9
The need to build on recent progressexamined in this report, it rose, even if
marginally in some cases, in all but one of the
countries analysed (Uruguay). Although cancer
is estimated to be the second-leading cause
of death across most of the countries (after
cardiovascular diseases generally), it is already
the leading cause of death in Peru, according
to the Ministry of Health. “Cancer is coming
to the top of the agenda, but there is still not
enough planning and projection for cancer
control,” says Gustavo Sarria, deputy head of
the Peruvian National Institute of Neoplastic
Diseases.A region full of contrasts
In spite of the cultural and historic linkages
among countries in the region, there are many
contrasts, reflecting different epidemiological
profiles. For example, country populations
range from 3.4m in Uruguay to about 210m
in Brazil. Bolivia has a life expectancy of 69
years and a gross national income per head
of US$3,370. Chile’s respective numbers, by
contrast, are 80 years and US$14,670 (the
highest in the region).^3Furthermore, economic inequality within
countries is high, with the region often
referred to as the world’s most unequal.^4
Lastly, age structures differ, with countries
like Uruguay and Chile with a median age
nearing 35, compared with younger Bolivia or
Paraguay, where the median age is about 24.^5The socioeconomic diversity contributes to
Latin America experiencing what is referred to
as a “double-burden of cancer”, with presence
of lifestyle-related cancers (such as prostate,
breast and colorectal cancers), particularly in
the richer countries, and persistent infection-
related cancers typical of developing countries
(such as cervical, stomach or liver cancers).^6
For example, colorectal cancer is considered
a marker of economic development, with
incidence rates higher in developed countries.^7Overall, the most common new types of
cancer (total cases) in the region are breast,
prostate and colorectal cancers, while lung,
colorectal and prostate cancers present
the highest mortality. Among women, the
three most common cancers (total cases) are
breast, colorectal and cervical cancers, while
it is prostate, colorectal and lung cancers
among men.^8The latest estimates from the IARC reveal
two patterns. Colorectal cancer is particularly
common in some of the most developed
countries in the group, such as Argentina, Chile
and Uruguay. Meanwhile, some of the most
rapid increases in breast-cancer incidence
in the world have been observed in South
America and other transitioning areas.9,10 This
is believed to be tied to conditions associated
with economic development, such as having
less children or postponing childbearing,
and unhealthy lifestyles in urbanised3 Data from https://data.worldbank.org/, income figures are “Atlas method”.
(^4) Alicia Bárcena, “Latin America is the world’s most unequal region. Here’s how to fix it”, ECLAC, 2016.
(^5) UN, World Population Prospects 2019.
(^6) MS Sierra et al., “Cancer patterns and trends in Central and South America”, Cancer Epidemiology, 2016.
(^7) F Bray et al., “Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries”, CA: a Cancer
Journal for Clinicians, 2018.
(^8) J Ferlay et al., Global Cancer Observatory: Cancer Today.
(^9) F Bray et al., “The changing global patterns of female breast cancer incidence and mortality”, Breast Cancer Research, 2004.
(^10) F Bray et al., “Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries”, CA: a
Cancer Journal for Clinicians, 2018.