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Thu 10 May 2007 01:14 PM

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Global gulf in cancer care

Access to cancer drugs shows "stark inequalities" between different parts of the world, experts say.

The use of modern cancer drugs can vary by a factor of 10 between different developed countries, while millions in Africa lack access even to basic pain relief, experts said on Thursday.

Swedish researchers said there were "stark inequalities" in access to cancer medicine around the world, contributing to significant differences in patient survival.

The United States, France, Switzerland and Austria are the leaders in using new cancer drugs, while Britain, New Zealand, Poland, the Czech Republic and South Africa are laggards, according to an analysis of 67 medicines across 25 countries.

The biggest differences were seen in four new colorectal and lung cancer drugs -- Avastin, or bevacizumab; Erbitux, or cetuximab; Tarceva, or erlotinib; and Alimta, or pemetrexed.

The uptake of Avastin for colorectal cancer in the United States, for example, was 10 times the European average, as was the use of Tarceva in lung cancer.

These drugs belong to a new class of targeted therapies that are helping patients live longer, with fewer side effects.

Dr Bengt Jonsson, director of the Centre for Health Economics at the Stockholm School of Economics, said better access to such medicines was one reason why rates of survival from cancer were higher in France and Spain than in Britain.

"The introduction of new drugs explains part of the improvement. It doesn't explain everything, but it generally explains more than advances in radiotherapy and surgery," he told Reuters in a telephone interview.

His colleague Dr Nils Wilking, a clinical oncologist at the Karolinska Institute in Stockholm, said experience from the United States also showed that survival of cancer patients was related significantly to the introduction of new drugs.


Their work updates a report published in 2005 and was sponsored by an unrestricted educational grant from Swiss drugmaker Roche Holding AG, which sells both Avastin and Tarceva in partnership with Genentech Inc..

Erbitux is made by ImClone Systems Inc. and Alimta by Eli Lilly and Co..

Publication of the study in the journal Annals of Oncology coincides with a two-day conference in London on the latest frontier for cancer -- Africa.

Although traditionally seen as a disease of the developed world, cancer rates are also rising steeply in the world's poorest continent.

"People don't perceive cancer as a developing world problem, but more than 70 per cent of all cancer deaths occur in low- and middle-income countries," David Kerr of Oxford University said.

"This figure is rising due to increased life expectancy, increased tobacco use and chronic viral infection."

Survival rates for cancer in the developing world -- where simple painkillers, let alone modern treatments, are frequently unavailable -- are often less than half those of developed countries, he added.

According to the International Agency for Research on Cancer, part of the World Health Organisation, more than 70 percent of the world's 7.6 million cancer deaths in 2005 occurred in low- and middle-income countries.

Deaths from cancer are projected to continue rising, with an estimated 9 million people dying from cancer in 2015 and 11.4 million in 2030.

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