Keywords

Introduction

Cancer is a complex and devastating disease that affects millions of people around the world. It is characterized by the uncontrolled growth and spread of abnormal cells in the body. There are various types of cancer, including breast cancer, lung cancer, prostate cancer, colorectal cancer, and many others. Understanding the causes and risk factors associated with cancer is crucial for prevention, early detection, and effective treatment. The exact causes of cancer are often multifactorial and can vary depending on the type of cancer. However, there are several common factors that are known to increase the risk of developing cancer. One of the primary causes of cancer is genetic mutations. These mutations can occur spontaneously or be inherited from parents. Certain genes, known as oncogenes, can promote the growth of cancer cells, while tumor suppressor genes help control cell growth and division. Mutations in these genes can disrupt the normal regulation of cell growth, leading to the development of cancer.

Environmental factors also play a significant role in the development of cancer. Exposure to carcinogens, which are substances or agents that can cause cancer, can increase the risk of developing the disease. Carcinogens can be found in various forms, such as chemicals, radiation, and certain infections. Tobacco smoke is one of the most well-known and preventable carcinogens, responsible for causing lung, throat, and mouth cancers. Other environmental factors that can contribute to cancer development include exposure to asbestos, certain chemicals in the workplace, and excessive sunlight or ultraviolet radiation.

Lifestyle choices and behaviors can significantly impact the risk of developing cancer. Poor diet and nutrition, lack of physical activity, and obesity have been linked to an increased risk of several types of cancer. A diet high in processed and red meats, saturated fats, and low in fruits and vegetables can promote cancer growth. Regular physical activity, on the other hand, has been shown to reduce the risk of certain cancers, such as colon and breast cancer. Additionally, excessive alcohol consumption can increase the risk of developing various types of cancer, including liver, breast, and colorectal cancer.

Another significant risk factor for cancer is age. Cancer is more common in older individuals, as the accumulation of genetic mutations and exposure to risk factors over time increases the likelihood of cancer development. However, cancer can occur at any age, and certain types of cancer, such as childhood cancers, have distinct risk factors.

Hormonal factors also contribute to the risk of developing certain types of cancer. For instance, the prolonged exposure to estrogen, a hormone produced by the ovaries, increases the risk of developing breast and uterine cancer. Hormone replacement therapy and certain oral contraceptives that contain estrogen may also increase the risk of breast and ovarian cancer. Similarly, long-term use of testosterone has been associated with an increased risk of prostate cancer.

Infections caused by certain viruses, bacteria, and parasites have been linked to the development of specific types of cancer. For example, human papillomavirus (HPV) is a sexually transmitted infection that can lead to cervical, anal, and oropharyngeal cancer. Hepatitis B and C viruses can cause liver cancer, while Helicobacter pylori infection is a significant risk factor for stomach cancer. Vaccines, such as the HPV vaccine and hepatitis B vaccine, have been developed to prevent some of these infections and reduce the risk of associated cancers.

Family history and inherited gene mutations can also increase the risk of developing cancer. Certain inherited gene mutations, such as BRCA1 and BRCA2, significantly increase the risk of breast and ovarian cancer. Individuals with a family history of cancer may have a higher risk due to shared genetic factors or common environmental exposures. In conclusion, cancer is a complex disease with multiple causes and risk factors. Genetic mutations, environmental factors, lifestyle choices, age, hormonal factors, infections, and family history all play a role in the development of cancer. Understanding these risk factors can help individuals make informed decisions about their health, adopt healthier lifestyles, and undergo appropriate screenings for early detection. Furthermore, ongoing research into the causes and risk factors of cancer is essential for developing effective prevention strategies and advancing treatments to combat this devastating disease.

Cancers in Developing Countries: Research

Research is very important in all medical and health sciences practice, healthcare, and patient care (Abd Rahim et al., 2016; Ahmed et al., 2018; Alakhali et al., 2020; Akkawi et al., 2022; Al-Meman et al., 2014; Al-Mohamadi et al., 2018; Alshahrani et al., 2019a, b; Al-Qahtani et al., 2015; Alshahrani et al., 2020a, b; Al-Worafi, 2013, 2014a, b, c, 2015, 2016, 2017, 2018a, b, c, 2020a, b, c, d, e, f, g, h, i, j, k, l, m, n, o, p, q, r, s, t, u, v, w, x, y, 2022a, b, c, 2023a, b, c, d, e, f, g, h, i, j, k, l, m, n, o, p, q, r, s, t, u, v, w, x, y, z, aa; Al-Worafi et al., 2017, 2018a, b, 2019, 2020a, b, 2021a, b, c, 2023; Al-Worafi & Ming, 2022; Ang et al., 2021; Atif et al., 2022a, b; Baig et al., 2020; Begum et al., 2020; Choudhry et al., 2021; Elangovan et al., 2020; Elkalmi et al., 2020; Elsayed & Al-Worafi, 2020; Guella et al., 2021; Hamdan et al., 2020; Hasan et al., 2019; Hassan et al., 2014; Hossain et al., 2022; Izahar et al., 2017; Jaber et al., 2022; Jefri et al., 2022; Khan et al., 2021; Kharaba et al., 2022; Kouider et al., 2019; Kumaran et al., 2020; Loy et al., 2022; Lee et al., 2017; Mahleyuddin et al., 2021; Mahmoud et al., 2020; Manan et al., 2014, 2016; Ming et al., 2016, 2020; Moshawih et al., 2022; Othman et al., 2020; Saeed et al., 2014; Saher et al., 2022; Shahid et al., 2021; Voo et al., 2021; Wahid et al., 2022; Yaseen et al., 2022). Cancer poses a significant challenge in developing countries, where the burden of the disease is increasing rapidly. Several factors contribute to the unique research needs and challenges faced by these countries in understanding and addressing cancer.

