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canceratlas.cancer.org

Figure 1Estimated numbers of new cancer cases and deaths, both sexes, 2018

canceratlas.cancer.org

ASR (World) per 100,000

Figure 4Incidence and mortality rates in selected countries in sub-Saharan Africa,2018

France, La Réunion

South Africa

Zimbabwe

Kenya

Malawi

Mauritius

Uganda

Cabo Verde

Burundi

Rwanda

0 25 50 75 100 125 150 175 200 225

canceratlas.cancer.org

ASR (World) per 100,000

Prostate

Liver

Colorectum

Esophagus

Lung

NHL

Kaposi sarcoma

Stomach

Leukemia

Bladder

40 32 24 16 8 0 8 16 24 32

canceratlas.cancer.org

ASR (World) per 100,000

Figure 2Incidence and mortality rates of mostcommon cancers in females, 2018

Cervix

Breast

Colorectum

Ovary

Liver

Esophagus

Stomach

NHL

Uterus

Lung

40 32 24 16 8 0 8 16 24 32

canceratlas.cancer.org

CASES DEATHS

canceratlas.cancer.org

MAP 17.1

The most common cancer cases and deaths in sub-Saharan Africa, both sexes combined, 2018

canceratlas.cancer.org

17 THE BURDEN

BreastCervixProstateColorectumLiverNHLKaposi sarcomaEsophagusOther cancers

1998–20022003–20072008–2012

IncidenceMortalitySub-Saharan Africa has a unique mix

of common cancers including several infection-related cancers.

A relatively low incidence to mortality ratio can indicate poorer cancer outcomes.

While the ratio between cancer incidence and mortality is 2.3 in Mauritius, one of the wealthiest

countries in the region, it is 1.4 in Uganda.

FIGURE 17.1

FIGURE 17.2

FIGURE 17.3 FIGURE 17.4

Estimated number* of new cancer cases vs. deaths and distribution (%) by type, both sexes, 2018

Incidence and mortality rates of the most common cancers in sub-Saharan Africa in males and females, 2018

Trends in incidence rates in selected countries in sub-Saharan Africa

Incidence and mortality rates in selected countries in sub-Saharan Africa, 2018

An estimated 752,000 new cancer cases (4% of the global total) and 506,000 cancer deaths occurred in sub-Saharan Africa in 2018. Although the overall cancer burden in the region is dominated by breast, cervical, and prostate cancers, the cancer profile in sub-Saharan Africa is quite diverse. MAP 17.1 

The most common cancers in men are prostate (69,000 cases, or 23% of all cancers) and liver cancers (24,000 cases, or 8% of all cancers) as well as Kaposi sarcoma (20,000 cancers, 7%). Breast (115,000 cases, 25% of all cancers) and cervical cancers (112,000 cases, 24%) are the most frequently diagnosed cancers in women. FIGURE 17.1, 17.2

Incidence rates have been increasing for several major cancer sites. For example, cervical cancer rates increased by 80% in Zimbabwe and 36% in South Africa, although they have risen and declined recently in Uganda. FIGURE 17.3 Major increases have been seen for breast as well as for prostate cancers where they have been measured, doubling in Zimbabwe (breast) and South Africa (both cancers) over the last 15 years. While the cause of elevated rates for certain cancers such as esophagus is still largely unknown, a westerniza-tion of lifestyle (e.g. dietary habits, fertility, excess body weight, and physical inactivity) has been related to observed increases in breast cancer, and is expected to give rise to increases in rates of other cancers such as colorectum. An improved aware-ness and increased capacity to perform prostatectomies on older men has been suggested to be linked to the increase in prostate cancer rates.

There is a large opportunity for cancer prevention and control programs to improve health outcomes in the region. Comparing incidence and mortality rates of all cancers combined across countries, large disparities in terms of incidence-to-mortality ratios are apparent. FIGURE 17.4 Large differences between incidence and mortality

suggest poor outcomes and substantial case-fatality from cancers. Yet primary prevention remains key in sub-Saharan Africa, where there is a need to prioritize the most cost-effective means of reducing the cancer burden. Improved access to diagnosis and treatment, including palliative care, is also essential to improve survival and limit suffering from the disease in the region.

Rates for several major cancers are increasing.

DEATHSCASES

Over one-third of all cervical cancer deaths

globally occur in sub-Saharan Africa,

though the region represents only

14% of the world female population.

Regional Diversity

SUB-SAHARAN AFRICAUp to 50% of the cancers diagnosed in some countries in Eastern Africa are still related to infection, and these are largely preventable.

Total estimated

752,000Total estimated

506,000

45 15 11

42 15 15

4 5 6

7

7

4 4 5 6

9

CERVIX BREAST (F) PROSTATE KAPOSI SARCOMA ESOPHAGUS (M)

INCIDENCE MORTALITY

INCIDENCE MORTALITY

MALE

FEMALE

*Excludes non-melanoma skin cancer.

copyright © 2019 the american cancer society, inc.

Opportunities for reducing suffering and death from cancer in Africa exist across all stages of the cancer

control spectrum.

— Max Parkin, cancer epidemiologist

“Prostate Lung Esophagus StomachLiver Kaposi sarcomaBreast Cervix