The ageing population, lack of knowledge, change in lifestyles, high HIV burden, excessive use of alcohol, smoking and high costs to receive care could contribute to the rise of cancer deaths in South Africa. This is according to the Director of Health and Vital Stats at Statistics South Africa, Ramadimetja Matji.

The Cancer in South Africa (2008 – 2019) report published last month shows that cancer-related deaths increased from 5.6% in 2008 to 10.2% in 2019. While diagnosed cancers also increased by about 50% between 2008 and 2019.

Matji believes the ageing population is a main contributor to the increase in deaths due to cancer. He says this is as cancer largely affects older age groups.

“Those aged above 60 years are at the highest risk for cancer. The life expectancy of people aged above 60 in SA is increasing. Thus the population at risk of cancer is increasing,” explains Matji.

He says the ‘Western lifestyle’ is a contributor, with a high prevalence of smoking, excessive alcohol use, and sedentary lifestyles. Additionally, high consumption of red and processed meats, and inadequate intake of fruit, vegetables and fibre are also factors.

HIV and cancer deaths

“These are some of the documented risk factors for cancer, and most non-communicable diseases such as diabetes, hypertension and heart disease. South Africa also has a high burden of HIV. And women living with HIV are at the highest risk of developing cervical cancer if infected by the Human Papillomavirus(HPV),” says Matji.

He says that black women have the highest prevalence of HIV and the high incidence of cervical cancer is likely due to this. “The roll-out of the HPV vaccination for adolescent females needs to be strengthened to reduce cervical cancer,” says Matji.

According to the report, cancer-related mortality was based on 43 613 cancer deaths over the 10 years. While overall deaths in the country have decreased in that time by 24.1% from 598 553 in 2008 to 454 014 in 2018. But at the same time, cancer deaths increased by 29.3% from 33 720 in 2008 to 43 613 in 2018.

Matji says that the leading cancers contributing to deaths among women were cancers of the cervix, breast, lung and colorectal. As these types of cancers accounted for 50% of cancer-related deaths among women.

While among males, the leading cancers contributing to death were cancers of the lung, prostate, oesophagus, and colorectal. These accounted for half of all cancer-related deaths.

Black Africans are the most affected

According to him, black Africans have the highest number of deaths due to cancer compared to other population groups. He says that this is likely due to poor knowledge of the signs and symptoms of cancer and poor access to cancer screening and treatment facilities.

“They are diagnosed at advanced stages. When the chances of survival are low. It is important for one to look at the actual mortality rates for specific cancers to understand which population groups are at the highest risk of dying from cancer,” says Matji.

Matji further stated that there is a need for education on the risk factors for cancer, the importance of screening and improved access to cancer treatment facilities.

Early detection remains the key

The Cancer Association of South Africa(CANSA), Head of Marketing and Communication, Lucy Balona says that patients with stage 1 and 2 cancers have excellent survival rates if detected early enough. But education is crucial to ensure early diagnosis and treatment to pursue good treatment outcomes and optimal survival rates.

“The lack of proximate affordable, effective and quality cancer services, which enables early diagnosis, appropriate treatment and care, means patients in lower-resourced areas will often suffer and die unnecessarily,” says Balona.

She says that distance to treatment centres is also a significant problem that cancer patients continue to face throughout the course of the disease. Inpatient and outpatient cancer diagnosis and treatment require frequent visits. “The travel burden influences treatment compliance,” says Balona.

According to the World Health Organisation, cancer is a leading cause of death worldwide, accounting for nearly 10 million deaths in 2020, or nearly one in six deaths.-Health-e News.