The increasing global burden of cancer: implications for anaesthesia and peri-operative medicine.

INTRODUCTION

Most patients with cancer will require surgery at some point in their lifetime. As the global burden of cancer continues to increase, changes and challenges in cancer epidemiology and care are also borne peri-operatively.

METHODS

Due to its broad scope, a formal systematic electronic literature search was not performed. This narrative review examines how an increasing global burden of cancer affects anaesthesia and peri-operative medicine. We aimed to describe current cancer statistics; economic implications; the increasing survival of individuals with cancer; and the role of anaesthetists in enhancing the quality of life and survival after oncological surgery.

RESULTS

Epidemiological reports show wide variation in cancer incidence and mortality worldwide. Countries with a lower human development index will be disproportionately affected by greater increases in cancer burden. At the same time, these countries will also suffer larger deficits in the surgical and anaesthetic workforce. Cancer has significant macro- and micro-economic implications. Thus, public health and policy should address the large economic burden of cancer surgery and care. The improvement in cancer-related survival can be attributed to research focused on a deeper understanding of tumour biology; effective awareness education campaigns and screening programmes; early diagnosis; newer cancer therapies; and patient-centred precision care. Increasing survival brings new global challenges, such as delivering an adequate survivorship care plan and addressing long-term psychosocial concerns in survivors. Anaesthetists are involved in all phases of a patient's cancer journey including facilitating diagnostic procedures; providing comprehensive peri-operative care needs for ablative procedures; provision of critical care; addressing acute and chronic pain; and provision of integrative and palliative care services.

DISCUSSION

Deeper engagement of anaesthetists in cancer care programmes will be instrumental in reducing postoperative complications; improving the quality of life for patients; enhancing population health; and contributing to improved global economies.