The Challenge of Non-Communicable Diseases and Road Traffic ...
The Challenge of Non-Communicable Diseases and Road Traffic ...
The Challenge of Non-Communicable Diseases and Road Traffic ...
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An Overview 17<br />
FIGURE 7: ASMR by NCD Cause, WHO Regions, 2008<br />
Age-st<strong>and</strong>ardized adult mortality rate by cause<br />
(ages 30-70 years per 100,000 population)<br />
2000<br />
1800<br />
1600<br />
1400<br />
1200<br />
1000<br />
800<br />
600<br />
400<br />
200<br />
0<br />
All Causes Cancer Cardiovascular Disease <strong>and</strong> Diabetes Chronic Respiratory Conditions<br />
Africa Americas South-East Asia Europe Eastern Mediterranean Western Pacific<br />
Source: [32]<br />
Cancers<br />
<strong>The</strong> burden from cancer is expected to more than<br />
double between 2008 <strong>and</strong> 2030, with new cases rising<br />
from 681,000 to 1.6 million <strong>and</strong> deaths rising<br />
from 512,000 to 1.2 million over that period [6].<br />
Risk factors for cancer can be infectious <strong>and</strong>/or non<br />
-infectious (Table 3). <strong>The</strong> most common cancers for<br />
men in Africa are HIV-associated Kaposi’s sarcoma,<br />
<strong>and</strong> cancer <strong>of</strong> the liver, prostate, <strong>and</strong> bladder; <strong>and</strong> for<br />
women they are cancer <strong>of</strong> the cervix, breast, Kaposi’s<br />
WHO Region<br />
sarcoma, <strong>and</strong> cancer <strong>of</strong> the liver. <strong>The</strong> lifetime risk <strong>of</strong><br />
cancer in females (0-64 years) in Africa is only 30<br />
percent lower than the risk in developed countries<br />
but their risk <strong>of</strong> dying is almost twice as high [41].<br />
<strong>The</strong> regions in the world with the highest risk for<br />
cervical cancer are Western <strong>and</strong> Eastern Africa [42].<br />
<strong>The</strong> growing use <strong>of</strong> tobacco <strong>and</strong> occupational <strong>and</strong><br />
environmental risks such as air pollution <strong>and</strong> exposure<br />
in mining, add to the cancer burden [43-44].<br />
TABLE 3: Common Cancers in SSA: Infectious <strong>and</strong> Other Risk Factors<br />
Cancer sites, in rank<br />
order <strong>of</strong> incidence<br />
Breast<br />
Infectious<br />
agents<br />
Other risk factors <strong>of</strong> high<br />
public health relevance<br />
Hormonal/reproductive factors, obesity,<br />
physical inactivity, alcohol<br />
Cervix HPV Tobacco<br />
Liver<br />
HBV, HCV<br />
Aflatoxins (produced by Aspergillus moulds),<br />
alcohol<br />
Prostate<br />
Lymphomas<br />
(non-Hodgkin <strong>and</strong> Burkitt)<br />
Colon <strong>and</strong> rectum<br />
Kaposi sarcoma<br />
Oesophagus<br />
Lung<br />
EBV, malaria,<br />
HIV (indirect), HCV<br />
Diet, obesity, physical inactivity, alcohol, tobacco<br />
HIV (indirect), HHV8<br />
Tobacco, alcohol<br />
Tobacco<br />
Helicobacter pylori<br />
Diets low in fruit <strong>and</strong> vegetables <strong>and</strong> high in salt,<br />
Stomach<br />
(bacterium)<br />
tobacco<br />
Bladder Schistosoma haematobium (fluke) Tobacco, occupational exposure<br />
Source: Adapted from [27, 44]<br />
Abbreviations: HPV Human papilloma virus; EBV Epstein-Barr virus; HBV hepatitis B virus; HCV hepatitis C virus; HHV8 human herpes virus 8.
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