Opportunities for cancer epidemiology and control in low- and middle-income countries: a report from the american society for preventive oncology international cancer prevention interest group.

Despite steady decreases in the cancer burden in industrialized countries, its rapid increase in the developing world means that the number of cancer cases and deaths will likely more than double worldwide over the next two decades (1). Already a leading cause of death around the globe, cancer—grouped as all types of the disease— was associated with 7.4 million deaths in 2004 and is projected to lead to 12 million deaths in 2030 (2). Notably, more than 70% of all cancer deaths occur in lowand middle-income countries (2). The key drivers of these epidemiologic trends are the increasing numbers of older individuals in developing countries coupled with the rising prevalence of behavioral risk factors. Specifically, the trends toward increased cigarette smoking, physical inactivity, and obesity are not offset by projected declines in infection-related cancers (3). Despite the dramatic increase in the cancer burden in the lowand middle-income countries, international awareness of the problem is low, as reflected by the omission of cancer from the United Nations Millenium Development Goals. In a major report released in 2007 that was entitled Cancer Control Opportunities in Lowand Middle-Income Countries, the Institute of Medicine called “for governments, health professionals, nongovernmental organizations, and others in lowand middle-income countries, with the help of the global health community, to achieve a better understanding of the current and future burden of cancer in lowand middle-income countries and take appropriate and feasible next steps in cancer control” (1).