Cancer Control in the EMR

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Cancer Control in the EMR

• Dr. Haifa Madi
• Director, Health Protection and Promotion
• WHO/EMRO

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Noncommunicable Diseases

• About 47 of the regions disease burden
  expressed as DALY is due to NCDs.
• Chronic diseases accounted for 52 of deaths in
  EMR.
• This burden is likely
• to rise
• Shared preventable risk factors
• Tobacco use
• Unhealthy diet
• Physical inactivity
• Harmful use of alcohol

Cancer
Chronic lung Diseases
Diabetes


Heart disease and stroke

Other NCDs

Unhealthy diets
Physical inactivity
Smoking

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Deaths by cause in the world
Noncommunicable diseases
Infectious diseases
HIV/AIDS 4.9
Tuberculosis 2.4
Heart disease 30.2
Malaria 1.5
Total 58Million
Other Infectious Diseases 20.9
Cancer 15.7
Injuries 9.3
Diabetes 1.9
Other chronic diseases 15.7
(WHO, 2005)
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Cancer in the EMR

• Cancer is the 4th cause of death and it kills
  more than HIV, malaria and TB together.
• The burden of cancer will increase with aging and
  unhealthy lifestyle and the EM region will
  witness the highest and fastest increase in the
  coming years. (100 and 180).
• 40 of cancers can be prevented
• 40 of cancers can be detected early and cured.
• 20 of cancer can be managed by palliative
  therapy

Source Rastogi et al. 2004.
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Increase in Deaths From Cancer In the next 15
years
INCREASE IN DEATHS FROM CANCER ()
INCREASE IN CANCER DEATH BY THE YEAR 2020 (From
Rastogi et al 2004)
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Cancer Incidence and Mortality in the EM Region
By Gender
Breast Cervix
Bladder Lung
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Children Cancer
In the EM region, the most common children
cancers are blood cancers
Incidence Mortality of children cancer in the
EM region compared to that in western countries
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Screening Early Detection In the EM region,
the vast majority of cancer are diagnosed at an
advanced stage when cure is improbable even with
the best treatment.
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Morphine consumption
Morphine consumption in western countries is
around 50 mg/capita
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Cancer programmes in EM Countries

• Cancer programmes in EM countries is
  characterized with lack of reliable comprehensive
  data, insufficient human and financial resources
  to cover the needs in many EM countries, and
  multidisciplinary management of cases is not
  instituted.
• In almost all countries, cancers are detected at
  an advanced stage which increases cost and
  mortalities.
• Access to treatment and palliative care is
  limited in many countries of the Region

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Cancer Risk Factors
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Prevalence of Smoking among Adults
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Currently Smoke Cigarettes, youth 13-15
Source is the GTYTS data in EMR MS
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Currently use Other Tobacco forms (Shisha), youth
13-15
Source is the GTYTS data in EMR MS
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Never Smoker Likely to Initiate Smoking Within a
year (13-15 yr)
Source is the GTYTS data in EMR MS
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Countries Ratified the FCTC

• ALL EMR countries, Except
• Morocco
• Tunisia
• Afghanistan
• Somalia
• Palestine

• tobacco use - responsible for 1.8 million cancer
  deaths per year (60 of these deaths occur in
  low- and middle-income countries)

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Main Issues with Tobacco

• Tobacco consumption is an epidemic.
• There are other components to it than only
  cigarettes. Shisha is a rising problem.
• Yet there are opportunities
• FCTC implementation (countries that have moved
  into stronger legislations are all FCTC parties).
• Even countries that are not FCTC parties can
  implement the internationally known evidence
  based interventions for tobacco control.

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Evidence based cost effective interventions for
tobacco control (FCTC AND MPOWER)

• Taxation increase (GCC countries- potentially
  Yemen, EGY, PAK and Iran).
• Tobacco free public places (BAH-UAE- EGY-
  IRA-JOR).
• Pictorial Health Warnings (JOR-EGY-IRA-DJI-GCC).
  
• Banning of ALL types of tobacco promotion
  (EGY-IRA-YEM-KUW-DJI-SUD-BAH-UAE-QAT).

WHO recommendation is to increase taxes to 70
of retail price. GCC adopted the PHW
specification but yet to choose the Image.
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Thank You