Cancer is the number two killer disease after cardiovascular disease, worldwide. Approximately 20 million people have cancer in Japan, Europe and N. America and 10 million new cases of cancer are diagnosed each year worldwide. According to the American Cancer Society, the second-leading cause of death by disease in the US cancer imposes a heavy economic burden on the country¹s healthcare system. In 1999, the estimated total cost of cancer was $107 billion, including approximately $37 billion in direct healthcare spending.
A significant portion of these expenditures was associated with cancer screening and diagnostics, which rely heavily on imaging systems and lab tests to determine the presence and extent of malignancy and to map optimal treatment protocols. More than 160 million cancer screening and diagnostic oncology procedures were performed in the U.S. in 1999, generating more than $1.6 billion in product sales.
There are general patterns of cancer prevalence and mortality throughout the world. The economically developing countries of Africa, Latin America and Asia tend to have high rates of cancers of the mouth and pharynx, larynx and esophagus, and of the stomach, liver, and cervix. The economically developed countries of Europe, North America and Japan tend to have relatively high rates of cancers of the colon and rectum, and of the hormone-related cancers of the female breast, the endometrium and the prostate. This pattern has now also emerged in urban areas of developing countries. Lung cancer, mainly caused by use of tobacco, is the most common cancer in the world.
With the anticipated growth in cancer cases as populations age, the discovery of more effective cancer therapeutics has become critical. It is becoming too expensive to continue prescribing drugs that are largely ineffective.
Cancer drug research is moving from traditional cytotoxic chemotherapies toward higher specificity immunological and biological approaches that target unique biochemical receptors and signaling pathways. These new drugs will be more cancer- and patient-specific and will have the potential for slowing cancer growth and inhibiting disease progression, with fewer adverse effects on the patient. As these drugs come to market, in vitro diagnostics will become critical to matching drug to cancer and to patient and then the monitoring of the drug's action on the disease.
This report is written from the point of view of diagnostic modalities for the early detection of cancer and in particular solid tumors. The technology to detect cancer of the blood - lymphomas and leukemias - is mature and well established. The emphasis is on in vitro diagnostic tests, primarily because this is where the major market opportunities lie.
Despite serious research efforts in the diagnosis and treatment of cancer, it remains a leading cause of morbidity and mortality, worldwide. There is therefore a concerted effort to commercialize lab tests that will help physicians diagnose and monitor cancer patients. Our research indicates that in the next few years some 50 immunoassays for new tumor markers, 20 or so biochip systems, 25 tests for genes and proteins in peripheral blood are near market. Not to be left behind, at least 25 new immunohistochemical and in situ hybridization assays will be introduced in the near future. There are even several point-of-care DNA analysis systems in development. Further, just about every major cancer treatment center and research group is working on gene and protein patterns for the early detection of cancer.
The report presents world cancer demographics and a brief discussion of the testing modalities most commonly used for the major cancer types. Market analysis, worldwide, is provided for the main in vitro and in vivo tests used.