Limited resources: Developing countries often have limited resources allocated to healthcare infrastructure, including cancer research. This scarcity affects the availability of funding, equipment, laboratories, and trained personnel required for conducting cancer research. As a result, there may be a lack of comprehensive and up-to-date data on cancer incidence, prevalence, and outcomes.

Diverse cancer profiles: Developing countries often experience a different pattern of cancers compared to developed nations. While certain cancers such as lung, breast, and colorectal cancer remain prevalent, there is a higher burden of cancers associated with infectious agents, such as cervical, liver, and stomach cancer. The diverse cancer profiles necessitate region-specific research to understand the underlying causes, risk factors, and potential interventions.

Infectious agents: Infections play a significant role in the development of certain cancers, particularly in developing countries. For example, the human papillomavirus (HPV) is a leading cause of cervical cancer, and hepatitis B and C viruses contribute to liver cancer. Research is needed to develop effective preventive strategies such as vaccination programs, early detection methods, and affordable treatment options to combat these infections and associated cancers.

Cultural and societal factors: Cultural beliefs, practices, and societal factors can influence cancer research in developing countries. Stigma associated with cancer may lead to delayed diagnosis and treatment-seeking behavior. Additionally, cultural perceptions and traditional remedies may impact the acceptance and utilization of conventional cancer treatments. Research focusing on understanding these cultural and societal factors is crucial to developing effective interventions and improving cancer outcomes.

Access to healthcare: Limited access to healthcare services and late-stage cancer diagnoses are prevalent challenges in developing countries. Research is needed to identify barriers to access, improve cancer awareness, and develop strategies for early detection and diagnosis. Additionally, studies focusing on cost-effective treatment options and strategies to improve healthcare infrastructure and delivery are essential to address the disparities in cancer care.

Capacity building: Developing countries often lack trained healthcare professionals, researchers, and scientists specialized in cancer research. Capacity-building initiatives, including training programs, collaborations with international institutions, and knowledge sharing platforms, are crucial to develop a skilled workforce capable of conducting quality cancer research. Building research capacity can lead to the generation of local data, tailored interventions, and sustainable solutions for cancer control.

Collaboration and partnerships: Collaborations between developing countries, as well as partnerships with international organizations, play a vital role in advancing cancer research. Sharing expertise, resources, and knowledge can accelerate research progress, facilitate technology transfer, and promote the implementation of evidence-based interventions. Collaborative efforts also enhance data collection, standardization of research protocols, and harmonization of cancer registries.

Policy and advocacy: Cancer research in developing countries needs strong policy support and advocacy to prioritize cancer control efforts. Advocacy efforts can raise awareness, secure funding, and influence policy decisions to allocate resources for cancer research, prevention, and treatment. Research on health policy and economics is crucial to guide evidence-based policymaking and ensure the integration of cancer control within national health agendas.

In recent years, there have been notable efforts to enhance cancer research in developing countries. International organizations, such as the World Health Organization (WHO) and the International Agency for Research on Cancer (IARC), have been actively involved in supporting research initiatives and building capacity. They provide technical assistance, facilitate collaborations, and promote the implementation of cancer control programs tailored to the specific needs of developing countries.

One important area of research in developing countries is the implementation of cancer prevention strategies. Understanding the local risk factors and developing culturally appropriate prevention measures can significantly impact cancer incidence and mortality rates. Research focusing on tobacco control, vaccination programs, healthy lifestyle promotion, and early detection methods can have a profound effect on reducing the burden of cancer in these regions.

Additionally, research efforts in developing countries are increasingly focused on improving cancer diagnosis and treatment. Accessible and cost-effective diagnostic tools, such as point-of-care tests and telemedicine, are being explored to overcome barriers to timely diagnosis. Studies are also being conducted to evaluate the efficacy and safety of novel treatment modalities, including targeted therapies and immunotherapies, in resource-limited settings.

Furthermore, the field of cancer genomics is gaining momentum in developing countries. Genetic research helps identify specific mutations associated with certain cancers and can inform personalized treatment approaches. Efforts are underway to establish genomic research programs, build bioinformatics capabilities, and create databases to facilitate data sharing and collaboration.

Another area of research in developing countries is palliative care and supportive oncology. With limited resources and advanced-stage diagnoses, ensuring quality end-of-life care becomes crucial. Research focusing on pain management, psychosocial support, and caregiver training can greatly improve the quality of life for cancer patients and their families.

