Breaking the Cycle: Early Maternal Deaths Due to Cancer Impacting Nations Education and Economic Stability

Every hour, 120 children lose their mothers to cancer; that is over one million children each year(A). This heartbreaking statistic underscores a crisis that extends far beyond individual families, deeply affecting education and economic stability within communities, especially the most vulnerable ones.

A Global Crisis: Unveiling the Hidden Impact

Cancer is the second most common cause of death worldwide, resulting in nearly 10 million deaths globally in 2020 (0) . Children in lower-income countries are at a higher risk of becoming maternal orphans due to cancer compared to those in high-income countries, exacerbating existing inequities. The leading culprits are breast and cervical cancer, both of which have the potential for low mortality rates with proper prevention and treatment.

Preventing Cervical Cancer: A Crucial Effort

Cervical cancer ranked as the fourth most prevalent cancer in women worldwide(B), accounting for approximately 604,127 new cases in 2020, and the age-standardized incidence rates were highest in eastern Africa, followed by Southern Africa and Middle Africa respectively (C). Low- and middle-income countries (LMICs) represented about 90% of the 342,000 deaths from cervical cancer in the same year. (C, D). This is particularly tragic because cervical cancer is largely preventable and treatable if detected early and managed effectively. (E)

HPV, responsible for approximately 99.7% of cervical cancer cases [BF1]?(F), can be detected through effective screening programs. Quick and accurate Cervical Cancer Screening (CCS) programs are critical so that every woman with cervical disease gets the treatment she needs and avoidable deaths are prevented (G). In Rwanda, for example, Elekta Foundation partnered with the government to screen over 28,000 women. Those who tested positive for HPV or early-stage cancer received prompt treatment, significantly improving their prognosis. This approach demonstrates that comprehensive screening and treatment programs can prevent many cases of cervical cancer and save lives. [read more here ]

Despite the effectiveness of these programs, screening coverage in LMICs averages only 19%, compared to 63% in high-income countries (H). A wide range of barriers, such as lack of knowledge and awareness of cervical cancer, cultural/traditional and religious factors, and health system barriers to screening, were identified across most LMICs(I). Awareness campaigns must address these barriers to ensure broader implementation of screening programs.

Ripple Effects: The Impact on Children and Families

The loss of a mother has profound implications for children, affecting their health, education, and overall well-being. Many children who lose their mothers are raised in mono-parental families, often ending up in orphanages or with relatives who may not be equipped to provide the necessary care and emotional support. This disruption can long-term affect a child's emotional and psychological development. The love and care of a mother in the early years are crucial for a child's sense of security and overall growth.

According to anthroposophical medicine, the first few years of a child's life are vital in forming their worldview. Children form their foundational concepts about safety and trust during the early years (0-3). From ages three to seven, they create mental images of whether the world is a good and safe place. ?Losing a mother during this critical period can lead to a negative perception of the world, impacting their future success and happiness. Furthermore, these children often face interrupted formal education.

Educational challenges

Motherless children face numerous educational challenges. Without a stable home environment and parental support, these children are less likely to remain in school. They often have to take on adult responsibilities prematurely, as they may need to start working early to support their families, further limiting their educational opportunities and prospects. This educational disruption contributes to the cycle of poverty and affects the broader economic health of their communities.

Beyond the Family: Economic and Social Repercussions

The economic ramifications of early maternal deaths are extensive. When children lose their mothers, they are less likely to receive a proper education, which directly impacts their ability to contribute meaningfully to the economy. This lack of education limits their future opportunities and perpetuates the cycle of poverty, further straining the community's economic stability (J).

Without educated children, their potential to contribute significantly to the economy diminishes drastically. The absence of a mother initiates a cascade of adverse effects, highlighting the critical need for intervention and support. Moreover, the lack of a stable family structure can lead to increased social challenges, including higher risks of violence and abuse.

Raising Awareness Through Marketing Strategy

Marketing strategies are pivotal in raising awareness about the critical issue of early maternal death and its impact on education and economic stability. The first step is to implement programs that inform women about cancers, such as breast and cervical cancer, and emphasize the importance of early detection.

Effective campaigns can educate the public on maternal health, the availability of screening programs, and the necessity of early detection. These campaigns must break cultural barriers and encourage women to seek regular screenings. However, it's important to note that raising awareness is not enough, and actual screening programs should also be implemented and made available. Awareness must be paired with accessible, actionable steps for women to protect their health.

The point is it's a combination of efforts. Awareness alone won't solve the problem unless there are actionable steps that women can take.

Collaborative Efforts

Partnerships with non-profits and governmental organizations can enhance the reach and impact of these awareness campaigns. For instance, working with local health departments can ensure educational materials reach underserved communities. Moreover, leveraging social media and other digital platforms can amplify the message and engage a broader audience.

