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Cancer is becoming an increasing problem for developing countries, and issues commonly associated with poverty are making it worse.

This was the message from specialists at an online seminar on 'Cancer and the Developing World', organised by the US National Cancer Institute and the American Society of Clinical Oncology last week (20 December).

Joe Hartford, director of the National Cancer Institute's Office of International Affairs, highlighted the risk posed by infectious viral diseases commonly associated with cancers, such as human papillomavirus with cervical cancer, viral hepatitis B and C with liver cancer, and HIV with Kaposi's sarcoma. 

"In more developed countries, infectious diseases account for eight per cent of cancers, while in developing countries infections account for 26 per cent," said Hartford.

But for many countries — India and Nigeria, for example — the cost of vaccinations against human papillomavirus and hepatitis is still too high to make them available for the population in general.

The seminar also heard how an increase in smoking will increase the number of cancer deaths in the developing world. Today it is responsible for 30 per cent of cancer deaths in the developing world.

The five million deaths worldwide caused by tobacco each year are now evenly distributed among developing and developed countries. The WHO say this is expected to grow to 10 million by 2020 — by which time 70 per cent of those deaths will be in the developing world.

China, for example, had 320 million smokers in 2004 and, like many other developing countries, has no anti-smoking policies but a powerful tobacco lobby.

Other issues discussed included the lack of specialised healthcare professionals in some countries, and the difficulties — both economic and geographic — of screening the population.

Ketayun Dinshaw, from the Tata Memorial Hospital in Mumbai, India, highlighted the problem of getting people to seek treatment for cancer.

Dinshaw said that 70 per cent of cancer cases in India are reported only in the advanced stages, resulting in high mortality rates. "The stigma and prejudice associated with cancer prevent many people from looking for help," she said.

Dinshaw mentioned low-cost programmes that provide training for non-specialists to help screen people living in Mumbai's shantytowns and India's rural areas for common types of cancer, with good results.

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