It is important to acknowledge that research in developing countries faces numerous ethical considerations. Protection of research participants, informed consent, and equitable distribution of benefits are critical aspects that must be addressed. Local ethical review boards and international guidelines help ensure that research is conducted ethically and with the best interests of the participants and communities in mind.

In summary, cancer research in developing countries faces unique challenges due to limited resources, diverse cancer profiles, infectious agents, cultural factors, access to healthcare, capacity building needs, and the importance of collaboration and advocacy. Addressing these challenges requires a comprehensive approach involving research institutions, policymakers, healthcare providers, and international partnerships to improve cancer prevention, diagnosis, treatment, and overall outcomes in these settings.

Cancers in Developing Countries: Causes and Risk Factors

In developing countries, the causes and risk factors of cancer can vary due to a combination of factors, including environmental, lifestyle, and infectious agents. Understanding these causes and risk factors is crucial for implementing effective prevention and control strategies. Here are some key causes and risk factors of cancer in developing countries:

  1. 1.

    Infectious agents: Infections play a significant role in the development of certain cancers in developing countries. For example, chronic infections with human papillomavirus (HPV) can lead to cervical, anal, and oropharyngeal cancers. Hepatitis B and C viruses are strongly associated with liver cancer, while Helicobacter pylori infection is a significant risk factor for stomach cancer. Preventive measures, such as vaccination programs, improved hygiene practices, and early detection and treatment of infections, are vital in reducing the burden of infection-related cancers.

  2. 2.

    Environmental exposures: Exposure to environmental carcinogens is a significant risk factor for cancer in developing countries. Occupational exposures, such as asbestos, silica, and certain chemicals, can increase the risk of lung, bladder, and other cancers. Environmental pollution from industrial activities, household air pollution from cooking fuels, and contamination of drinking water sources with chemical pollutants may also contribute to cancer development. Efforts to reduce exposure to these environmental carcinogens through regulation, improved work conditions, and environmental management are crucial in preventing cancer.

  3. 3.

    Tobacco use: Tobacco smoking remains a leading cause of cancer worldwide, including in developing countries. The tobacco industry often targets these regions with aggressive marketing and lower-priced products. Smoking is strongly associated with lung, throat, mouth, esophageal, and other cancers. Implementing comprehensive tobacco control measures, including tobacco taxation, public awareness campaigns, and smoking cessation programs, is essential to reduce the prevalence of smoking and its associated cancer risks.

  4. 4.

    Unhealthy lifestyle factors: Several lifestyle factors contribute to the risk of cancer in developing countries. These include poor diet and nutrition, physical inactivity, and excessive alcohol consumption. Diets high in processed and red meats, saturated fats, and low in fruits and vegetables are associated with an increased risk of various cancers, including colorectal, stomach, and breast cancer. Sedentary lifestyles and lack of physical activity are linked to an increased risk of colorectal, breast, and other cancers. Excessive alcohol consumption is a known risk factor for liver, esophageal, and breast cancer. Promoting healthy lifestyles, including balanced diets, regular exercise, and moderate alcohol consumption, can help reduce cancer risk.

  5. 5.

    Socioeconomic factors: Socioeconomic factors, such as poverty, limited access to healthcare, and educational disparities, contribute to cancer risk in developing countries. Lack of awareness about cancer prevention, limited access to screening and early detection services, and delays in seeking healthcare can result in late-stage cancer diagnoses and poorer outcomes. Addressing socioeconomic inequalities through improved access to healthcare, health education programs, and community outreach initiatives is crucial in reducing the burden of cancer.

  6. 6.

    Genetic factors: Genetic factors play a role in cancer development, and certain genetic mutations can increase the risk of specific cancers. In developing countries, limited resources for genetic testing and counseling may hinder the identification of individuals at high risk. However, research focusing on genetic predisposition, family history, and inherited gene mutations can contribute to better understanding of cancer risk and the development of targeted prevention and treatment strategies.

  7. 7.

    Reproductive and hormonal factors: Reproductive and hormonal factors can influence the risk of certain cancers in developing countries. For example, early age at first childbirth, multiple pregnancies, and prolonged breastfeeding have been associated with a reduced risk of breast and ovarian cancer. Conversely, late age at first childbirth, nulliparity (not having children), and hormonal factors such as early menarche (onset of menstruation) and late menopause can increase the risk of breast and ovarian cancer. Understanding the influence of reproductive and hormonal factors can help develop targeted interventions and educational programs for cancer prevention and early detection.

  8. 8.

    Lack of screening and early detection: In many developing countries, access to cancer screening programs is limited, resulting in a higher proportion of cancers being diagnosed at advanced stages. The lack of infrastructure, trained healthcare professionals, and awareness about the importance of early detection contributes to late-stage diagnoses. Implementing affordable and accessible screening programs for common cancers, such as breast, cervical, and colorectal cancer, can lead to early detection, better treatment outcomes, and reduced cancer mortality rates.

  9. 9.

