Introduction
In a world boasting molecular precision and cutting-edge therapies, cancer is increasingly revealed as a cruel lottery loaded with rigged dice. It’s no coincidence that in Mexico and across much of the globe, this disease disproportionately affects those with fewer resources and impoverished women who bear the invisible burden of inequality.
The Burden of Cancer
Breast cancer, cervical cancer, and uterine cancer are silent executioners that, according to the Global Burden of Disease 2023 by IHME (due to the lack of a cancer registry in Mexico), account for 35% of cancer deaths among Mexican women over 25 years old. However, there’s a sinister twist: colorectal cancer is now emerging among young adults, serving as a reminder that the scourge doesn’t respect age but only vulnerabilities. If we don’t act, this new phase of oncology won’t just be a health crisis but a social justice scandal.
Expert Insights
Rafael Lozano Ascencio, emeritus professor at the University of Washington and a UNAM titular, stressed this point during his presentation at the Mission Early Coloquio organized by All Can at UNAM: cancer is “a disease of the poor.” Not because the wealthy are immune—quite the contrary, their access to expensive treatments grants them years—but because disparities in access determine who survives and who dies silently. In Mexico, of 55,000 cancer deaths among women over 25 years old in 2023, one-third were preventable. Ideally, 85-90% of these deaths could be avoided with upstream policies—Lozano’s term for interventions targeting root causes: pollution, toxic diets, unregulated tobacco and alcohol. Let’s consider breast cancer (CAMA) and cervical cancer (CACU), the deadliest for Mexican women.
- Breast Cancer (CAMA): In 2023, there were 19,500 deaths in Mexico, with rates escalating in states where poverty is widespread. While mammography—secondary prevention with its caveat of proper interpretation—saves lives, it shifts blame to individuals: “Get regular check-ups, take care of your body.” Lozano critiques this narrative: the real front lies in reducing obesity, alcohol consumption, and unnecessary hormones by demanding food regulations and active environments.
- Cervical Cancer (CACU): It’s the only cancer today that could be eliminated through vaccination, yet in Mexico, it’s the second leading cause of cancer and death among reproductive-aged individuals: 28 diagnoses and 13 deaths daily.
The Disparity in Cancer Care
Lucely Zetina, an oncologist at the National Institute of Cancer (InCan) and founder of the Micaela Program, paints a stark picture: in a retrospective study of 4,000 cases at InCan (2003-2016), 74% of affected women were from lower socioeconomic backgrounds, 50% were rural or had no education, and 80% arrived in advanced stages. Why? Sociodemographic barriers, lack of awareness, and poor services.
- Detection Coverage: The detection coverage ranges from 70-89%, but where’s the impact on incidence? Implementation has failed.
- Discrimination by the Pharmaceutical Industry: While breast or lung cancer accumulates thousands of studies and therapies (trastuzumab, immunotherapies, etc.), CACU has only 164 global trials, with dozens in clinical phases concentrated in wealthy countries. Why invest in a poor man’s disease? Governments like ours prioritize “early detection” but skimp on universal vaccines.
As Lozano summarizes, cancer is increasingly a disease of the poor.
