1. Health, equity, and women’s cancers

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

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

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

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

6. Every minute a woman dies of breast cancer.
Every two minutes, a women dies of cervical cancer.
That's around 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

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

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

9. 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

10. 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

11. 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

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

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

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

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

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

17. “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

18. “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

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

20. 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 :
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

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

22. Globocan 2012 (IARC)

23. Globocan 2012 (IARC)

24. 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 by 2030, most in LMICs

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

26. 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

27. 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.

28. 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.

29. Health, equity, and women’s cancers