A Call to Action

There is an urgent need to reduce preventable premature women deaths from cancer and address the needs of the affected generation of children. On 17 November 2020, the World Health Organization (WHO) formally launched the Global Strategy to Accelerate the Elimination of Cervical Cancer. The World Health Organization’s Global Breast Cancer Initiative and Cervical Cancer Elimination Initiative aim to prevent millions of cancer deaths and mitigate the intergenerational consequences of these deaths.

Corporate social responsibility (CSR) initiatives can be aligned with these efforts to reduce early maternal death and support affected families. Cancer care companies can sponsor screening programs, fund educational initiatives, and participate in healthcare infrastructure improvements. Elekta, through its foundation, has demonstrated the impact of CSR by supporting screening programs and training healthcare professionals, notably in Rwanda. Other healthcare companies can collaborate to similar initiatives or form alliances to support government programs for early cancer detection and treatment.

● An example of a similar initiative in Latin America is ECHO ELA. This project, developed by the University of Texas MD Anderson Cancer Center, the US National Cancer Institute (NCI), and the Pan American Health Organization (PAHO), aims to eliminate cervical cancer in Latin America. ECHO ELA helps countries achieve the World Health Organization's goals of 90% HPV vaccination coverage, 70% cervical cancer screening, and 90% treatment rates. The project includes monthly Spanish telementoring conferences to support these efforts(K).

●????? In Assam,? India? The DESH (Detect Early Save Her, Him) initiative is a community-based cancer screening program that focuses on breast, oral, and cervical cancers.

A United Effort for a Future Without Maternal Deaths

It's time for all stakeholders—governments, healthcare providers, corporations, and communities—to unite to break the cycle of early maternal death. By prioritizing screening and early detection programs, we can prevent many cases of cervical cancer and improve outcomes for women and mothers. This will not only save lives but also ensure children grow up in stable, loving environments, receive proper education, and contribute positively to their communities.

Together, we can create a future where no child faces the loss of a mother due to preventable cancer and where every woman has access to the care she needs for a long, healthy life. Let's take tangible steps toward making this vision a reality.

Fabiana Bernabe

****************REFERENCES**************************

(A)?? WHO. Maternal orphans due to cancer: the intergenerational impact of cancer deaths in women retrieved from https://www.iarc.who.int/wp-content/uploads/2024/03/pr347_E.pdf

(B)?? WHO. Cervical cancer [cited 29 July 2023]. Available from: https://www.who.int/health-topics/cervical-cancer#tab=tab_1 .

(C)?? Singh D, Vignat J, Lorenzoni V, Eslahi M, Ginsburg O, Lauby-Secretan B, et al. Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the WHO Global Cervical Cancer Elimination Initiative. Lancet Glob Health. 2023;11(2):e197–e206. pmid:36528031.

(D)?? Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2021;71(3):209–49.

(E)?? WHO. Cervical Cancer Elimination Initiative. [cited 29 July 2023]. Available from: https://www.who.int/initiatives/cervical-cancer-elimination-initiative#cms ].

(F)??? Walboomers JM, Jacobs MV, Manos MM, Bosch FX, Kummer JA, Shah KV, Snijders PJ, Peto J, Meijer CJ, Munoz N. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 1999; 189: 12–19. [PubMed] [Google Scholar]

(G)?? WHO. New recommendations for screening and treatment to prevent cervical cancer. [cited 29 July 2023]. Available from: https://www.who.int/news/item/06-07-2021-new-recommendations-for-screening-and-treatment-to-prevent-cervical-cancer .

(H)?? Gakidou E, Nordhagen S, Obermeyer Z. Coverage of cervical cancer screening in 57 countries: low average levels and large inequalities. PLoS medicine. 2008;5(6):e132. Pmid:18563963

(I)???? Petersen Z, Jaca A, Ginindza T, Maseko G, Takatshana S, Ndlovu P, et al. Barriers to uptake of cervical cancer screening services in low-and-middle-income countries: a systematic review. BMC Womens Health. 2022;22(1):1–20, 486.

(J)??? Results for Development Organization (r4d). Exclusion-from-Education-Final-Report - the economic cost of out of school children retrieved from https://r4d.org/wp-content/uploads/Exclusion-from-Education-Final-Report.pdf

(K)?? Elimination of cervical cancer in Latin America (Project ECHO-ELA): lessons from phase one of implementation - PMC ( nih.gov ) ]

****************FURTHER READINGS*****************

●????? Maternal orphans due to cancer: the intergenerational impact of cancer deaths in women (IARC Evidence Summary Brief No. 5)

●????? Integration of cervical cancer screening into healthcare facilities in low- and middle-income countries: A scoping review | PLOS Global Public Health