    Radiation exposure: In certain developing countries, populations may be exposed to higher levels of ionizing radiation due to natural sources, occupational exposures, or inadequate safety measures. Prolonged exposure to ionizing radiation increases the risk of developing cancer, particularly radiation-related cancers such as leukemia, thyroid cancer, and certain solid tumors. Strengthening radiation safety regulations, monitoring occupational exposures, and promoting public awareness about the risks of radiation are important in minimizing radiation-related cancer risks.

  10. 10.

    Urbanization and changing lifestyles: Rapid urbanization in many developing countries brings about lifestyle changes that contribute to cancer risk. Urban areas often witness shifts in dietary patterns towards processed foods high in salt, sugar, and unhealthy fats. Sedentary lifestyles, increased stress, and exposure to environmental pollutants are also associated with urban living. These lifestyle changes can contribute to the rising burden of obesity, diabetes, and related cancers. Public health efforts targeting urban populations should focus on promoting healthy lifestyles, improving access to nutritious foods, and creating environments conducive to physical activity.

  11. 11.

    Lack of cancer registry systems: Cancer registries play a crucial role in collecting and analyzing data on cancer incidence, prevalence, and trends. However, many developing countries lack comprehensive and well-functioning cancer registry systems. The absence of accurate data hampers the understanding of cancer patterns, limits research opportunities, and impedes the development of targeted interventions. Establishing and strengthening cancer registry systems can provide vital information for cancer control planning, resource allocation, and monitoring of progress.

  12. 12.

    Limited access to treatment: Access to timely and affordable cancer treatment remains a challenge in many developing countries. Limited healthcare infrastructure, shortage of oncology specialists, high treatment costs, and lack of health insurance coverage contribute to disparities in cancer care. Improving access to essential cancer medications, radiation therapy facilities, and supportive care services, while addressing financial barriers, is crucial to ensure equitable access to quality cancer treatment.

  13. 13.

    Lack of research funding and infrastructure: Research funding and infrastructure are essential for advancing cancer research in developing countries. Limited funding sources and competing priorities often result in inadequate investment in cancer research. Strengthening research capacities, establishing research networks, and increasing funding opportunities for local researchers are necessary to generate evidence-based knowledge and interventions tailored to the specific challenges of developing countries.

  14. 14.

    Air pollution: Exposure to high levels of air pollution, particularly from industrial emissions and vehicle exhaust, has been linked to an increased risk of lung cancer and other respiratory-related cancers.

  15. 15.

    Water contamination: Contamination of drinking water sources with pollutants, heavy metals, or chemical substances can contribute to an increased risk of various cancers, including bladder, kidney, and liver cancer.

  16. 16.

    Traditional medicines and herbal remedies: The use of certain traditional medicines and herbal remedies without proper regulation and quality control measures can sometimes result in exposure to harmful substances that increase cancer risk.

  17. 17.

    Lack of health literacy: Limited health literacy and awareness about cancer prevention, risk factors, and early symptoms can hinder timely diagnosis and appropriate care-seeking behaviors.

  18. 18.

    Mental health and stress: Chronic stress, mental health disorders, and psychosocial factors can influence cancer risk through biological pathways, lifestyle behaviors, and immune system dysregulation.

  19. 19.

    Lack of vaccination programs: Limited access to vaccination programs targeting infectious agents associated with specific cancers, such as HPV and hepatitis viruses, can contribute to higher cancer incidence rates.

  20. 20.

    Occupational hazards: Exposure to occupational hazards, such as asbestos, pesticides, solvents, and heavy metals, can increase the risk of various cancers among workers in industries such as mining, agriculture, construction, and manufacturing.

  21. 21.

    Limited infrastructure for cancer diagnosis: Limited availability of diagnostic facilities, including imaging technologies, pathology services, and laboratory capacities, can lead to delayed cancer diagnosis and treatment initiation.

  22. 22.

    Inadequate treatment guidelines: The lack of comprehensive and updated treatment guidelines tailored to the local context can result in suboptimal treatment decisions and outcomes.

  23. 23.

    Lack of palliative care services: Limited access to palliative care services, including pain management, psychosocial support, and end-of-life care, can result in unnecessary suffering for cancer patients and their families.

  24. 24.

    Cultural norms and beliefs: Cultural norms, beliefs, and misconceptions surrounding cancer, such as fear, stigma, and supernatural beliefs, can impact cancer prevention efforts, timely diagnosis, and treatment adherence.

  25. 25.

    Genetic counseling and testing barriers: Limited availability of genetic counseling and testing services hinders the identification of individuals at high risk of hereditary cancers, preventing appropriate preventive measures and surveillance.

  26. 26.

    Limited cancer research collaboration: Limited collaboration between research institutions, both within and across countries, can impede the sharing of knowledge, resources, and expertise necessary for advancing cancer research.

  27. 27.

    Food insecurity: Lack of access to nutritious foods due to poverty and food insecurity can contribute to malnutrition and an increased risk of certain cancers.

  28. 28.

    Lack of rehabilitation services: Limited availability of rehabilitation services, including physical therapy and occupational therapy, can impact the quality of life and functional outcomes of cancer survivors.

