Challenges, hurdles and possible approaches to improve cancer care in developing countries – A short breakdown of the status quo and future perspective

Sabine D. Brookman-May, Oscar Rodriguez-Faba, Johan F. Langenhuijsen, Bulent Akdogan, Estefania Linares, Andrea Minervini, Tobias Klatte, Alessandro Volpe, Maurizio Brausi, Martin Marszalek


It was estimated that in 2012, 57% of the incidence and 65% of cancer deaths have occurred in developing countries, and in the future, the incidence of cancer-related mortality is even expected to rise significantly in these countries. Despite this alarming data, there are still significant disparities in access to cancer care and cancer control between developing nations and higher income countries. There are several hurdles for cancer patients in developing countries which impair adequate treatment, including very little access to programs of cancer prevention and screening measures, early diagnosis and adequate surgical and medical tumor treatment. In this review article, we provide a short assessment and breakdown of the main barriers for proper cancer treatment admission and provide a perspective on potential approached and solutions to enhance cancer research and care in developing countries.  


cancer care; clinical research; oncology; developing countries; hurdles

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World Health Organization. Cancer [Internet]. Geneva: World Health Organization; 2017 [cited 2017 Apr 8]. Available from:

World Cancer Report Web Site [Internet]. France: International Agency for Research on Cancer; 2008 [cited ]. Available from:

Plummer M, de Martel C, Vignat J, Ferlay J, Bray F, et al. Global burden of cancers attributable to infections in 2012: A synthetic analysis. Lancet Glob Health 2016; 4(9): e609–e616. doi: 10.1016/S2214-109X(16)30143-7.

Zwitter M. Independent clinical research may alleviate disparities in cancer treatment. Asia Pac J Oncol Nurs 2016; 3(4): 312–315.

The Garvan Research Foundation, 2015

Hu YJ, Chen J, Zhong WS, Ling TY, Jian XC, et al. Trend Analysis of Betel Nut-associated Oral Cancer and Health Burden in China. Chin J Dent Res 2017; 20(2): 69–78. doi: 10.3290/j.cjdr.a38271.

Madathil SA, Rousseau MC, Wynant W, Schlecht NF, Netuveli G, et al. Nonlinear association between betel quid chewing and oral cancer: Implications for prevention. Oral Oncol 2016; 60: 25–31. doi: 10.1016/j.oraloncology.2016.06.011.

Auluck A, Walker BB, Hislop G, Scott A. Lear, Nadine Schuurman, et al. Socio-economic deprivation: A significant determinant affecting stage of oral cancer diagnosis and survival. BMC Cancer 2016; 16: 569. doi: 10.1186/s12885-016-2579-4.

Beckmann KR, Bennett A, Young GP, Cole SR, Joshi R, et al. Sociodemographic disparities in survival from colorectal cancer in South Australia: A population-wide data linkage study. BMC Health Serv Res 2016; 16: 24. doi: 10.1186/s12913-016-1263-3.

McCutchan G, Wood F, Smits S, Edwards A, Brain K. Barriers to cancer symptom presentation among people form low socioeconomic groups: A qualitative study. BMC Public Health 2016; 16(1): 1052. doi: 10.1186/s12889-016-3733-2.

Australian Government. Australia's health 2014. Australian Institute of Health and Welfare Canberra: AIHW; 2014.

Loh S, Packer TL, Yip CH, Passmore A. Targeting health disparity in breast cancer: Insights into women's knowledge of their cancer profile in Malaysia. Asian Pac J Cancer Prev 2009; 10(4): 631–636.

Australian Bureau of Statistics. What's New in Regional Statistics, 2013[Internet]. 2013. Available from:

Pedro LW, Schmiege SJ. Rural living as context: A study of disparities in long-term cancer survivors. Oncol Nurs Forum 2014; 41(3): E211–E219. doi: 10.1188/14.ONF.E211-E219.

Cunningham J, Rumbold AR, Zhang X, Condon JR. Incidence, aetiology, and outcomes of cancer in Indigenous peoples in Australia. Lancet Oncol 2008; 9(6): 585–595. doi: 10.1016/S1470-2045(08)70150-5.

