Africaʹs growing cancer burden: Environmental and occupational contributions

Background: Primary prevention measures are needed for Africaʹs cancer burden (715,000 new cases and 542,000 deaths in 2008), a burden projected to double by 2030 due to demographic changes alone. Control of cancer-causing infections and lifestyle-related carcinogens will play a significant role in prevention, but less often addressed are environmental and occupational contributions. Methods: We review environmental issues that contribute to Africaʹs Cancer burden. Results: We demonstrate evidence of the impact of environmental carcinogens on the cancer burden as of now and that circumstances present today may increase their contribution further. Suboptimal implementation and monitoring of environmental protection and of occupational health standards, including in the informal sector, use of outdated technologies in industry and lack of awareness of potential hazards in the specific employment structure give rise to high levels of exposures. Carcinogens of concern include (i) those that have been long present (e.g. indoor air pollution) whose contribution may increase as life-expectancy increases and long latency periods for cancer are realised, (ii) exposures in mining and agricultural sectors and (iii) modern environmental hazards, including urban air pollution and agents arising from the mis-management of hazardous waste from local, industrial and trans-boundary sources. Conclusions: Actions taken to reduce exposures and research to fill gaps in knowledge, adapted to local settings, could help mitigate the cancer burden.