TB smoking toll 'could reach 40m'

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4 October 2011 Last updated at 23:00 GMT By Helen Briggs Health editor, BBC News website Smoking is a risk factor for TB Forty million smokers could die from TB by 2050, research suggests.

Smokers are about twice as likely to get the lung infection and die from it, compared with non-smokers.

Many of the new TB cases will be in Africa, the eastern Mediterranean and Southeast Asian regions, according to projections published in the BMJ.

A lung charity said global efforts to fight TB are being undermined by the tobacco industry's "aggressive promotion" of smoking in some places.

Dr John Moore-Gillon is a TB specialist and honorary medical advisor for the British Lung Foundation.

He said: "It is nearly 20 years since the World Health Organization declared tuberculosis to be a 'global health emergency'.

"Since that time rates have risen rather than fallen, and smoking increases the risk of getting - and dying from - TB.

"Concerted international efforts are now under way to try and turn the tide of TB, but this important research shows that all these efforts may be undermined by the tobacco industry's continuing aggressive promotion of smoking in many parts of the world."

Mathematical model

Nearly a fifth of people in the world are smokers; many in countries with high rates of TB where multi-national tobacco companies have expanded their markets.

Smoking is a known risk factor for TB, and may reduce the ability of the lungs to fight off infection.

X-ray of the chest of a patient with TB

Dr Sanjay Basu and colleagues from the University of California set out to predict the impact of smoking on future TB rates.

According to their mathematical model, worldwide smoking could lead to 40 million extra deaths from TB from 2010 to 2050.

If current smoking trends continue, the number of new cases of TB will rise by 18 million.

Smoking alone could undermine the worldwide goal of reducing TB mortality by half between 1990 and 2015, they say.

Writing in the BMJ, the team concludes: "Tobacco smoking could substantially increase tuberculosis cases and deaths worldwide in coming years, undermining progress towards tuberculosis mortality targets.

"Aggressive tobacco control could avert millions of deaths from tuberculosis."

Contagious

Tuberculosis is a contagious infection that mainly affects the lungs, but can spread to other parts of the body.

If not treated, it can damage the lungs to such an extent that a person cannot breathe properly.

Sometimes, people do not experience any symptoms for many months or even years after being infected.

TB can treated with antibiotics but is sometimes fatal.

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Women's cancers reach two million

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14 September 2011 Last updated at 21:43 GMT By Helen Briggs Health editor, BBC News website There have been steady increases in breast cancer deaths in the developed and developing world Two million women were diagnosed with breast or cervical cancer last year, according to global figures.

A sharp rise in cases was seen in women under 50 in low-income nations, say US experts.

Women in richer countries fared better due in part to screening, medicines, anti-smoking policies and vaccines, they report in the Lancet.

The research backs calls for world leaders to make cancer prevention a priority in the developing world.

The new global statistics from hundreds of cancer registries worldwide found there were about 2 million new cases of breast and cervical cancer in 2010, and 625,000 deaths.

The analysis, by the Institute for Health Metrics and Evaluation at the University of Washington, Seattle, highlighted a sharp rise in breast and cervical cancer among younger women in developing countries.

Cancer charities and scientists are calling for these diseases to be given a similar global priority to maternal mortality.

Continue reading the main story

Worldwide figures on breast cancer show cases are rising every year at a rate of about 3%, while death rates are also rising - at about 2% a year.

According to experts, this is driven partly by the ageing population and partly by a host of other factors, including diet, obesity, genetics, economics and the availability of national screening programmes.

Research evidence shows that some of these deaths are preventable, through early screening and treatment for breast cancer, HPV vaccination for cervical cancer, cervical cancer screening and anti-smoking measures.

The question for policy-makers is how to make such programmes available to more women around the world.

Vaccines against the virus linked to cervical cancer, for example, will only be used more widely when the cost falls.

Broad actions are warranted, supported by global funds, say public health experts.

In the past, complications during childbirth and pregnancy were among the leading causes of death in women of reproductive age in the developing world.

However, current trends suggest breast and cervical cancer deaths are starting to overtake, in poorer countries.

Study co-author, Dr Alan Lopez, of the University of Queensland, Australia, said: "We have poured an enormous amount of resources into addressing the serious concern of maternal mortality worldwide, and we've seen a great deal of progress.

"To expand that commitment, breast and cervical cancer need to become a standard part of the efforts aimed at saving more mothers' lives."

Mixed picture

The research in 187 countries for the period 1980-2010 highlighted stark differences in a woman's chances of developing, and surviving, cancer.

In the UK, a woman's risk of dying from breast cancer has fallen from 1 in 32 in 1980, to 1 in 47 by 2010. In countries such as Rwanda, however, the trend has reversed, with 1 in 60 women now at risk, compared with 1 in 97 in 1980.

Dr Rafael Lozano, professor of global health at IHME, another co-author of the paper, said the world used to think of breast cancer as a problem for high-income countries but as the world has become more globalised, this is starting to change.

"The main known risk factors for breast cancer - poor diet and obesity - are now becoming more commonplace in poor countries," he said.

"We have found that while countries such as the United States and United Kingdom have been able to lower the risks of women dying from breast cancer, through better screening and treatment, countries with fewer resources are seeing the risks go up."

With cervical cancer, the number of cases and deaths are rising more slowly than breast cancer, he added, with the number of deaths from cervical cancer going down in high-income countries.

"Our concern is that this is a disease that is almost entirely preventable through safe sex practices and early detection, yet it continues to kill nearly a half a million women every year.

"With the right investments and targeted policies, like the ones we have seen in places such as the UK, we can reverse this trend."

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