AFRO

 (AFRICA  REGION) WHO  Cancer  Regional  Profile  2020

BURDEN  OF  CANCER

Most  common  cancer  cases  (2018)  
Total  population  (2019)

Incidence   Mortality  
1'091'759'000
Breast   15.3%   10.5%  

Total  #  cancer  cases   Total  #  cancer  deaths     Cervix  uteri   13.8%   14.3%  
(2018) (2018)

811'138 533'877 Prostate   8.7%   7.1%  

Colorectum   5.9%   5.9%  

Liver   4.6%   6.8%  

Premature  deaths  from  NCDs  (2016)
Non-­‐Hodgkin  lymphoma   4.1%   4.2%  
1'326'373
Cancer  as  %  of  NCD  premature  deaths  (2016)
Kaposi  sarcoma   3.9%   3.3%  

25.2% Stomach   3.1%   4.4%  

Oesophagus   3.1%   4.6%  

Lung   2.8%   4.2%  

8.6  (median),   5.9  (median),   33.1  (median),   1.1  (median),   33.1  (median),   0.8  (median),  
3.6-­‐20.2  (range) 0.8-­‐10.7  (range) 12.9-­‐54.8  (range) 0.3-­‐5.2  (range) 3.0-­‐72.4  (range) 0.4-­‐4.4  (range)
PAFs Tobacco  (2017)a   Alcohol  (2016)a Infections  (2012)b Obesity  (2012)b UV  (2012)c
Occupational  risk  
 (population  attributable  fractions) (2017)a
a b c
PAF,  cancer  deaths PAF,  cancer  cases PAF,  melanoma  cases

TRENDS
Estimated  past  and  future  trends  in  total  cases  per  year
 (breast  and  lung) Probability  of  premature  death  from  cancer  per  year

 300'000    

 246'153    
 250'000     17.0%  

 200'000    

12.0%  
 150'000    
 124'119     7.5%  
 100'834     6.8%  
 100'000     7.4%  7.3%  7.3%  7.2%  7.1%  7.1%  
7.0%  6.9%  6.9%  6.8%  6.8%  6.8%  6.8%   6.64%  
6.05%  
6.59%  
6.30%   6.54%  
6.49%  
6.44%  
6.39%  
6.35%  
6.30%  
6.25%  
7.0%   6.15%  
6.00%  
5.85%   6.20%  
6.15%  
6.10%  
5.70%  
5.55%  
5.40%  
 47'354     5.25%  
5.10%  
4.95%  
4.80%  
 50'000     4.65%  
 18'167      23'058    

 -­‐         4.50%  
2.0%  
Breast  cancer   Lung  cancer   2000   2005   2010   2015   2020   2025   2030  

2012   2018   2040   Past  trends   Projected  linear  trend   SDG  target  

INVESTMENT  CASE  (2019)

At  this  income  level,  investing  in  a  package  of  essential  services  and  scaling-­‐up  coverage  will:  
Costs  per  year   Projected  lives  saved  per  year
$'4.50     1,200,000  
$'4.00    
1,000,000  
$'3.50    
800,000  
US$  (per  capita)  

$'3.00    
$'2.50    
600,000  
$'2.00    
$'1.50     400,000  
$'1.00     200,000  
$'0.50    
$'0.00     0  
2020   2022   2024   2026   2028   2030   2020   2022   2024   2026   2028   2030  
 AFRO  (AFRICA  REGION) WHO  Cancer  Regional  Profile  2020

HEALTH  SYSTEM  CAPACITY

a
per  10,000  cancer  patients

Availability  of  population-­‐based  cancer  

2019 15%  of  countries  have  high-­‐quality  PBCR  
WORKFORCE
registry  (PBCR)** a
per  10,000  cancer  patients
Available  staff  in  Ministry  of  Health  who  
2%  of  countries  have  high  quality   81%  of  countries  have  MoH  staff  with  
Quality  of  mortality  registration*** 2007-­‐2016 coverage
dedicates  significant  proportion  of  their  time   2019 dedicated  time  for  cancer
to  cancer