  29. 29.

    Limited awareness about clinical trials: Inadequate knowledge and awareness about clinical trials and their benefits can result in low participation rates, limiting access to novel treatments and potential advancements in cancer care.

  30. 30.

    Language and cultural barriers in healthcare settings: Language and cultural barriers can affect effective communication, understanding of medical information, and access to quality healthcare services among diverse populations.

  31. 31.

    Limited access to cancer-related education: Insufficient educational programs and resources focusing on cancer prevention, early detection, and treatment options can impede efforts to raise awareness and empower individuals to make informed decisions about their health.

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    Displacement and refugee populations: Displaced populations and refugees may face additional challenges in accessing cancer care due to disrupted healthcare systems, limited resources, and barriers related to language, cultural adaptation, and socioeconomic disparities.

  33. 33.

    Impact of armed conflict and disasters: Armed conflicts and natural disasters can disrupt healthcare systems, leading to reduced access to cancer screening, treatment, and supportive care services.

  34. 34.

    Gender disparities: Gender-based inequalities, including limited access to healthcare, lower socioeconomic status, and cultural factors, can result in differential cancer risk and outcomes between men and women.

  35. 35.

    Lack of comprehensive cancer control plans: The absence of comprehensive national cancer control plans, policies, and guidelines can hinder the implementation of systematic and coordinated efforts to prevent, detect, and manage cancer.

  36. 36.

    Limited data sharing and integration: Challenges in data sharing, integration, and interoperability across different healthcare systems and institutions can hinder comprehensive cancer surveillance and research.

  37. 37.

    Limited access to essential medicines: The high cost and limited availability of essential cancer medications, including chemotherapy drugs, targeted therapies, and supportive care medications, can impede access to life-saving treatments.

  38. 38.

    Traditional beliefs and alternative healing practices: Traditional beliefs and reliance on alternative healing practices without evidence-based efficacy can delay or deter individuals from seeking conventional cancer treatments.

  39. 39.

    Lack of research on indigenous populations: Indigenous populations may have unique cancer risks, cultural perspectives, and traditional healing practices that require specific research efforts and interventions.

  40. 40.

    Climate change and environmental degradation: Climate change and environmental degradation can impact cancer risk through increased exposure to pollutants, changing disease patterns, and disruptions to food security and healthcare systems.

  41. 41.

    Limited availability of rehabilitation services: Limited access to rehabilitation services, including physical therapy and psychosocial support, can impact the long-term functional outcomes and quality of life of cancer survivors.

  42. 42.

    Substance abuse: Substance abuse, including alcohol, tobacco, and illicit drug use, can increase the risk of various types of cancer, particularly when combined with other risk factors such as chronic infections or environmental exposures.

  43. 43.

    Lack of cancer survivorship programs: Limited availability of survivorship programs and long-term follow-up care can result in inadequate support for cancer survivors, including ongoing monitoring, management of late effects, and psychosocial support.

  44. 44.

    Rapid changes in lifestyle and diet: Rapid urbanization, globalization, and changing dietary patterns can lead to the adoption of unhealthy diets rich in processed foods, sugary beverages, and saturated fats, increasing the risk of obesity and associated cancers.

  45. 45.

    Access to reproductive health services: Limited access to reproductive health services, including family planning and safe abortion services, can contribute to a higher risk of certain reproductive-related cancers, such as cervical and ovarian cancer.

  46. 46.

    Disparities in cancer research funding: Disparities in funding for cancer research can contribute to gaps in knowledge, research capacity, and the development of context-specific interventions in developing countries.

  47. 47.

    Lack of cancer prevention programs in schools: Insufficient integration of cancer prevention education into school curricula limits opportunities for early awareness, healthy behavior promotion, and cancer risk reduction among children and adolescents.

  48. 48.

    Limited support for community-based cancer programs: Community-based cancer programs, including awareness campaigns, screening initiatives, and support groups, often face challenges in sustaining funding and engagement from local communities.

  49. 49.

    Aging population and noncommunicable diseases: Developing countries are experiencing demographic transitions, with increasing aging populations and a rising burden of noncommunicable diseases, including cancer, necessitating tailored healthcare strategies and research efforts.

  50. 50.

    Limited access to palliative care medications: Inadequate availability and affordability of essential palliative care medications, such as opioids for pain management, can result in uncontrolled pain and suffering among cancer patients.

In conclusion, the causes and risk factors of cancer in developing countries are multifaceted, encompassing infectious agents, environmental exposures, unhealthy lifestyle factors, socioeconomic disparities, and genetic factors. Efforts to address these risk factors through preventive measures, health education, improved access to healthcare, and research initiatives are crucial for reducing the burden of cancer and improving cancer outcomes in these regions.

Cancers in Developing Countries: Recommendations

Here are some recommendations to address the challenges of cancer in developing countries:

  1. 1.

    Strengthen prevention efforts: Implement comprehensive cancer prevention programs that focus on risk factor reduction, including tobacco control, promotion of healthy diets and physical activity, vaccination programs for infectious agents, and environmental pollution control.

