According to recent analysis from several entities including the World Health Organisation (WHO), there are indications that the highest increase in cancer cases will be in lower-income countries in the next few years, a public health crisis that will be too costly to handle.
The WHO projects that global cancer cases and deaths will rise drastically by 2050, and lower-income countries will mostly be affected.
French Oncologist, Professor David Khayat said recently in an interview that countries need to start working more on prevention of tobacco-related health complications, as the cost of treating cancer induced by smoking will be too huge to bear for low-income countries in the near future. He mentioned that working on prevention is better than waiting for the increase in cancer cases, as most low-income countries' economies are not prepared for the treatment burden that the crisis will come with.
Professor Khayat said that the fact that smoking causes cancer and smoking populations are increasing in low-income countries, is a source of concern because it has been predicted that at least 75 percent of cancer deaths will occur in such regions within the next 20 years.
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"These deaths will occur in countries that are not making more than 5 percent of the World Gross Domestic Product (GDP). So it is the poor countries including those in Africa that are going to pay the highest cost of cancer in the next 20 years." Professor Khayat added that, "They are not prepared but they have a chance to do something if they start now."
Professor Khayat explained that Africa, for instance, does not have enough trained oncologists or adequate facilities for the expected cancer crisis- a situation that needs to be improved as quickly as possible.
He expressed worry that the cost of the cancer crisis may not only be about huge treatment costs, but also people dying earlier than expected and therefore, not contributing to the growth of their countries' GDP.
"If an old man dies, society loses out. One might think that he is just collecting his pension so isn't it good if he dies? The answer is no. The man is contributing to his household and taking care of things within it. If he was not there, someone would have to be hired to do things like taking care of kids when parents are working," said Professor Khayat.
"You see, that has a cost, a value in monetary terms. The only way to face this projected situation is to work on prevention. If I have to prevent lung cancer due to smoking, I have to work today as treatment will be too high in the future," he added.
The WHO has already warned that smoking-related cancer cases are increasing globally, with an estimated 2.48 million new lung cancer cases and 1.82 million deaths in 2022. Without intervention, this number is predicted to rise to an estimated 4.62 million new cases by 2050, showing a 86.29 percentage increase.
Professor Khayat also challenged oncologists to trust the science that has proven that Harm Reduction works, and to use their voice to promote positive messages.
"As oncologists, we have to trust the science which says nicotine does not cause cancer but that tobacco combustion does. People want to smoke because they want nicotine. Let's give them nicotine and not tobacco," he said.
Professor Khayat recalled that he has seen thousands of patients die due to smoking, and witnessed their family members in grief, including children who were not prepared for the loss of their parents.
He is hopeful that the next generation of oncologists will see less of such terrible experiences, and that this can only be achieved if more efforts are channeled towards cancer prevention instead of emphasis on treatment.
He said with countries already knowing that smoking tobacco can cause cancer, they must work on ensuring that people who are addicted have safer alternatives.
He asked, "So who is going to pay for the cancer cost? Do we choose the cancer prevention cost today, or the treatment cost tomorrow? If we want to prevent lung cancer, we have to work today to safeguard the future economy," Professor Khayat said.
With the average population in low income countries being young, Professor Khayat believes it will not be fair for people to have cancer early on in life because of exposure to the cancer-causing toxins that come from smoking tobacco.
He expressed hope that prevention efforts will take centre stage to stop people dying from preventable diseases. He warned that with the changes in lifestyle and how people respond to food, alcohol, tobacco and lack of activity, prevention needs to equally focus on awareness to avoid a crisis.
He said there is currently a crisis in handling the burden, as research has already shown that there are limited human resources, facilities and financial resources in countries that need more oncology services.
Meanwhile, according to the Philip Morris International (PMI), burning tobacco is what makes cigarettes harmful, with the main causes of smoking related diseases being the high levels of harmful chemicals released in the smoke.
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PMI, however, says the best thing smokers can do is to entirely quit tobacco and nicotine products, but with 9 out of 10 smokers being unable to quit every year (as indicated by research findings), smoke-free products that do not burn tobacco are a better choice than continuing to smoke cigarettes.
PMI says that when combined with existing strategies to prevent first-time smokers and encourage those who smoke to stop, smoke-free products can more rapidly reduce the number of people who smoke cigarettes, thereby improving public health.
"Smoke-free products are fundamentally different from cigarettes. They create a nicotine-containing smoke-free aerosol. By not burning tobacco, they can significantly
reduce the levels of harmful chemicals released as compared to cigarette smoke. This has to be scientifically assessed on a product-by-product basis. Smoke-free products are a much better choice than continuing to smoke cigarettes, but this does not mean that they are risk-free. These products deliver nicotine, which is addictive, but not the main cause of smoking- related diseases. The main cause is the high levels of harmful chemicals in cigarette smoke," emphasised PMI.
