CANCER CONTROL PLANNING
CANCER CONTROL 2015 35
they have with child health. Acting also allows international
actors to take advantage of time-limited opportunities, such
as leveraging the September 2015 announcement of the UN
Sustainable Development Goals (SDGs) and implementing
tobacco control in Africa, where tobacco-use rates are
relatively low but projected to increase (20).
Prevention, management and treatment
interventions
The Task Force examined the specific cancers and health
risks that are causing large numbers of premature deaths in
low- and middle-income countries but far fewer in highincome
countries due to the widespread availability of
effective prevention and treatment measures. The findings
indicate that cost-effective measures exist to address the
most prevalent cancers - lung, liver, cervical, and breast
cancer - and their risk factors in developing countries in
both the short and near term. The Task Force provides an
investment case for each, which can be found in full in the
Task Force report (www.cfr.org/ncds_task_force).
Lung cancer
Lung cancer is the most common cancer and cause of death
from cancer in low- and middle-income countries, and the
burden is increasing (Fig. 4) (21). Seventy percent of lung
cancer deaths worldwide are due to tobacco use; smokers
are twenty times more likely to perish from that disease
than nonsmokers (22). Tobacco use and secondhand smoke
are also the leading risk factors for other cancers and all
major NCDs - diabetes, cardiovascular disease and
respiratory disease (23).
Tobacco control is cost-effective and evidence-based (23).
The Task Force recommends fostering partnerships
between United States and international development and
health agencies to provide technical assistance for tobacco
taxation and control to interested developing countries;
establishing a multi-donor trust fund at the World Bank to
provide seed funding for tobacco-tax legislation; increasing
resources for the United States Federal Drug
Administration (FDA) and CDC to support tobacco
regulations; integrating tobacco education and cessation
into maternal, child health and tuberculosis initiatives; and
including safeguards for tobacco control laws and
regulations in ongoing United States trade negotiations of
the Trans Pacific Partnership (TPP).
Liver cancer
The hepatitis B virus (HBV) is the source of most cases of
liver cancer and each year is responsible for 500,000 deaths
globally. The prevalence of this virus is greater and
increasing in low- and middle-income countries, especially in
sub-Saharan Africa and East Asia. A safe and highly effective
HBV vaccine is cost-effective, widely used, and provides 20
years (and possibly lifelong) protection in infants, children
and young adults (21, 24). Although 179 of 193 WHO
member states have introduced the HBV vaccine into their
immunization programmes, coverage remains suboptimal -
an estimated 75% (24).
Figure 4: Percentage change in lung cancer DALYs, 1990-2010