  2. 2.

    Improve access to screening: Establish and expand cancer screening programs, particularly for common cancers such as breast, cervical, and colorectal cancer. Ensure that screening services are accessible, affordable, and culturally appropriate, targeting high-risk populations.

  3. 3.

    Enhance cancer awareness and education: Conduct health education campaigns to raise awareness about cancer risk factors, early warning signs, and the importance of early detection and seeking timely healthcare. Tailor educational materials to address cultural and linguistic diversity, and engage community leaders and influencers in disseminating cancer-related information.

  4. 4.

    Strengthen healthcare systems: Invest in strengthening healthcare systems to improve cancer diagnosis, treatment, and supportive care. This includes enhancing infrastructure, ensuring an adequate supply of essential cancer medications, recruiting and training healthcare professionals, and improving access to quality cancer services in underserved areas.

  5. 5.

    Foster international collaboration: Promote collaborations between developing countries, international organizations, and research institutions to share knowledge, resources, and expertise in cancer research and control. Facilitate the exchange of best practices, research findings, and capacity-building initiatives to accelerate progress in cancer prevention, diagnosis, and treatment.

  6. 6.

    Support cancer research: Allocate adequate funding for cancer research in developing countries, focusing on region-specific risk factors, cancer profiles, and interventions. Promote research on prevention, early detection, treatment outcomes, survivorship, and the implementation of cost-effective strategies.

  7. 7.

    Strengthen cancer registry systems: Establish or enhance cancer registry systems to collect comprehensive and accurate data on cancer incidence, prevalence, and outcomes. Use the data to guide cancer control efforts, monitor trends, and evaluate the impact of interventions.

  8. 8.

    Advocate for policy change: Advocate for policy changes that support cancer control efforts, including the implementation of evidence-based interventions, the development of comprehensive cancer control plans, and the integration of cancer care into national health agendas. Engage policymakers, civil society organizations, and advocacy groups to prioritize cancer prevention and control.

  9. 9.

    Address health inequalities: Tackle health inequalities and disparities in cancer care by addressing socioeconomic determinants, improving access to healthcare services, reducing financial barriers, and ensuring equitable distribution of resources and services.

  10. 10.

    Promote palliative care: Integrate palliative care services into cancer care programs to ensure that individuals with cancer receive comprehensive support, pain management, and psychosocial services throughout their journey. Raise awareness about the importance of palliative care among healthcare professionals, policymakers, and the general public.

  11. 11.

    Support cancer survivorship: Develop and implement survivorship programs that provide long-term follow-up care, address late effects of treatment, and offer psychosocial support to cancer survivors. Ensure continuity of care and facilitate reintegration into society for survivors.

  12. 12.

    Foster community engagement: Involve local communities, community-based organizations, and patient advocacy groups in cancer prevention and control efforts. Engage them in program planning, implementation, and evaluation to ensure cultural appropriateness, sustainability, and community ownership.

  13. 13.

    Strengthen health systems for early diagnosis: Improve healthcare infrastructure and systems to enable early diagnosis of cancer, including accessible and affordable diagnostic services, trained healthcare professionals, and timely referral mechanisms.

  14. 14.

    Support research capacity building: Invest in research capacity-building initiatives, including training programs, mentorship opportunities, and funding support for local researchers and institutions. Foster collaboration between researchers, institutions, and international partners to enhance research capabilities.

  15. 15.

    Public health campaigns: Launch public health campaigns aimed at raising awareness about the causes and risk factors of cancer. These campaigns should emphasize the importance of lifestyle modifications, such as smoking cessation, healthy eating, regular physical activity, and moderation in alcohol consumption.

  16. 16.

    Tobacco control: Implement comprehensive tobacco control measures, including higher taxation on tobacco products, bans on tobacco advertising and sponsorship, and the enforcement of smoke-free policies in public spaces. Offer smoking cessation programs and support services to help individuals quit smoking.

  17. 17.

    Vaccination programs: Expand vaccination programs targeting infectious agents linked to cancer, such as HPV and hepatitis B viruses. Ensure that vaccines are accessible, affordable, and integrated into routine immunization schedules.

  18. 18.

    Environmental protection: Strengthen environmental regulations to reduce exposure to carcinogens in air, water, and soil. Implement pollution control measures, promote clean energy sources, and enforce occupational safety standards to minimize occupational exposures to carcinogens.

  19. 19.

    Healthy food policies: Develop and implement policies that promote healthy diets and nutrition. This can include measures such as improving access to affordable fresh fruits and vegetables, reducing the availability of processed and unhealthy foods, and implementing food labeling systems.

  20. 20.

    Access to healthcare: Improve access to quality healthcare services, including cancer screening, diagnosis, treatment, and palliative care. This can be achieved by expanding healthcare infrastructure, ensuring the availability of essential cancer medications and technologies, and reducing financial barriers through health insurance schemes or subsidized healthcare programs.

  21. 21.

    Education and awareness programs: Incorporate cancer prevention and risk factor education into school curricula and community outreach programs. Promote health literacy and empower individuals to make informed decisions about their health, including cancer prevention strategies and early detection practices.

