Media Centre – IARC News

 Illustrating the nutritional transition in Africa, Dr Pedro Pisa, a post-doctoral student at Dietary Exposure Assessment Group, IARC, responds to a number of questions on his work on the evolution of nutrition patterns in sub-Saharan Africa.

Dr Pisa, who are you?

I am Dr Pedro Pisa, currently a post-doctoral research scientist at the International Agency for Research on Cancer under a Marie Curie Research Fellowship Award. I am from Zimbabwe, which is in the southern African region.


In terms of public health, what is the situation in Africa at present?

Africa is currently undergoing a major transition in terms of health and epidemiology, driven mainly by rapid urbanization. This transition is characterized by a high prevalence of infectious diseases related to undernutrition, the emergence of noncommunicable diseases such as diabetes, and the HIV/AIDS pandemic. This shift conventionally includes changes in dietary patterns, from traditional diets rich in unrefined foods and high in fibre to more processed “western diets” high in sugars, fat, and animal-based foods.


What are the trends with respect to cancer in Africa?

Because of improvements in the control of communicable diseases over the years, life expectancy has increased slightly in several African countries, and cancer is now one of the leading causes of death in these developing countries. Cancer is expected to account for more deaths globally each year than HIV/AIDS, tuberculosis, and malaria combined. In Africa, cancer accounts for 4% of all deaths, and the incidence and mortality rates for cancer are increasing rapidly. More than half of all new cancer cases occur in developing regions. It is estimated that by 2020 there will be 15 million new cancer cases every year worldwide, and 70% of these will be in developing countries. Over the next 20 years, it is anticipated that there will be significant increases in morbidity, mortality, and economic cost due to cancer.


What challenges do researchers face when studying cancer in Africa?

The actual burden of cancer in Africa is severely underestimated. This could be due to the fact that the quality and availability of existing African cancer registries remains inadequate. Currently, out of 54 African countries only 5 cancer registries are of sufficient quality to be included in the IARC series Cancer Incidence in Five Continents. This collection of data is published every five years by the Section of Cancer Information at IARC and has become the reference source of data on the international incidence of cancer. 


What can be done to decrease the incidence of cancer in Africa?

It has been estimated that 30 to 40% of all cancers can be prevented by appropriate diets and physical activity, which are both modifiable lifestyle factors for decreasing cancer risk. In Africa, research about nutrition and physical activity as determinants for risk of cancer and other noncommunicable diseases is lacking and has several challenges. The major challenge is a lack of research infrastructure and comparable dietary and physical activity methods across countries and regions. It is important to be able to assess diets and physical activity patterns in different cultures and populations across Africa. In addition, if valid and standardized methodologies are used across Africa, we can gain a better understanding of ethnic differences in incidence of diseases, including cancer, and this could ultimately lead to harmonized policies or health prevention programmes.


What is currently being done in Africa to address this problem?

Our project (it’s called AS-PADAM for Africa’s Inventory Study on Physical activity and Dietary Assessment Methods) is aimed at assessing the situation in Africa with respect to dietary and physical activity methods as well as cancer registries. The project will carry out an inventory of existing dietary and physical activity methodologies as well as cancer registries across Africa. It will assess the availability and quality of dietary and physical activity methods and identify challenges related to this research as well as cancer registry needs. This project is housed within the Section of Nutrition and Metabolism at IARC
In line with IARC’s mission and research objectives to establish strong international collaborations with existing networks to support cancer research and prevention in Africa, the IARC-led project will be implemented with support from 3 main networks, namely (i) the African Network, which consists of 22 countries; (ii) the international institutional network, which consists of several institutions globally; and (iii) and the African Association of Cancer Registries, which consists of 60 registries within 27 countries. This inventory will thus serve as a basis for broader discussions with the existing networks and the stakeholders involved in strategic plans about how resources could be best invested to support infrastructure and cancer research in Africa. 
More pragmatically, we will then be able to identify and prioritize the methodologies and cancer registry needs to local settings to further support cancer research in Africa, drawing on the experience accumulated in Europe and elsewhere.