INTRODUCTION:

After the cardiovascular diseases, cancer is a second major cause of death in this world. The word “Cancer” came from a Greek word “karkinos" to describe carcinoma tumours by a physician Hippocrates (460–370 B.C), but he was not the first to discover this disease. Some of the earliest evidence of human bone cancer was found in mummies in ancient Egypt and in ancient manuscripts dates about 1600 B.C. In 2000, 5.3 million men and 4.7 million women developed a malignant tumour and altogether 6.2 million died from the disease¹. According to the statistics in 2016, an estimated 1,685,210 new cases of cancer will be diagnosed in the United States and 595,690 people will die from the disease.

The most common cancers in 2016 are projected to be breast cancer, lung and bronchus cancer, prostate cancer, colon and rectum cancer, bladder cancer, melanoma of the skin, non-Hodgkin lymphoma, thyroid cancer, kidney and renal pelvis cancer, leukaemia, endometrial cancer, and pancreatic cancer². The number of people living beyond a cancer diagnosis reached nearly 14.5 million in 2014 and is expected to rise to almost 19 million by 2024.Approximately 39.6% of men and women will be diagnosed with cancer at some point during their lifetimes (based on 2010-2012 data).In 2014, an estimated 15,780 children and adolescents ages 0 to 19 were diagnosed with cancer and 1,960 died of the disease. National expenditures for cancer care in the United States totalled nearly $125 billion in 2010 and could reach $156 billion in 2020³. The present review emphasizes the Historical Status, Government Regulation and Current Scenario of Socio - Economic Impact.

The current Indian population is 1,270,272,105 (1.27 billion). The incidence of cancer in India is 70-90 per 100,000 populations and cancer prevalence is established to be around 2,500,000 (2.5 million) with over 800,000 new cases and 5, 50,000 deaths occurring each year. More than 70% of the cases present in advanced stage accounting for poor survival and high mortality⁴. About 6% of all deaths in India are due to cancers which contribute to 8% of global cancer mortality. Regarding world health organization survey, cancer rates could further increase by 50% to 15 million new cases in the year 2020.

MATERIALS AND METHODS:

As is the case with retrospective research of the cancer patients and their socio-economic impact in the present health care system, peer reviewed articles and journal works were studied and collected information based on the reports.

GOVERNMENT REGULATIONS IN CANCER PREVENTION:

Lots of programmes initiated by our government of India have been trying to slow down the increasing prevalence of cancer. Government, be it local, state, provincial, national, or even a union of nations, has clear roles in the control of cancer. It is widely appreciated that much of the research that has defined the causes and treatment of cancer was, and is, government funded. Less appreciated, the body of work about how to control cancer shows the importance of an environment that encourages individuals to adopt healthy behaviours, and government has a vitally important role. Through regulation, education, and support programmes, governments can create an environment in which tobacco use is reduced and citizens maintain good levels of physical activity, healthy bodyweight, and good nutrition. Cancer prevention and the creation of a culture of health is an essential mission of government, beyond that of the traditional health-focused departments such as health ministries. The central government shows their effort by supplying technical and financial support through National Program for Prevention and Control of Cancer, Diabetes, CVD and Stroke (NPCDCS)⁵.

SOCIO-ECONOMIC IMPACT OF CANCER:

The world cancer report says that cancer rates are set to increase at an alarming rate globally. Approximately 60 percent of all cancers occur in patients who are 65 years or older, 40 percent of cancers occur in the age group of 20 to 64 and around 1 percent are age 19 or younger⁶. Moreover, all the cancer survivors will face psychological and emotional factors that can show up many years after the treatment. The most common psychosocial issues that cancer survivors may deal with fear of recurrence, grief, spirituality, depression.

In India, evidence suggests that cancer prevalence is highest among the elderly and females in the reproductive age groups. Expenditure on cancer treatment is among the highest for any ailment. The average cost of money spending on inpatient care in private facilities is about three-times that of public facilities. Furthermore, treatment for about 40 percent of cancer hospitalization cases is financed mainly through borrowings, sale of assets and contributions from friends and relatives. Also, over 60 percent of the households who seek care from the private sector incur out of pocket expenditure more than 20 percent of their annual per capita household expenditure. Globally, the cancer aetiology as well as epidemiology has received significant attention of researchers. In fact, cancer is the second leading cause of deaths worldwide and accounts for a share of 13 percent in total global deaths (or 8.7 million deaths)⁷. The prevalence of cancer was conventionally much evident in developed nations, but in recent years, it has increased substantially in developing countries as well. The estimates from Global Burden of Disease (GBD) suggest that about 70 percent of all cancer deaths are now concentrated among low and middle-income countries⁸. However, cancer research and treatment are one of the most challenging fields in biomedical sciences and oncologists have been struggling to ensure greater survival chances among cancer patients. In general, there is a consensus that about 60 percent of cancer deaths can be prevented with improved and screening (test or procedure used to detect disease) facilities.

