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Comment by twothreeone | Hacker News Reader

Figure 3 shows incident rate changes in percent by country, it seems there are stark increases in South American and African countries and mainly declining incident rates in western countries. Intuitively, I would associate increases in those regions with increased access to medical care there - so, overall a good thing?

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Yeah, that map looks a lot like developed world vs. developing world. So two major factors here almost certainly are:

1) Fewer people in developing countries are dying from other things than they were 30 years ago, for example malnutrition and maternal or infant mortality.

2) Better diagnostics and screening. Screening is a big deal, in a sufficiently immature medical system you'll have people who die of cancer that never even get diagnosed. Start doing better screening and you will find and treat these cases earlier.

The fact that one of the biggest increases was in prostate cancer supports this idea (at least to my layman's eye). Prostate cancer tends to remain benign for a long time so you won't catch it without screening.

If you look at the right-hand column you will notice, compared to the West, there's barely any cancer in Africa! (Incidence rate is very low) Of course that isn't because no one gets cancer in Africa, it's because much of the population has limited access to screening/diagnoses.

I don't think we need to leap to the conclusion that microplastics are causing cancer to skyrocket.

In the developed world it is almost all good news. Incidence rates are flat to down over the last 30 years. Death rates are flat to dramatically down due to improved treatment.

Here is a direct link https://bmjoncology.bmj.com/content/bmjonc/2/1/e000049/F3.la...

Could it because of decreased mortality from other factors like infectious disease or malnutrition, which would allow for cancer to rise to the top for cause of death?

Yeah. If more people are living long enough to have cancer, you'll see more cancer.

FWIW, age expectancy has been above 50 y/o for a while, even in developing countries.

There is also the effect of improved health systems being able to diagnose more. You’re not going to get a cancer diagnosis if you don’t have access to a hospital.

not 80% more.

When I was living in Kenya around 2013, open pit burning was the main way of dealing with trash... And included a lot of plastics, batteries, you name it.

Same in a lot of developing countries. I'm in the Philippines right now and I've seen this not only here, but in other SE Asian countries. Of course, when I do, I seek to get as far away from it as possible as quickly as possible. It doesn't seem like the local governments do anything about it even when it's reported.

When I was in Armenia last year, this was the modus operandi for removing large amounts of trash also. Just throw it on the side of the road and burn it in heaps.

that's how most of rural America still gets rid of trash.

It used to be 50 years ago. But the state where I'm from banned burning trash decades ago. I'm not saying people don't ever do it, but if you get caught you can be fined.

And is this something read somewhere, or a friend of a friend told you in NYC?

This is 100% false that most of rural America still burns trash.

I grew up on a farm, we burnt trash and stopped before I barely remember seeing any fires. Not because we are environmentalist, but because we were told to stop just like everyone else in the state.

People in rural areas here in Canada do that now in 2024.

My thinking is that they switched to a more westernized diet full of sugars, instead of their local food. But then again it could be a thousand factors together.

I think a SAD puts upward pressure on this number, and modern healthcare puts downward pressure on it.

Agreed! SAD = Standard American Diet for who doesn't know

A truer acronym has never been coined.

Dow the rabbit hole I go, is it pronounced as S.A.D or “sad”. If it’s each letter (like CIA or FBI) it’s an initialism not an acronym; the latter should be pronounced as a word.

Which befuddles my industry joke of TLA (three letter acronyms) since it is pronounced as T.L.A. Not “tella”

I spend 0 time worrying about stuff like this.

Modern healthcare is somewhat effective at detecting and treating cancer but does very little for prevention. The only really effective preventative intervention seems to be removing polyps during a colonoscopy before they have a chance to turn cancerous.

Vaccines to prevent cervical cancer?

Yes, good point. That one seems to be having a significant effect in the last few years.

https://www.gardasil9.com/

Also hepatitis B vaccinations and screening for early enough detection to treat surgically.

Intuitively I thought it was about the developing countries are getting more industrialized and polluted. But perhaps both.

You think the undeveloped world has cleaner water and food than the industrialized world?

Water, no. Food, probably. A lot of the undeveloped world eats only locally produced food, minimally processed. Highly processed foods don't necessarily make it out there.

As they start developing, they are able to import things with high levels of preservatives etc.

As someone who's traveled the undeveloped world pretty heavily, you would be surprised at how bad the "raw" food quality is; especially if poverty is very high. Undeveloped doesn't mean "without access to industrialized goods", it just means industrial infrastructure of their own is lacking.

You seem to be mixing undeveloped (Port au Prince, Khartoum, Dhaka, etc) up with "tribal". They still have access to pesticides, heavy metals, low-quality/toxic feeds, gasoline, etc; in addition to having generally very lax/non-existent regulations.

Traditional foods or methods of cooking are not necessarily healthy. If eaten in excess cassava is high glycemic index like other Western starches, and stuff like cooking in animal fats is very unhealthy.

A lot of obesity in developing economies comes from people who have experienced food scarcity overcompensating and overfeeding themselves and their children.

>A lot of obesity in developing economies comes from people who have experienced food scarcity overcompensating and overfeeding themselves and their children.

This is true and easily observable everywhere, even in advertising. I'm in the Philippines at the moment, and there's a trope in Filipino television advertising that includes the "cute, chubby/fat kid." Having a chubby kid signifies to other Filipinos that you are middle class and have enough money and resources to overfeed your child.

There's nothing necessarily unhealthy about cooking in animal fats.

In moderation, sure.

That being said, to give an example, an excess of lard is linked to increased obesity in Mexico.

They use massive amounts of pesticides and have huge pollution issues due to burning trash and trash disposal problems, including out in fields.

If you spend any time in India, for example? Holy moly.

I'd prefer preservatives over contaminants like heavy metals.

I think industrial wastes and parasites cause different kinds of diseases.

More doctors to know that people aren’t just dropping dead from mysterious reasons. And more industrialization to have more cancer. I would bet more on the former than the latter.

Even with that, cancers metabolize sugars. The more sugars you put into your body, the faster and larger cancer cells can get. Add to this that sugars are inflammatory, and this heightens cancer risks. Add to both of those factors and increase in pollution and it’s just a perfect storm.

You are probably referring to the Warburg effect. While there is a clear link between obesity and cancer, cutting sugar intake doesn't appear to be an effective cancer treatment. (It's still generally a good idea for other reasons, though.)

https://www.mskcc.org/news/no-sugar-no-cancer-look-evidence

The quality of postmortems has probably improved globally but most in those places. One could imagine a cancer death in youth being treated like any death since the family/country is unable to afford autopsies for all suspicious deaths.

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