get it will live. Now compare that - a 90 percent survival rate - to some poorer nations.

COLEMAN: In Jordan, it's 16 percent. In Lesotho in southern Africa, it's 40 percent. And in the central region of Tunisia in northern Africa, it is 50 percent.

KELTO: There are also countries where we have no idea how many kids are dying from leukemia because there just isn't good data. So just how bad is it in these places? I ask that to Dr. Corey Casper, the head of global oncology at the Fred Hutchinson Cancer Research Center in Seattle. He told me about this doctor he met in Uganda a few years ago.

COREY CASPER: This one guy was seeing 10,000 patients a year in a facility that had, you know, no roof, inconsistent electricity and no meds.

KELTO: That guy was literally the only cancer doctor for Uganda and four surrounding countries. And then there are cultural barriers, too.

CASPER: Uganda has 57 different tribes, and there are different languages within each of those tribes. And many of them don't even have a word for cancer because it's so not part of, you know, the local culture.

KELTO: So people go a very long time before they even realize they have a problem. And when they seek care, it's usually too late.

COLEMAN: More than 75 percent of the patients who come to the Cancer Institute in Uganda come with stage three or four cancer.

KELTO: But Casper says look, it's not all doom and gloom. Uganda is opening up a 10-million-dollar cancer center next month. And smaller centers have sprung up elsewhere in Africa and in Latin America and Southeast Asia. And he says it's no big surprise that the countries making the biggest strides are the ones investing the most in cancer care. Anders Kelto, NPR News. Transcript provided by NPR, Copyright NPR.