Cancer incidence in South Africa expected to rise by 2030

The incidence of breast, cervical, prostate, lung, blood and pediatric cancers is increasing in South Africa and is expected to continue to rise over the next decade.

Source: Emma Finestone of UCT.

By 2030, a new study by University of Cape Town (UCT) actuaries and public health experts Emma Finestone and Jodi Wishnia of the University of the Witwatersrand, predict there will be 121,000 incidences of cancer compared to 62,000 in 2019. This is the result of increases in the age-specific cancer incidence rate, as well as the growth and aging of the population.

The results highlight the need to increase the resources available for cancer services, as well as the rapid implementation of cancer prevention strategies, in order to reduce the number of future cases of cancer, and thus to reduce the burden on the health system.

In the study, a model was developed to predict the incidence of five of the most commonly diagnosed cancers in South Africa. The model aimed to estimate the true underlying burden of cancer, as opposed to only diagnosed cases.

Cancers in the public sector population

Finestone said the majority of cancer incidence – between 80% and 90% over the forecast period – occurs in the public sector population.

“This is normal, given that the majority of the population (84%) depends on the public health sector. However, given the higher case detection rate in the private sector, the incidence rate in the private sector is expected to be higher than in the public sector as a whole.

Write in the SA Journal of OncologyFinestone added that cancer service planning should be evidence-based to ensure resource allocation is commensurate with the projected disease burden and associated costs.

“This requires the availability of relevant, recent and reliable data. Currently, this data is not publicly available. This highlights the need for comprehensive data on incidence and costs in the public and private sectors. »

Budgeting according to the actual burden of disease

“Accurate estimation of disease burden is essential as South Africa moves towards universal health coverage under its planned national health insurance, where capacity will likely be expanded by contracting with the private sector. This expansion, given the magnitude of the projected needs, has significant financial implications,” she said.

According to the World Health Organization’s Cancer Report 2020, the number of cancer cases is expected to double over the next 20 years, with the majority of increases occurring in low- and middle-income countries.

“In South Africa, infection-related cancers, such as cervical cancer and Kaposi’s sarcoma, are among the most commonly diagnosed cancers. This is in line with our model predictions, which identify cervical cancer as one of the three cancers with the highest incidence,” says Finestone.

Management of HIV-related cancers

She noted that the high prevalence of HIV in the public sector is a key factor in the rising incidence of cervical cancer, Hodgkin’s lymphoma and non-Hodgkin’s lymphoma. “About a third of these cancers occur in people living with HIV (PLHIV).

Given the reduced risk of developing these cancers and improved treatment outcomes associated with effective antiretroviral therapy in PLHIV, ensuring that PLHIV receive and adhere to treatment is a cost-effective way to reduce the incidence of HIV-related cancers while simultaneously preventing other HIV- and AIDS-related morbidities. »