Saturday, November 05, 2011

Weekend Post - We’re all dying

More people are dying these days than ever before. And that’s a good thing.

There was a news story from the BBC last week entitled “Cancer cases projected to rise 45% in next two decades”. The research by Cancer Research UK projected 23 different types of cancer and concluded that the “numbers of cancers in men and women are projected to increase by 55% and 35%, respectively”. The impact on the health sector in the UK is going to be profound. The UK has rapidly increasing health care costs, just like we do, and the costs of care for cancer are amongst the highest. Such a dramatic increase in the number of cancer cases is going to have an enormous impact on everyone. While the story was specific to the United Kingdom, I don’t think there’s any reason to suspect we’re very different.

I’m prepared to stick my head above the parapet and make a dangerous prediction. More people reading this will die of cancer than did in their parent’s generation. In fact I’ll go further. I predict that a larger number of people will die in the next century than died in the last one. Many more.

The first reason for this prediction of doom is simple. More people will die because more people will be alive. Whether we like it or not, everyone who is alive will, one day, be dead and a greater number of living people means that eventually there will be a greater number of deaths. That’s just a sign of progress.

The fact that there are more living people is a direct result of many influences including better health care, lower infant mortality and better education. Despite what certain “alternative” health product manufacturers with a vested interest in selling their bogus products will tell you, our diet these days is much better than it was in our grandparent’s time. Our food is more hygienically produced, more nutritious and even tastes better than it did in the past. Our health care systems, while still imperfect, are an immense improvement over what existed in the past. While “traditional” knowledge systems had something to offer us, the truth is that they are nothing compared with what a pharmacy can give you today. Better transportation means that doctors and nurses are more available to us than ever before, even in a country as large as ours and with a population as small and as widely distributed.

In Botswana even with the extra burden of HIV/AIDS our life expectancy is improving. Our nation’s life expectancy at birth, even including our brothers and sisters with HIV, is now double what it was a few years ago thanks to anti-retroviral drugs and PMTCT. Our population now apparently exceeds 2 million, up by almost a quarter in a decade.

So because of all these dramatic improvement more people are alive and as a result more will die.

The second reason for growing levels of cancer is due to that longer lifespan. As a result of living longer and of all this progress we’re now dying of different diseases and conditions that afflicted us in the past. We’ve completely eradicated diseases like smallpox and can prevent many other diseases like polio and influenza and consequently most of us are living through our youth and middle age into our elderly years when we’re susceptible to an entirely different set of diseases. Most of us are now dying of diseases of the elderly, not of the young.

Cancer is a good example. The vast majority of cancer victims develop cancer in their 50s or later. If people don’t survive until their 50s they’re not going to get cancer at all. All you have to do is increase life expectancy from 50 to 60 and you’ll see a massive increase in cancer rates. It’s the downside of living longer but you have to ask yourself something. Knowing that you’re certainly going to die one day, would you rather do it tomorrow or in 10 years? Or in 20 or 30 years time? The effect of scientific and medical progress is that you and I will hopefully live long enough to die of something our great grandparents had never even heard of. What better example can there be of progress?


The original BBC story can be seen here and the Cancer Research UK paper in the British Journal of Cancer it's based on is here. Cancer Research UK also provide historical data on levels of cancer over time and by age here.

Loads of fascinating data on life expectancy in Botswana can be seen here.

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