Although significant progress has been made against cancer, especially in the United States, which has seen the overall death rate from cancer fall by 33% over the past 3 decades, translating into averting an estimated 3.8 million deaths from the disease,1 progress worldwide has not been as successful. Data showed that when adjusted for demographic changes, the death rate from cancer globally has fallen by only 15% over that same period.2
According to survey results from 115 countries on the global burden of cancer, published by the International Agency for Research on Cancer (IARC), just 39% of participating countries covered the basics of cancer management as part of their financed core health services for their citizens. In addition, only 28% covered services for patients requiring palliative care. The survey also highlighted the disproportionate impact of cancer on underserved populations in low-resource countries who are unable to access basic cancer care.
For example, when cancer inequity is measured by the Human Development Index (HDI), which considers a country’s social and economic development, global estimates showed that in countries with a very high HDI, 1 in 12 women will be diagnosed with breast cancer over a lifetime, and 1 in 71 women will die of the disease. However, in countries with a low HDI, although only 1 in 27 women will be diagnosed with breast cancer over a lifetime, 1 in 48 women will die of the cancer.3
Ulrika Årehed Kågström
Closing the global cancer disparities gap is among the top priorities of Ulrika Årehed Kågström as she begins her 2-year tenure as President of the Union for International Cancer Control (UICC). She succeeded Professor Jeff Dunn, AO, after his presidential term ended in October 2024.
In addition to her role as President of the UICC, Ms. Kågström also serves as Secretary General of the Swedish Cancer Society and is a board member of the Nordic Cancer Union. The ASCO Post met with Ms. Kågström during the 2024 ASCO Annual Meeting to discuss the goals she hopes to accomplish over the next 2 years and her biggest challenges ahead.
Making a Difference in Patients’ Lives
Please talk about your top goals as you begin your term as President of the UICC.
There are four main areas of concern on my agenda. The first, of course, is improving equity in cancer control. Second, I want to ensure that improving cancer control in low-resource countries is at the forefront of the global health and development agenda. Third is uniting and supporting the cancer community by engaging our members, so we have a more membership-centered approach to implement our priorities globally. And the fourth area of concern is in extending our relationships with our global partners to secure global and national commitments to reduce the global cancer burden and ensure equitable access to cancer services to all patients no matter where they live.
Currently, we have more than 1,150 members in more than 170 countries and territories. They all are fundamental to providing long-term and measurable changes in cancer control.
Accomplishing these goals will take longer than just 2 years. Hopefully, if I’m able to put these changes into effect, we will start to see the benefits over the next 5 to 10 years. I want to have an impact in cancer control over the long term to make a difference in patients’ lives.
Equity in cancer care is a challenge between countries and within countries, even in a high-income country like Sweden (where I live) as well as in the European Union and the United States. We can see the growing gaps in care in our populations, which will get worse as the rate of cancer incidence increases. According to the World Health Organization (WHO), more than 35 million new cancer cases are predicted in 2050, a 77% increase from the estimated 20 million cases in 2022.3
We are all struggling with the increasing cancer incidence, and our health systems aren’t equipped to deal with the impending crisis, despite all the human suffering cancer causes. We have to determine how we can actually meet this challenge and close the gaps in the whole continuum of health care—from prevention to screening and early cancer detection to treatment, including palliative care—and survivorship care programs.
Tackling the Global Threat of Antimicrobial Resistance
Please talk about some of the greatest challenges you expect to face over the next 2 years.
Of course, among the biggest challenges are promoting and funding national cancer control policies, plans, and programs as part of universal health coverage in low-resource countries. Workforce shortages and lack of political will are also impeding progress.
Another huge challenge is the development of antimicrobial resistance, including antibiotic resistance, which is a growing global threat to health. Research has shown that antimicrobial resistance is one of the top 10 global public health emergencies we are facing, and it was associated with nearly 5 million deaths in 2019, with 1.27 million deaths directly the result of drug-resistant infections.4 It puts a strain on health systems through high health-care costs from increased hospital admissions and expensive, intensive therapy. Antimicrobial resistance also undermines advances in cancer care by adversely affecting treatment outcomes, threatening the survival of patients with cancer.
The UICC supports the cancer community in addressing antimicrobial resistance. The UICC aligns its efforts with the WHO’s global action plan on antimicrobial resistance, adopted by the World Health Assembly in 2015.5
And although there are so many challenges to overcome, there are also many opportunities to reduce the global cancer burden with the discoveries of new therapies, implementation of cancer registries in each country, and research tailored to the local disease burden and available resources. So, I’m optimistic that the efforts we make today will pay off over the coming decade.
Setting Priorities
The UICC has created several initiatives to address the long-term public health challenges of cancer and the unmet needs of patients, including the City Cancer Challenge (which supports resource-limited countries in reducing their cancer burden), the breast cancer program, and the cervical cancer elimination program. Do you have plans to launch new initiatives during your presidency?
Right now, it’s important to follow through and build on our current initiatives and add value to them, so we can measure their impact over the long term. The UICC supports the WHO’s Cervical Cancer Elimination initiative, which proposes a global strategy to accelerate the elimination of cervical cancer as a public health problem through the achievement of reaching the three key 90-70-90 targets by 2030. They include having 90% of girls fully vaccinated against the human papillomavirus by age 15; having 70% of women screened with a high-performance test by ages 35 and 45 as well as removing precancerous lesions; and having 90% of women diagnosed with cervical cancer receive treatment.
We are monitoring the uptick in young-onset colorectal cancer as well. That may present another initiative for us, but we have to study the data first before we can develop a new program.
Currently, we are preparing for the Fourth High-level Meeting of the United Nations General Assembly taking place in September 2025. At this meeting, heads of state and governments will set a vision to prevent and control noncommunicative diseases by 2050. We want our members to put more pressure on their governments to adequately fund cancer and palliative care services as part of universal health coverage in their countries as well as to hold them accountable for the development of policies that promote equitable cancer care for all their citizens and improve cancer outcomes.
We have a lot of challenges ahead, but I’m optimistic that we will make progress for patients with cancer.
DISCLOSURE: Ms. Kågström reported no conflicts of interest.
REFERENCES
1. American Association for Cancer Research: Cancer in 2023. Available at https://cancerprogressreport.aacr.org/progress/cpr23-contents/cpr23-cancer-in-2023. Accessed August 29, 2024.
2. Roser M, Ritchie H: Cancer. Our World in Data, first published in July 2015 and last revised in March 2024. Available at https://ourworldindata.org/cancer. Accessed August 29, 2024.
3. World Health Organization: Global cancer burden growing, amidst mounting need for services. February 1, 2024. Available at www.who.int/news/item/01-02-2024-global-cancer-burden-growing--amidst-mounting-need-for-services. Accessed August 29, 2024.
4. Antimicrobial Resistance Collaborators: Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis. Lancet 399:629-655, 2022.
5. World Health Organization: Global action plan on antimicrobial resistance. Available at www.who.int/publications/i/item/9789241509763. Accessed August 29, 2024.
