Dr. Sophie Pilleron is our most recent non-communicable disease (NCD) researcher guest feature. She is an epidemiologist specializing in cancer and aging. A summary of one of Dr. Pilleron's research studies is documented as follows:
Cancer on the rise among older adults in sub-saharan Africa
Sub-saharan Africa is experiencing the most rapid growth of older adults in the world primarily attributed to the decline of child and infant mortality. According to the latest United Nations estimates, Africans who reach the age of 60 between 2010 and 2015 are expected to live a further 16 years on average. The aging of sub-saharan African population is accompanied by an increase in incidence of non-communicable diseases, including cancer.
With an estimated 321,100 new cancer cases occurring among adults aged 60 years and older in WHO Africa region in 2018, population aging in the region will lead to a considerable rise in cancer incidence in the next decades, with an almost three-fold increase in the number of new cancer cases projected by 2050, even if incidence rates remain stable.1
Older adults living in Sub-saharan Africa are often underrepresented in research studies, resulting in a more limited understanding of the health status in this population. The vast majority of older adults living in sub-Saharan Africa have no access to retirement schemes or health insurance, and family members often cannot afford long-term care. Additionally, cancer management in older adults is complicated by the co-occurrence of other chronic diseases, age-related physiological changes and lower tolerance of treatment, placing older adults with cancer at higher risk of catastrophic health expenditure. Although cancer is becoming more common in sub-Saharan Africa, there are very few studies on the cancer burden among older adults in this region.
Thanks to the work of the Global Initiative for Cancer Registry2 and the African Cancer Registry Network3, cancer registries exist in several African countries. These registries are essential to inform cancer control policies at national levels by describing the cancer burden.
Using the high-quality cancer incidence data compiled in the Cancer Incidence in Five Continents4(CI5), a recent study described for the first time the cancer burden in adults aged 60 years and older living in Nairobi (Kenya), Eastern Cape Province (South Africa) Kyadondo county (Uganda), and the black (African) population of Harare (Zimbabwe). This study reveals that over the period 2008–2012, almost 9,000 new cancer cases were registered in older adults in the four populations, representing one-third of all cancer cases. Prostate and esophageal cancers were the leading cancer sites in older males, while breast, cervical and esophageal cancers were the most common among older females. Among younger people, Kaposi sarcoma and non-Hodgkin lymphoma were common.
In addition, this study investigated trends in cancer incidence in Uganda and Zimbabwe (the only sub-saharan African registries included in CI5 with annual incidence data) over the past 20 years. It showed that incidence rates among older adults have increased in both sexes while rates have stabilized among the younger age group (<60 years). Among older adults, the largest rate increase was observed for breast cancer with an average annual increase of 5% of the rate in females and for prostate cancer (6–7%) in males.
Due to the specific needs of older adults, tailored considerations should be given to geriatric oncology when developing, funding and implementing national and regional cancer programmes. For more information, read the full paper: https://onlinelibrary.wiley.com/doi/10.1002/ijc.31880
Dr Sophie PILLERON
Cancer and aging epidemiologist
1 Pilleron S, Sarfati D, Janssen-Heijnen M, Vignat J, Bray F, Soerjomataram I. Global cancer incidence in older adults, 2012 and 2035: a population-based study. Int J Cancer. 2019; 144(1):49-58. doi: 10.1002/ijc.31664.