According to WHO Survey, India has a cancer mortality rate of 79 per 100,000 deaths and accounts for over 6 percent of total deaths. These numbers are very close to those of high-income countries. Further, the cancer mortality in India is projected to increase to over 900,000 deaths by the end of this decade. Also, with higher burden of breast and uterine cancer, the cancer incidence in India is also identified with a significant gender dimension. Most importantly, in India, and as elsewhere, the term cancer resonates shock and fear because of two concurrent reasons; first, very high treatment costs and second, poor chances of survival. The financial burden associated with cancer treatment can force patients and households to acute depression and even insolvency. Some of the earlier hospital-based studies shows, on usual, a household spends about Rs. 36,812 for the entire cancer therapy excluding non-medical costs⁹. It is also noted that out of pocket (OOP) expenditure on cancer hospitalization is about 2.5 times of overall average hospitalization expenditure. While catastrophic expenditure on cancer inpatient treatment is highest among all NCDs. In fact, previous studies on India suggest that about 60 and 32 percent households resort to borrowings and contributions (from friends and relatives) respectively for cancer hospitalization. The problem increases manifold for developing nations such as India that has poor geographical coverage of medical services and negligible financial protection in health.

PREVENTIVE APPROACHES:

Lots of advanced treatment and improvements are available in the present situation from the prevention side¹⁰. The basic thing is to be talked to develop an awareness regarding the risk factors of cancer. It is usually not possible to predict the causes of the cancer. But the scientific research shows that certain risk factors may increase a person’s chances of developing cancer. Like exposure to chemicals or other substances, as well as certain behaviours. These include improper lifestyle modification, imbalanced diet, immunosuppressant etc. Regarding this point of view, large number of health services, production of drugs for every patient, quality of service and targeting on research field also increased in the present situation. The prevention of cancer from the childhood level is an essential area to focus for the treatment. By the way of helping them to take healthy diet, regular physical activity and proper maintenance of body weight.

CONCLUSION:

A definite need to improve health care management is an important way to reduce cancer and cancer related illness. The effect of cancer is due to the lack of self-awareness and uncontrolled behavioural changes. Development of self-improvement from the public is a key measure to overcome the impact of cancer. Further, it is an essential need to improve health care system and creating awareness among the public to overcome the prevalence of cancer.

CONFLICT OF INTEREST:

The authors (present and previous) do not have any conflict of interest in publishing this retrospective research work.

REFERENCE:

1. World health organisation Cancer Statistics Report, 2018.

2. National Cancer Institute Survey Report, 2015, 1-800- 4- CANCER.

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4. Ajay Mahal,Anup Karan, Victoria Y. Fan and Michael Engelgau (2013). The Economic Burden of Cancers on Indian Households, 12.293-298.

5. Brawley OW, (2017). The role of government and regulation in cancer prevention, PMID, 2017, Lancet Oncol. 18(8): 483 - 493.

6. Role in Prevention and Control of Non-Communicable Diseases (NCDs), 2015, NHP CC DC.

7. Sunil Rajpal, Abhishek Kumar, William Joe (2018). Economic burden of cancer in India: Evidence from cross-sectional nationally representative household survey, 2018, PLoS One. 13(2).

8. Jyothi Chakrabarty, Economic Burden of Cancer in India, 2017, Indian Journal of Public Health Research and Development. 8(3):137-141.

9. Sabatucci I, Maltese G, Lepori S, Tripodi E, Bogani G, Lorusso D, Rucaparib (2018). A New Treatment option for ovarian cancer, Expert Opin Pharmacotherapy, 19:1-7.

10. A Cervantes, G.Curigliano, R.A. Stahel, (2018) Cancer Treatment Reviews, Elsevier, ISSN: 0305-7372.

Received on 25.05.2018 Accepted on 13.07.2018

Asian J. Pharm. Res. 2018; 8(3): 133-135.

DOI: 10.5958/2231-5691.2018.00023.0