  22. 22.

    Strengthen primary healthcare: Enhance the capacity of primary healthcare systems to provide early detection, diagnosis, and management of cancer. Train healthcare professionals at the primary care level to recognize early signs and symptoms of cancer and refer patients appropriately.

  23. 23.

    Research and innovation: Invest in cancer research and innovation to understand the specific causes and risk factors of cancer in the local context. This research can help develop targeted interventions, tailored prevention strategies, and improved treatment modalities suited to the needs of the population.

  24. 24.

    Collaborative partnerships: Foster collaboration between governments, international organizations, research institutions, and civil society organizations to pool resources, share expertise, and promote knowledge exchange. Collaborative partnerships can support capacity building, resource mobilization, and the implementation of evidence-based interventions.

  25. 25.

    Empowerment and advocacy: Empower individuals, communities, and patient advocacy groups to advocate for cancer prevention, access to quality care, and policies that support cancer control. Encourage the involvement of affected individuals and community representatives in decision-making processes and policy development.

  26. 26.

    Sustainability and monitoring: Ensure the sustainability of cancer control efforts by incorporating long-term planning, monitoring, and evaluation mechanisms. Regularly assess the impact of interventions, adjust strategies as needed, and share lessons learned to inform future initiatives.

  27. 27.

    Community-based interventions: Implement community-based interventions that engage local communities in cancer prevention and control efforts. This can include organizing awareness campaigns, providing educational materials, and facilitating community-led initiatives for healthy lifestyle promotion.

  28. 28.

    Mobile health technologies: Leverage mobile health technologies, such as smartphone applications and text messaging platforms, to deliver cancer prevention messages, provide screening reminders, and offer support for behavior change.

  29. 29.

    Workplace interventions: Implement workplace policies and interventions that promote a healthy work environment, reduce occupational exposures to carcinogens, and provide opportunities for employees to engage in physical activity and healthy eating.

  30. 30.

    Early childhood interventions: Introduce cancer prevention interventions and health education programs targeting early childhood settings, such as schools, daycare centers, and preschools. This can instill healthy habits from an early age and create a foundation for lifelong cancer prevention.

  31. 31.

    Supportive policies: Advocate for policies that support cancer prevention and control, such as mandating the use of safe and clean cooking fuels to reduce indoor air pollution, promoting access to clean water sources, and encouraging urban planning that facilitates physical activity.

  32. 32.

    Gender-specific strategies: Develop gender-specific strategies for cancer prevention and control, taking into account the unique risk factors, barriers, and cultural considerations for men and women. This can include gender-targeted education campaigns, screening programs, and support services.

  33. 33.

    Health system integration: Integrate cancer prevention and control into existing healthcare systems, ensuring that primary healthcare providers are equipped with the knowledge and tools to address cancer risk factors, provide counseling, and refer patients for appropriate care.

  34. 34.

    Targeted messaging: Tailor health messaging to specific cultural and linguistic contexts, considering local beliefs, customs, and languages to ensure maximum reach and effectiveness of cancer prevention efforts.

  35. 35.

    Health equity approaches: Adopt health equity approaches that focus on reducing disparities in cancer risk and outcomes among marginalized populations, including rural communities, ethnic minorities, and low-income groups.

  36. 36.

    Telemedicine and teleoncology: Utilize telemedicine and teleoncology services to bridge the gap in cancer care, particularly in underserved and remote areas. This can enable remote consultations, remote monitoring, and access to specialist opinions.

  37. 37.

    Peer education programs: Establish peer education programs where trained individuals from the community can disseminate accurate information about cancer prevention, early detection, and available healthcare services.

  38. 38.

    Integration of traditional medicine: Integrate traditional medicine practices into cancer care, ensuring that they are evidence-based, safe, and used in conjunction with conventional treatments. This can help address cultural beliefs and improve patient adherence to treatment plans.

  39. 39.

    School-based prevention programs: Implement comprehensive school-based programs that promote healthy behaviors, including physical activity, healthy eating, and tobacco and substance abuse prevention, to reduce cancer risk factors among children and adolescents.

  40. 40.

    Research on traditional practices: Conduct research to evaluate the safety and efficacy of traditional practices and herbal remedies commonly used in the local context. This can provide evidence-based guidance on their appropriate use and potential interactions with cancer treatments.

  41. 41.

    Empowerment of healthcare providers: Provide training and capacity building for healthcare providers, including physicians, nurses, and community health workers, on cancer prevention, early detection, and management. Empower them to be advocates for cancer control in their communities.

  42. 42.

    Support for cancer-related NGOs: Provide support and resources to cancer-related nongovernmental organizations (NGOs) that work on prevention, advocacy, and support services. Collaborate with these organizations to leverage their expertise and community reach.

  43. 43.

    Social support networks: Establish social support networks for cancer patients and their families, offering emotional support, information sharing, and practical assistance throughout the cancer journey.

  44. 44.

    Access to palliative care medications: Ensure availability and accessibility of essential palliative care medications, such as opioids, to manage pain and improve the quality of life for cancer patients in need of palliative care.

