Lack of equity in cancer care

World cancer day is observed on the 4th of February every year. For the occasion, UICC (Union for International Cancer Control) has declared a new theme, called "Close the Care-Gap" for this year and the next two years.

In its first year, the campaign will raise awareness about the lack of equity in cancer care, and explain the barriers that restrict many people from getting access to treatment services. The campaign will also address how these barriers reduce a patient's chance of surviving cancer.

The care gap exists to some extent all over the world, but it is significantly more prevalent in underdeveloped or developing countries. Socioeconomic factors, such as culture, income, literacy levels, as well as prejudices and discrimination against age, gender, sexual orientation, ethnicity, disability, and lifestyles, create wide disparities in cancer diagnosis, treatment. and survival. All these factors need to be addressed to reduce the care gap for cancer patients.

In Bangladesh, many of the above-mentioned barriers directly affect the quality of cancer care. To dissolve these barriers and improve cancer treatment, we should learn about all these biases, their influences, and address them from different platforms.

Why is it so important to close the care gap when treating cancer?

By identifying our own problems and resolving them, we can gradually bring down the incidences of cancer, we can create national guidelines regarding screening methods, diagnosing modalities, and staging workups that are to be followed for different cancers.

Incidences of cancer may decrease if we can identify our own problems that create an internal environment for cancers to develop. Among the many contributing factors, are lifestyle choices such as smoking, indiscriminate use of food preservatives, excess consumption of deep-fried food and fast food, overconsumption of carbohydrates, lack of physical activities, along with external environmental problems like air, soil, and water contamination, indiscriminate use of chemical pesticides in plantations, pollution of soil and water by untreated industrial wastes, and so on.  

Subsequently, by analysing essential data on the developmental factors for cancer, a standardised treatment can be created and circulated throughout the nation so that every patient gets a fair chance of fighting the disease. 

By introducing nationwide screening programmes for certain common cancers, we can conduct the diagnosis of those cancers at an early stage while it's still curable. In order to facilitate correct management decisions, we can ensure access to different investigational facilities all across the country. By using correct staging facilities, we can properly determine the cancer stage to formulate the intent of the treatment, choosing between curative, or palliative control.

Consequently, by ensuring standard guideline-based treatment for all cancers, we can be at par with the management and treatment of cancer patients in developed countries.

If we gradually address and resolve all the above issues, only then we can close the care gap that exists for cancer patients. However, it should be noted that this needs to be a collaborative effort. Individuals, caregivers, society, and the government, should all come forward to mitigate this issue.

Dr. Ferdous Shahriar Sayed is the Coordinator and Senior Consultant of Medical Oncology, Evercare Hospital Dhaka.