An overview of cancer survival in Africa, Asia, the Caribbean and Central America: the case for investment in cancer health services.

Population-based cancer survival data, a key indicator for monitoring progress against cancer, are reported from 27 population-based cancer registries in 14 countries in Africa, Asia, the Caribbean and Central America. In China, Singapore, the Republic of Korea, and Turkey, the 5-year age-standardized relative survival ranged from 76-82% for breast, 63-79% for cervical, 71-78% for bladder, and 44-60% for large-bowel cancer. Survival did not exceed 22% for any cancer site in The Gambia, or 13% for any cancer site except breast (46%) in Uganda. For localized cancers of the breast, large bowel, larynx, ovary, urinary bladder and for regional diseases at all sites, higher survival rates were observed in countries with more rather than less developed health services. Inter- and intra-country variations in survival imply that the levels of development of health services and their efficiency to provide early diagnosis, treatment and clinical follow-up care have a profound impact on survival from cancer. These are reliable baseline summary estimates to evaluate improvements in cancer control and emphasise the need for urgent investment to improve awareness, population-based cancer registration, early detection programmes, health-services infrastructure, and human resources in these countries in the future.