Campbell I, Scott N, Seneviratne S, Kollias J, Walters D, et al. Breast cancer characteristics and survival differences between Maori, Pacific and other New Zealand women included in the quality audit program of breast surgeons of Australia and New Zealand. Asian Pac J Cancer Prev 2015; 16(6): 2465–2472.

Are C, Wong S, Leon A. Global cancer surgery, or lack thereof: A wake-up call. Ann Surg Oncol 2016; 23(1): 1–3. doi: 10.1245/s10434-015-4964-7.

Olver I, Marine F, Grogan P. Disparities in cancer care in australia and the pacific. Oncologist. 2011; 16(7): 930–934. doi: 10.1634/theoncologist.2010-0404.

Brach C, Fraser I. Reducing disparities through culturally competent health care: An analysis of the business case. Qual Manag Health Care 2002; 10(4): 15–28.

Lopes G. (2011). The new front in the war on cancer. Presented at the First South East Asia Cancer Care Access Network Meeting, Singapore. Available from:

Al Lamki Z. Improving cancer care for children in the developing world: Challenges and strategies. Curr Pediatr Rev 2017; 13(1): 13–23. doi: 10.2174/1573396312666161230145417.

World Health Organization Web SitePlanning and developing population-based cancer registration on low-and middle-income settings. IARC Technical Publication No 43.

Bradford NK, Caffery LJ, Smith AC. Telehealth services in rural and remote Australia: A systematic review of models of care and factors influencing success and sustain ability. Rural and Remote Health 2016; 16(4): 3808.

Bray F, Ferlay J, Laversanne M, Brewster DH, Gombe Mbalawa C, et al. Cancer incidence in five continents: Inclusion criteria, highlights from volume X and the global status of cancer registration. Int J Cancer 2015; 137(9): 2060–2071. doi: 10.1002/ijc.29670.

Olver I. Cancer control - A global perspective. Eur J Cancer Care (Engl) 2017; 26(1). doi: 10.1111/ecc.12654.

Ervick MJ. [Internet]. 2017 [cited ] Available from:

Department of Health and Ageing & AIHW. (2008). Cervical screening in Australia 2005–2006. Cancer series no. 41. Cat. no. CAN 36. Canberra: AIHW.

Sankaranarayanan R. Screening for cancer in low- and middle-income countries. Ann Glob Health 2014; 80(5): 412–417. doi: 10.1016/j.aogh.2014.09.014.

Bruni L, Diaz M, Barrionuevo-Rosas L, Herrero R, Bray F, et al. Global estimates of human papillomavirus vaccination coverage by region and income level: A pooled analysis. Lancet Glob Health 2016; 4(7): e453–e463. doi: 10.1016/S2214-109X(16)30099-7.

Campos NG, Sharma M, Clark A, Kim JJ, Resch SC. Resources required for cervical cancer prevention in low-and middle-income countries. PLoS One 2016; 11(10): e0164000. doi: 10.1371/journal.pone.0164000.

World Health Organization. Hepatitis B [Internet] Geneva: World Health Organization; 2017. Available from:

Hoekstra HJ, Wobbes T, Heineman E, Haryono S, Aryandono T, et al. Fighting global disparities in cancer care: A surgical oncology view. Annals of Surgical Oncology 2016; 23(7); 2131–2136. doi: 10.1245/s10434-016-5194-3.

Lopes G. (2011). The new front in the war on cancer. Presented at the First South East Asia Cancer Care Access Network Meeting, Singapore. Available from:

Lopes G., de Souza J, Barrios C. Access to cancer medications in low- and middle-income countries. Nat Rev Clin Oncol2013; 10, 314–322. doi:10.1038/nrclinonc.2013.55

Adedokun BO, Olopade CO, Olopade OI. Building local capacity for genomics research in Africa: recommendations from analysis of publications in Sub-Saharan Africa from 2004 to 2013. Glob Health Action 2016; 9(1): 31026. doi: 10.3402/gha.v9.31026.

Manica Balasegaram. Drugs for the poor, drugs for the rich: Why the current R&D model doesn’t deliver [Internet]. 2014 [cited 2017 April 30] Available from:



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