Access to cutting edge cancer treatments, screening technology and preventive measures to reduce risk should not be a barrier based on where you live in the world.
That’s why the UW Carbone Cancer Center has joined other academic, governmental and humanitarian health organizations in advocating global oncology initiatives and partnerships that can help bridge gaps for low- and middle-income countries and save more lives.
“Cancer is not just a problem in high-income countries. It’s a huge and growing problem in low- and middle-income countries,” according to Dr. Nabeel Zafar, a surgical oncologist and director of the UW Carbone Global Oncology Program. “And it’s compounded by the fact that it’s been ignored for a very, very long time.”
Zafar, who was recruited to UW in 2020, was born in Pakistan and grew up both there and in the United Kingdom. This gave him a firsthand view of the disparities of health care between what are considered wealthy nations and those that are low- or middle-income. As he chose his specialty in cancer surgery, Zafar knew he also wanted to pursue health equity in his work.
Low- and middle-income countries represent about 63% of the countries in the world. In the past, much of the health aid and focus for these countries has been addressing tropical and infectious diseases, but as these countries become more developed and people are living longer, the instances of cancer diagnoses have also been increasing.
“Now we’re seeing this big tsunami, this big tide of cancer increasing really rapidly in low- and middle-income countries,” he said. “There are a lot of reasons for that, some we know and some we don’t. And the infrastructure to support the prevention, diagnosis, treatment and survivorship of cancer patients is not there for the most part just because it hasn’t been a priority, so there’s a huge gap in what’s needed and what’s available.”
The complexity of solving those needs is how to bring in existing knowledge and technology available in Western countries in sustainable and scalable ways, and the cost of making those services accessible and affordable to all citizens. There is also a need for new research into what drives cancer trends among different populations, the genomic differences that can affect treatment, and new clinical research involving patients from those regions.
“We do know now from some genomic analysis that cancers behave differently in different populations,” Zafar said. “Stomach cancer in one part of the world behaves differently than stomach cancer in different parts of the world. Even in the United States, stomach cancer in white Caucasians is a little bit different than stomach cancer in Hispanic patients.”
Awareness, collaboration and policy recommendations are part of the answer, which is why UW Carbone formed its Global Oncology Program in 2020. Among the first steps was identifying what research efforts were already underway at UW, how to support and amplify those efforts, and create new funding opportunities. UW will host its first Global Oncology Summit this May to expand local networking opportunities and encourage new research.
Collaborations with other universities, governmental agencies like the National Cancer Institute, and humanitarian organizations are also key to strengthening efforts and influencing change. Zafar was among more than 50 co-authors of a Lancet Oncology Global Cancer Surgery Commission report that provides a roadmap of practical ideas and policy recommendations to address inequities and barriers in surgical care.
As UW’s Global Oncology Program continues to grow, Zafar looks forward to expanding into new avenues, such as establishing educational exchange opportunities at UW so that health care workers and researchers from UW can interact with their counterparts in low- and middle-income countries and together we can learn how to address these needs.
“The work is immense — there’s a lot to be done, so we’re just trying to start small and build on it,” Zafar said.
