Armenia’s Cancer Crisis

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Cancer has now become the second leading cause of death in Armenia, a stark reality underscored by a 2016 report indicating that the country holds the highest cancer mortality rate in the world. Despite advancements in cancer detection tools and the development of novel treatments that have improved survival odds globally, Armenia’s cancer incidence rate has nearly tripled since 1999. This alarming trend can be attributed to a combination of factors, including unhealthy lifestyle choices, the absence of standardized screening protocols, limited access to treatment, shortages of essential chemotherapy drugs, and a healthcare system that fails to meet the needs of people. 

Diet in particular, plays a role in Armenia’s cancer rates. The World Health Organization (WHO) reports that nearly half of all Armenian adults (48%) are overweight, and salt consumption is double the WHO’s recommended maximum daily intake. Moreover, over 75% of Armenians don’t consume the daily recommended amounts of fruits and vegetables, with the country ranking fifth lowest in the world for vegetable consumption. This is especially concerning given that a diet rich in vegetables is known to reduce the risk of certain cancers. According to the National Cancer Institute, individuals who maintain a plant-based diet have a lower likelihood of developing at least six types of cancer. 

Colorectal cancer in particular, is on the rise in Armenia, with higher rates observed among millennials and Generation Z compared to older generations. The staples of Armenian cuisine, such as basturma, Armenian barbecue (khorovats), minced meat, and deli meats, are contributing factors. Red meat, processed meat, smoked meat, and cured meats have all been linked to an increased risk of colorectal cancer. A 2024 study conducted by USC’s Keck School of Medicine found that individuals with the highest levels of red and processed meat consumption have a 30-40% higher risk of developing colorectal cancer. While red meat is prevalent in many cultures, its dominant role in Armenian cuisine poses a particular concern for public health specialists and medical professionals. Yet there is a lack of Armenian literature on this issue, and no prominent voices are raising awareness of the risks associated with these dietary habits.

In 2020, the Ministry of Health released statistics showing that the three most common cancers in Armenia are breast, lung and colorectal cancer. Almost all medical facilities responsible for oncological treatment are located in Yerevan, with just one facility in Gyumri and another in Vanadzor. This makes it particularly difficult for many Armenians to schedule appointments for treatment, especially considering repeated rounds of chemotherapy and radiotherapy required. Armenia’s out-of-pocket expenditure accounts for 84% of health expenditure, the highest rate in the world. 

In 2019, the government targeted this issue by making surgical treatment and radiotherapy free for all Armenian citizens with cancer, but the funds allocated were insufficient to cover all costs, leading to impractical wait times. In Soviet Armenia, citizens could get free medical treatment. However, since independence and the transition to a privatized system, this shift has left hundreds of thousands of Armenians unable to pay for general visits to their primary care family doctor, let alone chemotherapy, radiotherapy, and surgery needed for cancer treatment. 

Statistics indicate that half of all cancers in Armenia are diagnosed at a late stage, with some cancers, such as lung and gastric cancer, diagnosed in stage III or IV about 70-80% of the time. Regular cancer screening and cancer detection tools must be standardized in hospitals to identify cancer in earlier stages. This is important because early detection generally results in better prognoses, leading to lower mortality rates. Cancer screenings are a vital preventive measure to identify tumors before they become malignant. 

A 2023 study found that only 18% of Armenian females have ever had a mammogram, but the reasons for this low rate are unclear. This must be investigated to understand why the country scores so poorly in utilizing cancer detection methods.

51% of Armenian men smoke cigarettes. Many argue that education campaigns should inform the public about the link between smoking and lung cancer. However, a 2023 study found that 71% of Armenian smokers believe they will get lung cancer in their lifetime, indicating that society recognizes this connection. Of respondents, 86% also agreed that cancer screenings could detect lung cancer early, yet many have refused to get a lung scan. Of those, 53% said they don’t wish to get a lung scan because they fear being unable to pay for treatment if cancer is detected. 

While it would be simplistic to attribute this situation to a single entity, the national government has the greatest capacity to reverse lung cancer mortality on a large scale. The Armenian government must address these financial concerns by providing a safety net for those who can’t afford medical services. With 24.8% of the Armenian population living below the national poverty line, it’s unreasonable to expect a quarter of the population to cover cancer treatment costs. Middle-class individuals also worry about paying for medical treatment; the lack of universal healthcare is a widespread societal issue. 

To mitigate this, Armenia’s government could consider increasing healthcare expenditures. Enhanced funding for hospitals and clinics would improve the availability of diagnostic services, allowing more patients to be seen promptly. With cancer, time is the most crucial factor. 

The Ministry of Health has shown a troubling lack of progress in making improvements. Despite Armenia’s classification in the “high human development” category by the United Nations, the state of its healthcare system and cancer rates are alarming. Armenia has many oncologists and receives substantial financial support and expert guidance from international NGOs aiming to improve the healthcare infrastructure. Yet, new cancer cases grew 10.5% in 2022 and 3% in 2023. 

While the Armenian government has introduced a plan to tax the public to allocate 1.6 million drams to each cancer patient, this amount is insufficient for the required therapy rounds needed to treat cancer in the long term. Armenian politicians need to recognize that a temporary increase in healthcare funding is a necessary investment, not an indefinite burden. If the government increases healthcare spending and implements measures to reduce carcinogenic factors in society (e.g. smoking, obesity, diabetes, high red meat consumption, low vegetable consumption), we will see lower cancer incidence rates. This proactive approach would improve public health outcomes and result in significant long-term financial savings by reducing the overall cancer burden on the healthcare system. These savings could then be used for disease prevention or funding various healthcare subsectors, benefiting patients and future generations.

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