National Health Insurance
The Effect of Poverty on Site of Cancer

Download full PDF Document

In the introduction to a comprehensive Medical Research Council report on Poverty and Chronic Disease in South Africa, the editors said: “South Africa, a middle income country, has amongst the most extreme disparities in wealth in the world. ... While poor maternal and child health, infectious diseases and malnutrition are known to be associated with poverty, there remains a need to investigate the relationship between poverty and chronic diseases and their determinants.”

In a chapter on policy implications, the authors found that “ lung cancer occurred more frequently in the rich group compared to the poor group for males and females, (suggesting higher smoking rates in the past). ... Cancer of the oesophagus is usually diagnosed too late to achieve a cure, and thus the high mortality pattern reported here. Death due to cancer of the cervix is the commonest cause of cancer deaths among poor women, and account for a quarter of the years of life lost by these women. If adequate health services were in place to diagnose and treat this cancer through early pap smears or visual examination of the cervix ...  the condition can be cured and/or death prevented. ... For poor men the high death rates due to liver cancer also suggest the preventive measure of hepatitis B vaccination has not been adequate among them in the past”.

“A most unfortunate sequence of events has inadvertently exposed a group of children living in poor areas to exposures to a carcinogenic mycotoxin, Aflatoxin, which increases their risk of developing liver cancer in later life. The School Feeding scheme for children attending primary schools in poor areas, introduced by President Mandela since 1994, included the use of large amounts of peanuts. In some regions, the necessary quality control to ensure that these peanuts were not contaminated with the mycotoxin Aflatoxin was not done. Exposure to Aflatoxin among people who also are carriers of the hepatitis B virus results in an exponentially increased risk to develop liver cancer. As the programme to vaccinate young children against hepatitis B was only recently introduced, there is a cohort of children exposed to Aflatoxin in peanuts who have not received this vaccine”.

“Smoking-related causes of death account for a higher proportion of mortality ... in the rich compared to the poor, particularly in the case of women. Mortality due to lung cancer featured for poor men as well as rich men, suggesting that despite limited resources, poor men do indeed spend their limited resources on tobacco products, competing with food or other essential items. ... However, it is likely that poor people have significantly more exposure to indoor air pollution, resulting from burning wood or coal for cooking and heating during the winter.”

Contact Details:

Innovative Medicines SA
Val Beaumont

P.O. Box 2008
Houghton, 2041

Tel: +27 11 880-4644

Fax: +27 11 880-5987

Contact Us!