Is Poverty a Cancer-Causing Agent?
How does poverty impact cancer incidence and survival?
A cancer diagnosis can be exhausting. Coming to terms with it, undergoing treatment and waking up every morning with a conscious effort to be optimistic and hopeful; requires courage, strength and persistent willpower.
But willpower is only half the milestone reached. The other half requires financial backing — and everything that comes with it.
When a lack of resources and money gets coupled with cancer, the struggle multiplies manifold; and the chances of survival fall to a bare minimum.
But is cancer survival the only aspect that a person’s financial status determines? Or does the socio-economic background also play a role in causing cancer?
Poverty Is a Carcinogen — It’s Proven
The evidence is abundant. American Cancer Society has time and again considered poverty one of the most potent cancer-causing factors.
- In a 2019 study, it found that even though cancer death rate fell by 27 percent between 1991 and 2006 in the US, it remained worse among people living in poverty. People living in poorer regions were more 20% more likely to die from cancer.
- A 2013 study titled ‘Poverty as a Risk Factor in Human Cancers’ stated that evidence from industrialized and less developed societies shows that cancer survival and incidence are related to socioeconomic circumstances. “Lower social classes tend to have a higher cancer incidence and poorer cancer survival rates than higher social classes, although this pattern differs for specific cancers.”
- The World Health Organisation predicts an 81% jump in cancer cases by 2040 in low- and middle-income countries.
- A study published in the Lancet in 2018 found that there are constant disparities between the rich and the poor when it comes to chances of surviving cancer.
- Even former director of National Cancer Institute, Dr. Samuel Broder had, among other environmental factors, identified poverty as a cancer-causing agent.
But what explains this link?
FIT spoke to Dr Niranjan Naik, Director, Surgical Oncology, Fortis Memorial Research Institute at Gurugram. “Approximately two out of three cancer deaths are caused by smoking, alcohol, poor diet, obesity, sedentary lifestyle, or failing to use cancer screening tests.”
Tobacco alone is directly associated with around 12 types of cancer, he adds. The habit of chewing tobacco and smoking bidis is more prevalent among the poor, making them highly susceptible to the consequent health hazards — cancer being one of them.
Dr Shravan Shetty, an Onco Surgeon from Asian Cancer Institute, substantiates this with a study. A survey by the Cancer Patients Aid Association found that among 3,000 autorickshaw drivers, 85% consumed tobacco and 45% had precancerous lesions.
“With a heavy heart, I have to say that oral cancer is now affecting even younger people. Tobacco initiation age is coming down from 24-year-old adults to 11-year-old children. This is because chewing tobacco is the cheapest form of entertainment for the poor. You can get it for just five rupees.”Dr Shravan Shetty
These lifestyle factors also work towards determining the type of cancer that certain sections of the society are more at risk of. As pointed by Dr Niranjan, oral cancer, lung cancer, mouth cancer, cervical cancer, colon cancer, and rectum cancer are a few that are triggered by smoking, alcohol, poor hygiene and diet. Lack of proper nutrition, by itself, reduces the body’s immunity and leads to multiple health issues.
Underprivileged in More Ways Than One
The facts become gloomier when you realize that many of these cancers, including oral, breast and cervical, are preventable and can be treated if detected early. Poverty doesn’t just limit a person’s financial resources and access, but also their awareness about the prevention of diseases.
“Poverty means lack of finances and a lack of awareness. Many among the poor don’t even know that treating cancer is possible. There is a common assumption that cancer is a death sentence. They’re not aware of timely screening, possible treatments and the need to continue the treatment. They don’t even visit the doctors. While we see advertisements and hoardings, we still don’t know how much of these reach the grassroots.”Dr Shravan Shetty
For instance, getting screened for cancers is not that even that expensive, especially if you consider the money spent on tobacco every month. But among the poor, there is a general lack of basic information and awareness about the need to get tested.
Cancer Is Expensive; Affordable Healthcare Is the Need of the Hour
Dr Niranjan also adds the aspect of family support and financial strain that the poor face. To daily wage workers, for instance, missing one day of work to go for cancer tests or screening just doesn’t seem worthwhile. And once diagnosed, the treatment for cancer could disrupt their household income. Most treatment options, such as chemotherapy, surgery or radiation therapy cost a huge sum of money.
“Any cancer treatment will take a minimum of six months. During this time, a family would have to spend lakhs of rupees from their household income. And even after that, you need to keep going for regular check ups — so it becomes a recurring expenditure. This is why people either don’t come for treatment at all, or they just leave it midway — giving up on the very real possibility of getting treated. This is why affordable healthcare is so important.”Dr Shravan Shetty
Even insurance is a privilege that the poorest of the poor don’t get.
Acknowledging these factors, several NGOs work towards helping those in need. ‘Leukemia Crusaders’ is one such organisation that provides bridge-funding to underprivileged children affected by Leukemia. Speaking to FIT, Monica Vohra, Managing Trustee, said, “Families are often seen abandoning treatment and opting for alternate traditional therapy (dues to lack of awareness) and financial constraints. Some families lose the battle at the initial stage, being unaware of the fact that ‘cancer is curable’. Reasons like gender bias, the toxicity of treatment and cancer taboo also contribute significantly to the cause of abandonment.”
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