Most women in poorer countries miss early cancer detection, says Lancet

Women's cancers like breast, cervical, and ovarian are often detected late in poorer countries, sharply reducing survival chances, according to a global Lancet study

Fewer than one in five women in low- and middle-income countries are diagnosed with breast or cervical cancer at an early stage, dramatically lowering their chances of survival compared to women in richer nations, finds a new study published in The Lancet.

 

The research, titled Global variation in patterns of care and time to initial treatment for breast, cervical, and ovarian cancer from 2015 to 2018 (VENUSCANCER), analysed data from more than 2,75,000 women across 39 countries. Conducted by the Cancer Survival Group at the London School of Hygiene & Tropical Medicine, the study gives the first global picture of how women’s cancers are diagnosed and treated, exposing stark inequalities in access to timely, guideline-based care.

 

What did The Lancet study find about early detection?

The study revealed that:

• For breast and cervical cancer, only one in five women in poorer nations were diagnosed early, while in richer countries, two out of five were.
• For ovarian cancer, the picture is even bleaker, that is less than one in five women worldwide were diagnosed at an early stage, earning it the grim nickname “silent killer.”

“Too many women, especially in low- and middle-income countries, are only diagnosed when their cancer is already advanced,” the researchers said in a press statement. “This reduces their chances of survival compared to women in wealthier nations.”

 

With data from 103 population-based cancer registries, the study built the largest global database of breast, cervical, and ovarian cancer cases ever assembled.

How were women in poorer countries treated differently?

The study found major treatment disparities:

• In high-income countries, 78 per cent of women were offered surgery for early-stage cancer. In contrast, only 56 per cent of women in low- and middle-income countries received surgical care, and even then, the treatment often did not follow international clinical guidelines.
• Older women were especially disadvantaged. Across all countries, women over 70 were less likely to be offered treatment consistent with international recommendations compared to younger women.
• Even when care was offered, waiting times were longer in poorer regions, stretching to months between diagnosis and first treatment, compared to just weeks in wealthier countries.

Ovarian cancer: the silent killer

According to the study, ovarian cancer remains the hardest to detect. Less than 20 per cent of cases were diagnosed early across all countries studied. The disease often causes subtle symptoms such as bloating, abdominal swelling, or pain, which can be mistaken for digestive issues.

 

By the time women seek help, the cancer has usually spread, limiting the effectiveness of treatment.

What can governments do to close the cancer care gap?

The researchers stress the urgent need for governments in low- and middle-income countries to support population-based cancer registries, which provide vital data for policymaking.

 

“Governments should include the provision of stable financial support for population-based cancer registries in any cancer control plan,” said Professor Claudia Allemani, Global Public Health, London School of Hygiene & Tropical Medicine, in a press statement.

 

She added that the findings should guide international efforts such as the WHO’s Global Breast Cancer Initiative and the Cervical Cancer Elimination Initiative, both aimed at improving survival and early detection worldwide.

 

Dr Veronica Di Carlo, co-author of the study, added that “international clinical guidelines must be simplified, translated, and adapted to local needs, so women everywhere can make informed decisions about their treatment.” 

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