Africa: Women in Low-Income Countries Bear the Brunt of Ovarian Cancer

“But conversely, when it comes to healthcare dollars spent per capita on ovarian cancer, middle- to lower-income countries spend significantly more.”

“Current estimates suggest that by 2040, 70% of all cancer mortality will occur in lower and middle-income countries.  These numbers serve as a call for action. We cannot let it stand,” said Jeff Dunn, President of the Union for International Cancer Control (UICC) at the opening of the 2024 World Cancer Congress in Geneva.

The burden of ovarian cancer goes beyond health concerns and extends to economic strain, where obtaining advanced treatments is extremely difficult. This is often due to a lack of resources and inadequacy in the healthcare systems of these regions to handle the complex needs of cancer patients. The high cost of diagnosis and care can be catastrophic for families already struggling with poverty, exacerbated by this inadequacy.

Ovarian cancer is the eighth most commonly diagnosed cancer in women around the world. The World Ovarian Cancer Coalition reports that ovarian cancer accounts for 324,000 new cases each year and 207,000 deaths from cancer among women worldwide.

“Despite recent advances in the treatment of ovarian cancer, it remains one of the most lethal of women’s cancers. Globally, more than 900,000 women have been diagnosed with ovarian cancer in the last five years, with around 7 out of every 10 women diagnosed in advanced stages,” said Clara MacKay, CEO of the World Ovarian Cancer Coalition.

“By 2050, the number of ovarian cancer diagnoses is expected to increase by more than 55% and deaths by more than 70%,” said MacKay.

“This is a global concern,”  she said. “If current trends continue, nearly 8 million women will die from ovarian cancer by 2050, with the heaviest burden, falling on low and middle-income countries where 70% of those diagnosed live.”

Ovarian cancer imposes a major burden on society, disrupting lives, health systems, and national economies.

Globocan projections indicate a significant increase in ovarian cancer incidence by 2050, with 70% of cases expected to be diagnosed at advanced stages, adversely affecting survival rates. These rises are due to aging populations and shifts in risk factors linked to socioeconomic development. It is estimated that ovarian cancer will cost 11 countries $70 billion in lost income by 2023 as a result of ovarian cancer.

“This study is the first of its kind to quantify the socioeconomic impact of ovarian cancer across multiple countries, in this case, 11 countries. This study quantifies the overall societal cost of ovarian cancer using the value of a statistical lifetime,” said MacKay.” “It quantifies the healthcare expenditure for diagnosis, treatment, and palliative care. It quantifies the loss to national economies through productivity losses when you take women out of the workforce due to ovarian cancer. And importantly, it quantifies the unrecognized cost of unpaid caregiving time.”

“RTI International, a U.S.-based agency, commissioned the study, which we conducted in collaboration and with a significant amount of support from the WHO, who provided significant input and data access,” says Mackay. “This study provides insight into ovarian cancer’s true burden, a burden that extends far beyond healthcare expenditures.”

The countries studied for their socioeconomic burden of ovarian cancer included Australia, Canada, Colombia, India, Kazakhstan, Kenya, Malawi, Malaysia, Nigeria, the United Kingdom, and the United States. The countries were selected based on their population size to ensure a geographical spread across all continents and a mixture of income groups, as defined by the World Bank.

“Middle- to lower-income countries spend significantly more per capita on ovarian cancer, indicating that diagnosing and treating ovarian cancer places a greater burden on countries with the least available healthcare resources,” she said.

There is a higher financial burden associated with ovarian cancer in wealthier countries, according to the study. For example, in the U.K., costing 0.24% of gross domestic product. In contrast, in lower-income countries, they face a smaller financial impact. For example, Malawi has just 0.02% of GDP. This difference is partly because newer, advanced cancer treatments are more available in richer countries, and there’s a higher emphasis on the value of worker productivity and statistical lives.

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“Diagnosing and treating ovarian cancer places a greater per capita burden on countries with the least available healthcare resources, as specialist treatments like chemotherapies are significantly more costly compared to basic healthcare services. We also found that women spend nearly 3,700 years traveling to or receiving treatment,” says MacKay.

“Patients in low- and middle-income countries spend almost twice as much time traveling compared to receiving treatment, resulting in a labor productivity loss equivalent to 2.5 million workdays and leaving over 9,400 women missing from the workforce.”

“We need to ensure that in low- and middle-income countries, where ovarian cancer treatments are often unaffordable, we improve global access to affordable care. We must also recognize the significant contribution of caregivers and align strategies with existing global women’s health initiatives to enhance outcomes for those living with ovarian cancer, enabling them to make a more substantial contribution to society,” said MacKay.

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