Media release

From: The Lancet

The Lancet: Largest study to date reveals vast disparities in cancer care and treatment for women worldwideWomen living in low- and middle-income countries (LMICs) face much longer waits for treatment after diagnoses for breast, cervical, and ovarian cancer than those in higher income countries (HICs), according to the largest and most comprehensive dataset of its kind, published in The Lancet. The study provides the first truly global picture of how these three common cancers are diagnosed and treated, offering the clearest evidence yet of global inequalities in care.

Breast, cervical, and ovarian cancers remain major global public health challenges, with survival rates varying vastly across the world. Understanding differences in how these cancers are detected and managed is essential to understanding these survival gaps and improving outcomes for women everywhere.

The VENUSCANCER project analysed records from almost 276,000 women across 39 countries from 2015-2018, creating the largest and most detailed database for women’s cancers to date, including information on stage at diagnosis, staging procedures, treatments, and biomarkers. The data suggests that in HICs more than 40% of women with breast and cervical cancers were diagnosed at earlier stages and began treatment within one month of diagnosis. Conversely, in LMICs, early diagnosis rates for all three cancers were generally below 20%, with many women only seeking care when their cancer was more advanced. For example, in sub-Saharan Africa, fewer than 3% of women with breast cancer were diagnosed early. While the study suggests that international treatment guidelines were generally followed in HICs, they were applied inconsistently in LMICs, especially for those undergoing surgery and radiotherapy for early breast cancer, chemotherapy for advanced cervical cancer, or surgery plus chemotherapy for ovarian cancer that has spread. Furthermore, the results suggest that when cancers are caught early in LMICs, women can often access treatment consistent with global standards, but levels of diagnosis at this stage remain low.

The authors say VENUSCANCER provides real-world evidence to support global initiatives, including WHO’s efforts to eliminate cervical cancer and improve breast cancer survival. They call for governments and policymakers to act to close gaps in women’s cancer care by expanding early detection, strengthening radiotherapy capacity, training more specialists, and tailoring guidelines to local resources.