Health, equity, and women’s cancers

Every minute a woman dies of breast cancer. Health, equity, and women’s cancers

Every minute a woman dies of breast cancer. Every two minutes, a women dies of cervical cancer. Health, equity, and women’s cancers

Every minute a woman dies of breast cancer. Every two minutes, a women dies of cervical cancer. That's around 800 000 women every year. Health, equity, and women’s cancers

Every minute a woman dies of breast cancer. Every two minutes, a women dies of cervical cancer. That's around 800 000 women every year. Most of these women are living in low- and middle-income countries. Health, equity, and women’s cancers

Every minute a woman dies of breast cancer. Every two minutes, a women dies of cervical cancer. That's around 800 000 women every year. Most of these women are living in low- and middle-income countries. Most of these deaths are premature… and preventable. Health, equity, and women’s cancers

But it doesn’t have to be this way… Health, equity, and women’s cancers

“This situation is a largely preventable tragedy for hundreds of thousands of women each year” Health, equity, and women’s cancers

43 authors from 18 countries Editorial & Commentaries: 3 papers 43 authors from 18 countries Editorial & Commentaries: Chilean President Hon. Michelle Bachelet of Chile Dr Otis Brawley & Ambassador Sally Cowal, American Cancer Society Health, equity, and women’s cancers

Health inequity- definitions… Differences in health “…that are unnecessary, avoidable, unfair and unjust”1. Poor health within countries and inequities between countries reflect an unequal distribution of power, income, goods, and services that result from “ineffective social policies, unfair economic arrangements, and bad politics”2. 1. Whitehead M, Whitehead M. Int J Health Serv. 1992 2. Marmot M, Friel S, Bell R, Houweling TA, Taylor S. Lancet. 2008 Health, equity, and women’s cancers

Paper 1: The global burden of breast and cervical cancer: a grand challenge in global health Incidence, mortality, survival, predicting the future burden Social and economic impact- systematic review Inequities among women in high income countries: e.g. poor women, ethno-cultural minority and immigrant women, indigenous women… Health, equity, and women’s cancers

These girls and women face higher risks of cancer than their mothers & grandmothers did …. Photo: CDC Photo: CDC Photo: The Lancet Global Health

“Women’s Cancers” – why breast & cervical cancer? big #s Breast Cervix

“Women’s Cancers” – why breast & cervical cancer? big #s major cause of premature M&M Breast Cervix

“Women’s Cancers” – why breast & cervical cancer? big #s major cause of premature M&M Breast Cervix

“Women’s Cancers” – why breast & cervical cancer? big #s major cause of premature M&M effective interventions to reduce mortality Breast Cervix

“Women’s Cancers” – why breast & cervical cancer? big #s major cause of premature M&M effective interventions to reduce mortality prevention at relatively low cost Breast Cervix

“Women’s Cancers” – why breast & cervical cancer? big #s major cause of premature M&M effective interventions to reduce mortality prevention at relatively low cost some interventions at primary care Breast Cervix

Breast Cancer Country A Country B 45 years old 61 years old

Breast and cervical cancer survival CONCORD-2 (Allemani et al Breast and cervical cancer survival CONCORD-2 (Allemani et al., The Lancet 2015)* Breast cancer: data on 5.5 million women in 61 countries 5-year survival 2005-2009: 80% or higher in 34 countries 60-69% in India and Malaysia 53% in South Africa and Mongolia Cervical cancer: data on 600,000 women in 61 countries 70% or higher in 6 countries 60-69% in 34 countries <60% in 21 countries   *Data from 279 population-based registries in 67 countries for over 25 million adults (15-99 years) diagnosed with one of 10 common cancers during the 15-year period 1995-2009

Cervical Cancer 85% of all cases 87% deaths Occur in low-income and middle-income countries..

Globocan 2012 (IARC)

Globocan 2012 (IARC)

Predicting the future burden… Breast cancer: predicted to almost double from 1.7 million in 2015 to 3.2 million in 2030 Cervical cancer is predicted to rise by at least 25% to over 700000 by 2030, most in LMICs

The impact on societies… 1 676 255 studies* 3% included an economics component. 10% from a low-income or middle-income setting.  * 1990-2015, original quantitative estimates, 4228 studies, 30 full text Health, equity, and women’s cancers

Key Messages- 1 Where a woman lives, and her socioeconomic, ethno-cultural, or migration status, need not mean the difference between life and death from these common cancers, for which cost-effective, life-saving interventions exist. Health, equity, and women’s cancers

Key Messages- 2 It is crucial to understand the social, economic, and financial impact of breast and cervical cancers, which take a disproportionate toll on women in LMIC, and in the prime of life.

Key Messages- 3 Global efforts, particularly in recent years, have led to significant improvements in maternal health outcomes. Similar efforts are urgently needed to address breast and cervical cancer, which take the lives of half a million more women each year.

Health, equity, and women’s cancers