More than a year since the new coronavirus crisis began, its impact on cancer care has been stark, with “50% of governments (having) cancer services partially or completely disrupted because of the pandemic,” said André Ilbawi, MD, of the World Health Organization’s (WHO) Department of Noncommunicable Diseases, during a recent United Nations briefing. Dr. Ilbawi also reported that breast cancer is now the most commonly occurring cancer globally, overtaking lung cancer.
André Ilbawi, MD
COVID-19's Impact
“Delays in diagnosis are common. Interruptions in therapy or abandonment have increased significantly,” said Dr. Ilbawi, adding that the COVID-19 pandemic would likely have an impact in the total number of cancer deaths in coming years.
“Health-care professionals have been under great stress to deliver services, and there are significant reductions in research and clinical trial enrollment. To state it simply, the consequences of the pandemic on cancer control efforts have been profound,” said Dr. Ilbawi.
An unspecified number of countries “of all income levels” had been affected, although some wealthier nations had managed to counter the effects of the pandemic, including the Netherlands, where special programs have been set up to speed up access to cancer diagnosis and treatment for those with symptoms.
Amid uncertainty over which COVID-19 vaccine might be most suitable for patients with cancer, given the increased vulnerability of some individuals, Dr. Ilbawi said that data from ongoing clinical vaccine trials had yet to be published.
“We do appreciate that [patients with] cancer are being noted in these clinical trials, because evidence has shown that [patients with] cancer are at greater risk for COVID-related morbidity and mortality because of their immunosuppression,” he said.
Breast Cancer Overtakes Lung Cancer
“In 2020, the number of people diagnosed with cancer globally reached 19.3 million, with the number of people dying increasing to 10 million,” said Dr. Ilbawi.
According to the agency, there were 2.3 million new breast cancer cases in 2020, representing almost 12% of all cancer cases. It is also the leading cause of cancer death worldwide among women.
Speaking via Zoom in a United Nations briefing ahead of World Cancer Day, Dr. Ilbawi noted that “for the first time, breast cancer now constitutes the most commonly occurring cancer globally.”
According to a report from Reuters, lung cancer was the most common type for the past 2 decades, but is now in second place, ahead of colorectal cancer, which is the third most widespread, according to Dr. Ilbawi.
Dr. Ilbawi noted that obesity in women was a common risk factor in breast cancer, and is also driving overall cancer numbers.
Global Burden
Dr. Ilbawi also warned that the burden of cancer is expected to rise further in the years ahead for a variety of reasons, including population growth, with the number of new cases worldwide in 2040 likely to be 47% higher than in 2020.
The greatest increases will be in low- and middle-income countries, where late-stage diagnosis and lack of access to quality and affordable diagnosis and treatment are common.
Cervical Cancer
Highlighting efforts to tackle cervical cancer, WHO noted that it is the fourth most-common cancer among women globally, with an estimated 604,000 new cases in 2020 and 700,000 cases and 400,000 deaths forecast in 2030.
Patients with cervical cancer from poorer countries are disproportionately affected, with nearly 90% of global deaths in 2020 from cervical cancer occurring in low- and middle-income countries.
Underscoring the benefits of early diagnosis and appropriate treatment, the WHO appealed for better availability of the human papillomavirus (HPV) vaccine and low-cost approaches for screening and treating precancer “before it progresses to invasive cancer,” in addition to new approaches to surgical training.
“To get on the path to eliminate cervical cancer, we must achieve three targets by 2030: 90% of girls fully vaccinated with the HPV vaccine by age 15, 70% of women screened using a high-performance test by age 35—and again by age 45, and 90% of women identified with cervical cancer treated,” said WHO.
Achieving these targets would lead to a decline in cases of more than 70% by 2050 and help to avert 4.5 million cervical cancer deaths.