  45. 45.

    Health insurance coverage: Expand health insurance coverage to include comprehensive cancer care, ensuring that individuals have access to necessary screenings, treatments, and supportive care without financial hardship.

  46. 46.

    Multidisciplinary care teams: Develop multidisciplinary cancer care teams that include healthcare professionals from various specialties, such as oncology, radiology, pathology, and supportive care, to provide comprehensive and coordinated care.

  47. 47.

    Cervical cancer screening programs: Strengthen cervical cancer screening programs by increasing the availability of HPV testing, offering visual inspection with acetic acid (VIA) as an alternative screening method, and integrating screening into existing women’s health services.

  48. 48.

    Mobile clinics: Establish mobile clinics or outreach programs to provide cancer screenings and preventive services in remote or underserved areas where access to healthcare facilities is limited.

  49. 49.

    Survivorship care plans: Implement survivorship care plans that provide cancer survivors with personalized information on their treatment history, potential late effects, and recommendations for follow-up care.

  50. 50.

    Prevention in high-risk communities: Target high-risk communities, such as those with high smoking rates, high exposure to environmental carcinogens, or high prevalence of infectious agents, with tailored prevention programs and interventions.

  51. 51.

    Early detection awareness programs: Conduct awareness programs to promote early detection and prompt healthcare-seeking behavior, emphasizing the importance of recognizing early signs and symptoms of cancer and seeking medical attention without delay.

  52. 52.

    Training for community health workers: Provide training and support for community health workers to deliver cancer prevention messages, conduct screenings, and facilitate referrals to appropriate healthcare facilities.

  53. 53.

    Patient navigation programs: Establish patient navigation programs to guide individuals through the cancer care system, providing support and assistance with scheduling appointments, coordinating care, and addressing barriers to access.

  54. 54.

    Prevention programs for high-risk occupations: Develop targeted prevention programs for occupations with higher cancer risk, such as miners, agricultural workers, and industrial workers, to reduce exposure to occupational carcinogens.

  55. 55.

    Integration of cancer prevention in maternal and child health programs: Integrate cancer prevention strategies into maternal and child health programs, including promoting breastfeeding, ensuring access to HPV vaccination, and providing education on childhood cancer prevention.

  56. 56.

    Mobile mammography and breast cancer awareness programs: Provide mobile mammography services to improve access to breast cancer screening, particularly in rural and underserved areas. Conduct breast cancer awareness programs to educate women about the importance of self-examination and early detection.

  57. 57.

    Research on herbal remedies: Conduct research to evaluate the safety and efficacy of herbal remedies commonly used in the local context for cancer prevention and treatment. This can inform evidence-based guidelines for their appropriate use.

  58. 58.

    Collaboration with traditional healers: Collaborate with traditional healers to promote awareness about cancer risk factors and symptoms, encourage timely referrals to healthcare facilities, and facilitate the integration of traditional healing practices with modern cancer care.

  59. 59.

    Mobile cancer education units: Establish mobile cancer education units equipped with educational materials, screening resources, and trained staff to reach underserved populations and provide on-site education and screening services.

  60. 60.

    Task shifting: Implement task shifting strategies that allow trained healthcare workers, such as nurses and community health workers, to take on roles traditionally performed by physicians, such as conducting screenings and providing basic cancer care services.

  61. 61.

    Cancer prevention in workplace settings: Develop workplace policies that promote healthy behaviors, including smoking cessation programs, opportunities for physical activity, and access to nutritious food options, to reduce cancer risk among employees.

  62. 62.

    Research on indigenous medicinal plants: Conduct research on indigenous medicinal plants to identify potential compounds with anticancer properties, aiming to develop affordable and locally available treatment options.

  63. 63.

    Integration of cancer control in chronic disease programs: Integrate cancer control efforts with existing chronic disease programs, such as those focused on diabetes and cardiovascular disease, to address shared risk factors and improve overall health outcomes.

  64. 64.

    Longitudinal studies: Conduct longitudinal studies to track cancer incidence, risk factors, and outcomes over time, providing valuable data for the evaluation of prevention and control strategies and informing future interventions.

Implementing these recommendations requires a comprehensive and multisectoral approach involving government commitment, healthcare systems strengthening, community engagement, research collaborations, and resource allocation. By addressing the causes and risk factors of cancer in developing countries, we can make significant progress in reducing the burden of cancer and improving the health and well-being of populations.

Conclusion

In conclusion, addressing the causes and risk factors of cancer in developing countries is crucial for reducing the burden of this disease and improving outcomes for affected populations. Developing countries face unique challenges, including limited access to healthcare, environmental exposures, infectious agents, and socioeconomic disparities. However, through targeted interventions and collaborative efforts, progress can be made in cancer prevention, early detection, treatment, and supportive care. It is essential to prioritize public health campaigns, strengthen healthcare systems, promote research and innovation, and empower communities to take an active role in cancer prevention and control. By implementing these recommendations, developing countries can work towards a future where the impact of cancer is significantly reduced, and individuals have improved access to timely and quality care.