Cancer deaths rising
CANCER brings fear to everyone.
Guyana Chronicle
February 4, 2007
It is a non-communicable disease. As is happening in developing and developed countries alike, cancer is imposing a considerable disease burden in Guyana, both in terms of illness (morbidity) and deaths (mortality).
Globally, more than 6.7 million persons died of cancer in 2005. This is about 13% of all deaths. Only cardiovascular diseases cause more deaths than cancer. Most of the deaths are occurring in developing countries.
More than 10.9 million new cases were recorded in 2005 and now there are more than 25 million persons living with cancer worldwide.
Guyana has not been spared. Cancer (neoplasms) now ranks as the third most prevalent cause of death in Guyana, rising from the fourth leading cause of death in 2000.
In Latin American and the Caribbean, lung cancer and stomach cancer are the leading causes of cancer deaths among men. Among women, cervical cancer is the leading cause of cancer deaths in most countries and breast cancer is the leading cause of cancer deaths in other countries.
There were an estimated 480,000 deaths due to cancer in Latin America and the Caribbean in 2002 and according to projections this is expected to rise to 841,000 by 2020.
Mortality rates for all cancers in men are highest in Uruguay (200.9/105), Bahamas (179.5/105), U.S. (171.3/105) and Canada (166.8/105). The lowest rates are seen in Bolivia (60.4/105), Guyana (72.1/105) and El Salvador (91.5/105). Among women, mortality rates are highest in Haiti (130.4/105), Jamaica (130.5/105) and Ecuador (130.2/105) and lowest in Guyana (72.9/105) and Puerto Rico (72.2/105).
While cancer is a problem everywhere, it is not manifested in the same way worldwide. A substantial portion of cancers in developing countries, up to 25 per cent, are associated with chronic infection. Liver cancer is casually associated with hepatitis B infection, cervical cancer with infection by certain types of human papillomavirus and stomach cancer with Helicobacter pylori infection.
In 2000, seven types of cancer accounted for approximately 60 per cent of all newly diagnosed cancer cases and cancer deaths in developing countries: cervical, liver, stomach, oesophagus, lung, colorectal and breast. The first four exhibit elevated incidence and mortality rates in developing countries. The last three have a lower but increasing incidence because of demographic and industrial transitions.
Developing regions also exhibit considerable variation in their cancer burdens. Deaths from liver cancer are relatively high in East Asia and Africa because of the high prevalence of chronic hepatitis B infection and inadequate food storage and preservation in those regions. Deaths from colorectal and breast cancer are relatively high in Eastern Europe as people in those regions have adopted less healthy, high fat diets and more sedentary lifestyles. Deaths from oral cancer are particularly high in South Asia, where chewing betel quid is common. These different types of cancer call for different intervention strategies.
In Guyana, cancer is among the principal causes of morbidity and mortality, as can be seen in the table below. The diversity of disorders, the effect on the quality of life of the affected patients, as well as the high cost of the diagnosis and treatment mean that cancer is an important health problem.
treatment in guyana
Treatment options available in Guyana:
Surgery for some cancer patients is available in both the private and public health sectors Chemotherapy Radiation therapy available through a public/private sector partnership
Ten Leading Causes of Death 2003, 2000
Cause of Death Rank 2003 Cause of Death Rank 2000
Cerebrovascular Diseases 1 Ischemic Heart Diseases 1
Ischemic Heart Diseases 2 HIV Diseases (AIDS) 2
Neoplasms 3 Cerebrovascular Diseases 3
HIV Diseases (AIDS) 4 Neoplasms 4
Diabetes Mellitus 5 Diabetes Mellitus 5
Intentional Self-Harm (Suicide) 6 Hypertensive Diseases 5
Hypertensive Diseases 7 Acute Respiratory Infections 7
Assault (Homicide) 8 Intentional Self-Harm (Suicide) 8
Acute Respiratory Infections 9 Undetermined Intent 9
Heart Failure 10 Heart Failure 10
Source: Health Statistical Department of the Ministry of Health, Georgetown, Guyana
Incidence of Cancer in Guyana 2000-2004
During the period 2000-2004, there were 2,236 recorded cases of cancer. This represents a cumulative incidence rate of 301.3 x 105 inhabitants. The incidence rate in the period tends to increase per year, which can be related to a greater coverage of the system of registry of the cases. The annual figures are as follows:
Distribution of the Incidence of Cancer by year
YEARS CASE RATE
2000 345 46.5
2001 393 53.0
2002 449 60.5
2003 574 77.3
2004 475 64.0
The principal cancers are breast comprising 15.4% of the total incidence, prostate representing 14.6% and cervical cancer with 12.9%. Other most frequent cancers were: the colon, the stomach, the lung, the cervix, the uterus and the liver, that include from 5.6% to 3.1%. These locations contributed 64% of the total of recorded cases in this period.
Distribution of Types of Cancer by Year
SITE 2000 2001 2002 2003 2004 TOTAL %
Breast 54 55 76 74 85 344 15.4
Prostate 53 52 59 90 72 326 14.6
Cervix 27 59 56 82 64 288 12.9
Colon 21 24 29 27 24 125 5.6
Stomach 27 26 17 28 17 115 5.1
Lung 13 21 19 21 13 87 3.9
Liver 16 9 10 20 15 70 3.1
Others 134 147 183 232 185 881 39.4
TOTAL 345 393 449 574 474 2236 100.0
Distribution of cancer cases by site and Regions
Guyana 2000-2004
Region Breast Prostate Cervix Colon Stomach Lung Liver Other Total
1. 4 3 9 3 3 - 3 12 37
2. 18 19 13 2 6 9 3 52 122
3. 30 32 26 14 7 18 5 81 213
4. 191 159 146 63 63 42 25 453 1142
5. 19 26 8 10 12 6 3 49 133
6. 61 39 38 24 13 10 16 120 321
7. 1 7 5 - 1 - 4 15 33
8. - 1 2 - - - - - 3
9. 1 2 5 1 - - - 7 16
10. 12 33 10 7 10 2 10 45 129
Ignored 7 5 26 1 - - 1 47 87
Total 344 326 288 125 115 87 70 881 2236
(Produced by the Ministry of Health)