Where you live changes your chances of beating cancer

Cancer around the world

In 2024 there were about 20.6 million new cases of cancer and 9.7 million deaths worldwide. One in five people will develop cancer by age 75, and almost everyone will have someone close to them with the disease. By 2050 the number of cases is expected to reach 35 million a year, and the growth will be fastest precisely in the poorest countries, where cases may more than double.

The same disease, different chances

According to the World Health Organization (WHO), the chance of surviving cancer depends less on the tumor than on where the person lives. Some examples:

• For breast cancer and childhood cancers, more than 85% of patients are alive after five years in wealthy countries. In poor countries, fewer than 45%.
• Almost half the world's population has little or no access to basic diagnostic tests.
• In wealthy countries, treatment starts within two to four weeks. In low- and middle-income countries, it can take two to six months.
• Only 14% of people who needed palliative care, the care that relieves pain and suffering, were able to get it. Morphine, cheap and essential, is still unavailable in many places.

The main barriers

• Late diagnosis. In many countries, most cancers are found when they are already advanced and harder to treat.
• Lack of facilities and staff. There are too few pathologists, surgeons, radiotherapy machines and trained teams, and much equipment sits idle for lack of maintenance.
• Cost. Between 45% and 60% of patients face health costs that strain their family's finances. New drugs can cost hundreds of thousands of dollars a year, and many people cannot complete treatment.
• Research in too few places. About 90% of clinical trials take place in wealthy countries, which account for only a share of cases. The results do not always apply to other populations.
• Lack of data. Without good-quality cancer registries, planning is difficult.
• Misinformation. The vast majority of newly diagnosed people are exposed to false information about cancer.

Almost 40% of cases could be prevented

Many cancers are linked to factors we can change. Smoking alone accounts for about 15% of cases worldwide. Infections that can be vaccinated against or treated, such as HPV and hepatitis B and C, account for about 10%. Alcohol, excess weight and air pollution round out the list.

A conversation that began 20 years ago

In 2005 the World Health Assembly adopted its first resolution on cancer. It called on every country to have a national plan, cancer registries, access to essential medicines and morphine, and a special focus on prevention. Two decades later, 82% of countries have a plan, but only 27% of them have guaranteed funding to carry it out. As the WHO sees it, the gap today is not between what we know and what we don't, but between what we know and what we do.

The way forward

• Cancer care within universal health coverage, with national plans that are funded and measured by real outcomes: survival and quality of life.
• Prevention: taxes on tobacco and alcohol, vaccination and environments that encourage healthy habits.
• Concrete global targets: eliminate cervical cancer, with 90% of girls vaccinated against HPV, 70% of women screened and 90% treated; reduce breast cancer deaths by 2.5% a year; and reach at least 60% survival for childhood cancer worldwide by 2030.
• Affordable essential medicines, through generics, biosimilars and joint purchasing between countries.
• Patients at the decision-making table and research designed around the needs of those who need it most.

What about Brazil?

Brazil's National Cancer Institute (INCA) estimates 781,000 new cases a year in Brazil between 2026 and 2028, or about 518,000 excluding non-melanoma skin cancer. The most common are prostate cancer in men and breast cancer in women, followed by bowel cancer in both.

The differences between regions reflect the same problem the WHO describes worldwide. In the North and Northeast, cervical cancer, which is preventable, is still among the most frequent, and stomach cancer weighs more heavily among men. According to INCA, these differences reflect unequal access to prevention, diagnosis and treatment.

There has been important progress:

• In 2023, Law 14,758 created the National Cancer Prevention and Control Policy within the SUS, Brazil's public health system, along with a patient navigation program to guide patients from diagnosis to treatment.
• According to preliminary 2025 data, HPV vaccination reached 85% of girls and 73% of boys.
• HPV DNA testing has begun replacing the traditional Pap smear for screening, initially in 12 states, and screening mammography has been extended to women aged 40 to 74.
• In 2025, 24 new radiotherapy machines came into service, and another 131 are planned for 2026.

But access to newer treatments is still unequal. In my research on access to pembrolizumab through the courts, we showed how many SUS patients have to file a lawsuit to receive immunotherapy.

What each of us can do

• Vaccinate children and teenagers against HPV and keep hepatitis B vaccination up to date.
• Don't smoke, and cut down on alcohol.
• Have the screening tests recommended for your age.
• Look for information from reliable sources, such as INCA, and be wary of miracle promises.
• Know your rights as a patient. INCA publishes a booklet on the social rights of people with cancer.

For information only.