#  of  external  beam  radiotherapy   #  of  radiation  oncologista 2019 0  (median),  0-­‐6  (range)
2019 0.3  (median),  0-­‐11.9  (range)
(photon,electron)a #  of  medical  physicist a 2019 2  (median),  0-­‐27  (range)

#  of  mammographsa 2020 10.4  (median),  0-­‐62.4  (range) #  of  surgeonsa 2019 52  (median),  11-­‐889  (range)

#  of  CT  scannersa 2020 11.5  (median),  0-­‐108.1  (range) #  of  radiologista 2019 19  (median),  0-­‐264  (range)

#  of  MRI  scanners a 2020 1.3  (median),  0-­‐28.3  (range) #  of  nuclear  medicine  physician a 2019 0  (median),  0-­‐21  (range)

#  of  PET  or  PET/CT  scanners a 2020 0  (median),  0-­‐15.6  (range) #  of  medical  &  pathology  lab   2019 203  (median),  3-­‐1643  (range)

scientistsa

FORMULATING  RESPONSE
55%  of  countries  have  operational   #  Public  cancer  centres  per  10,000  cancer  
Integrated  NCD  plan 2019 2019 1  (median),  0-­‐15  (range)
integrated  NCD  plans patients

38%  of  countries  have  operational   Early  detection  programme/  guidelines  

NCCP  (including  cancer  types) 2019 for  4  cancers  (breast,  cervix,  colon,   2019
2%  of  countries  have  all  4  cancer  early  
cancer  plan
detection  programme/guidelines
childhood)
MPOWER  measures  fully  implemented  and   57%  of  countries  have  generally  available  
2018 0  (median),  0-­‐4  (range) Pathology  services 2019
achieved pathology  services

2%  of  countries  have  generally  available  

Cancer  management  guidelines 2019 49%  of  countries  have  cancer  guideline Bone  marrow  transplantation  capacity 2019
BMT

Palliative  care  availability:   11%  of  countries  have  generally  available  

Palliative  care  plan 2019 47%  of  countries  have  operational  NCD   2019
integrated  plan  that  includes  palliative   community/home-­‐based  care palliative  care
care

#  of  treatment  services  (surgery,   2019 30%  of  the  countries  have  generally   Availability  of  opioids*  for  pain   2015-­‐2017 3  (median),  0-­‐475  (range)
radiotherapy,  chemotherapy) available  treatment  capacity management

17%  of  countries  have  breast  cancer  

Breast  cancer  screening  program 2019
screening   *Defined  daily  doses  for  statistical  purposes  (S-­‐DDD)  per  miliion  inhabitants  per  day

Breast  cancer  screening  program:  Starting   40%  of  countries  adhere  to  best  
2019
age,  target  population practices

GLOBAL  INITIATIVES  
Elimination  of  Cervical  Cancer Global  Initiative  for  Childhood  Cancer

15%  of  countries  have  ≥  50%  coverage;   Annual  cancer  cases  

HPV  vaccination  programme  coverage 2018 2020                                                                                                                                61'552  
4%  have  ≥  90%  coverage (0-­‐14  years  old)
2019 6%  of  countries  have  early  detection  
21%  of  countries  have  cervical  cancer   Early  detection  programme/guidelines
Cervical  cancer  screening 2019 programme/guidelines
screening  programme
Defined  referral  system 2019 13%  of  countries  have  defined  referral  
4%  of  countries  have  organized,   system
Screening  programme  type 2019
population-­‐based  programme

2%  of  countries  use  HPV  test  as  their   Annual  cancer  cases  (0-­‐14  years  old)
Screening  programme  method 2019
screening  programme  method  

Screening  participation  rates 2019 0%  of  countries  have  >70%  coverage  

36%  of  countries  have  early  detection  

Early  detection  programme/guidelines 2019
programme/guidelines
 7'306     Acute  lymphoid  leukaemia  

Defined  referral  system 2019 57%  of  countries  have  defined  referral    3'098     Hodgkin  lymphoma  
system
Burki\  lymphoma  
 3'396    
CNS,  low  grade  tumours  
 1'877    
Re^noblastoma  
 2'660    
 38'688     Wilms  tumour  

 4'527     Other  childhood  cancer