TOKYO -- As Asians become wealthier, lead more sedentary lives and adopt unhealthier habits, there are predictions that cancer cases will keep rising. How well are the region's medical facilities equipped to face and treat such a cancer tide?
Australia, South Korea and Malaysia are most prepared to meet the burden of more cancer cases, according to a newly released index developed by the Economist Intelligence Unit. Most other countries, including the Philippines and Vietnam, are ill-prepared to face such a challenge.
The coronavirus pandemic has compounded the problem of cancer in the region as patients refrained from visiting hospitals for fear of catching COVID-19. Hospitals were also busy dealing with coronavirus patients, leaving those that need other forms of medical care on the back burner.
In the Philippines, for instance, cancer patients who were no longer able to attend advanced medical facilities were simply discharged into the wider community without any continuity of care, said Jesse Quigley Jones, managing editor at The EIU.
The EIU warns of a possible "mini-tsunami of cancer cases" once patients returned to hospitals for treatment and checkups.
The index measured the preparedness of 10 Asia-Pacific countries using 45 indicators and created a score card for each country, with 100 being most prepared.
Cancers are caused by damage to genes and such genetic errors tend to increase with age, obesity and bad habits, such as smoking, alcohol consumption and a lack of exercise.
Cancer has often been referred to as a disease of rich countries. Yet, half of cancer patients live in Asia. By 2030, cancer cases are expected to rise by 35% in the region, even as its population is expected to grow just 9%, according to the EIU.
In the EIU survey, Australia led the ranking with a score of 92.4, followed by South Korea with 83.4, and Malaysia with 80.3.
These countries tend to be aggressive in gathering information about individual cases at a national level so policymakers can understand the scale of the problem and design effective responses.
The three countries also have rigorous vaccination programs, including for hepatitis B which is linked to liver cancer, and HPV which can cause cervical cancer.
The numbers do not mean that Australia and South Korea have the lowest numbers of cancer patients or deaths, but they reflect the fact that these countries have managed to keep the mortality rate down. This indicates that they are either detecting cancers at an early stage and/or are able to treat their patients effectively. Cancers that are more advanced are difficult to cure.
Countries that rank at the bottom, such as the Philippines, Vietnam and Indonesia, are all rapidly growing economies whose populations have developed bad habits such as smoking. For example, nearly 40% of Indonesians aged 15 and older smoke.
Obesity among children in China and Thailand could also become future health issues, the EIU said. But medical services are harder to access in these countries, resulting in high mortality rates.
Governments could support low-income groups by subsidizing health care costs, and the EIU said that patients should not have to pay more than 20% of their medical bills.
But 62.4% of medical expenses are still paid by patients in India, 53% in the Philippines, 45.3% in Vietnam and 36.1% in China.
Government health care expenditure is also low in these countries, at just 3.4% of total expenditure in India, 7.1% in the Philippines, 9.1% in China and 9.5% in Vietnam.
Japan tops the table in terms of health service affordability, accessibility to cancer treatments such as radiotherapy and cancer research. With cancer being the leading cause of death since 1981, the country has been tackling the issue for a longer time than other countries.
But Japan performed poorly in data collection, an issue that also became clear during the coronavirus crisis, when the government was unable to gain a full picture of the spread of the disease because it lacked a system that can register such information. Privacy protection was often cited as a reason by the government, but experts also point to a lack of IT investment by hospitals.
The EIU also noted "a concerning prevalence of modifiable risk factors such as smoking and alcohol consumption in Japan," and urged the government to promote healthier lifestyles.
The country is also slow to introduce vaccination programs for sexually transmitted diseases such as hepatitis B and HPV. The government considers such diseases to only affect small groups of people. Reports of side effects from the HPV vaccine in 2013 led the government to stop recommending the vaccination.
Despite the advanced medical infrastructure in the country, Japanese cancer patients also face higher mortality rates than those in Australia or in South Korea, according to the EIU.