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World Cancer Day - 4th February 2013

by Michael Evans 04 Feb 2013
World Cancer Day - 4th February 2013

World Cancer Day; Credit: © Shutterstock

World Cancer Day is led by the Union for International Cancer Control (UICC) based in Geneva. This is a membership organisation that has been a major force in global cancer control since 1933 and now includes 760 organisations from 155 countries.

Figures published by World Cancer Research UK estimates the global number of cancer cases each year to be around 12.7 million, but by 2030 this is expected to rise to 26 million.

The UICC prefers to consider death rates rather than actual cases and estimates that cancer will kill some 8 million people during the current year, with the annual global death toll reaching 13.2 million by 2030.

Whichever way these figures are looked at, that is an awful lot of people, but one thing that is quite clear is that these days cancer is not necessarily fatal.

Lifestyle can have an important influence on cancer risk. Scientists estimate that in the UK, for instance, a third of the most common cancers could be prevented by an appropriate diet, plus more physical exercise and careful attention to weight.

In other words, it is possible to stop many cancers before they have a chance to start.

Although there have been significant and dramatic advances in the treatment of many forms of cancer, cancer remains a major worldwide heath issue and the UICC, through its membership, has published a Declaration of eleven key targets to be achieved by 2020.

This year World Cancer Day will focus on the fifth target of the Declaration: "the dispelling of damaging myths and misconceptions about cancer".

Four myths have been identified.

  1. Cancer is just a health issue;

  2. Cancer is a disease of the wealthy, elderly and developed countries;

  3. Cancer is a death sentence

  4. Cancer is my fate.

The truth of the first myth is that cancer is not just a health issue. It has far-reaching social, economic, development and human rights implications. Approximately 47% of cancer cases and 55% of cancer deaths occur in the less developed regions of the world.

Cancer is both a cause and effect of poverty. In the developing world, lack of education and indifferent healthcare can increase the risk of cancer and an early death as a result. A poverty-stricken family of a cancer sufferer can be pushed further into poverty. Not only will it seriously affect the family's ability of the to generate income, but the high cost of treatment can provide the final crippling blow.

Three-quarters of a million women die each year from just two cancers: breast cancer and cervical cancer. A large majority of these deaths occur in developing countries.

Investing in cancer prevention and early detection is extremely cost-effective. It is estimated that by 2030 the worldwide cost of cancer will reach $US 458 billion per year. Correspondingly, investing in proven strategies that address common cancer risk factors, such as tobacco use, unhealthy diet and physical activity would cost a mere $US 2 billion per year.

Targeted spending is also important. In 2007 $US 22 billion were allocated in overall development assistance for health. Non-communicable diseases, such as cancer received only 3% of the total fund although they account for 65% of global deaths On the other hand, HIV/AIDS received approximately 40% of the funding.

In answer to the second myth, cancer is certainly not limited to the wealthy, elderly and developed countries. It is a global epidemic that affects all ages and socio-economic groups and it is the developing countries that are bearing a disproportionate burden.

Cancer accounts for more deaths than HIV/AIDS, tuberculosis and malaria combined and of the 7.6 million global deaths from cancer in 2008, more than 55% occurred in the less developed regions of the world.

275,000 women die each year as a result of cervical cancer. Efficient screening procedures lead to early detection, but 85% of these women are from the developing world where screening is often non-existent. If left unchecked it is confidently predicted that the annual death toll from cervical cancer could rise to 430,000 a year, with the majority being in the developing countries.

It is also worth remembering that cancer does not just affect the elderly, particularly in the developing world. Here approximately half the cancer cases occur to individuals under the age of 65 and in many countries cancer is the leading cause of death among children aged between 5 and 14.

Much of this could be remedied if there was universal health coverage, with access to proven effective cancer treatment and services on equal terms for everyone, without the risk of financial hardship.

As for the third myth about cancer being a death sentence, many cancers that were once considered to be killers can now be cured. With few exceptions, early stage cancers are less lethal and more treatable than late stage cancers, but early detection is the key.

Cost-effective screening and early detection can significantly reduce the risk of death from cancers such as cervical cancer and breast cancer, but unfortunately these comprehensive services, with access to essential medicines, are largely restricted to wealthy countries and individuals.

This need not be the case and it is another myth is that cancer solutions are too complex and too expensive for developing countries. There are well-documented examples of low-resource settings that are providing effective cancer services that span the spectrum of cancer control and care, from prevention, through to palliation.

The fourth myth, that cancer is simply the sufferer's fate, again is untrue. With the correct strategies a third of the most common cancers can now be prevented. Prevention is the most cost-effective and sustainable way of reducing the long-term global burden of cancer.

Global, regional and national policies to promote healthy lifestyles can substantially reduce cancers. Risk factors include excessive alcohol consumption, tobacco consumption, lack of physical activity, poor diet and being over weight.

Tobacco use is linked to 71% of all lung cancer deaths and accounts for at least 22% of all cancer deaths. Based on current trends, it is estimated that tobacco use will kill a billion people during the current century.

Several of the most common cancers in developing countries such as liver, cervical and stomach cancers are associated with viruses such as hepatitis B, which can be controlled by safe, effective and affordable vaccines.

In developing countries it is lack of information and awareness about cancer that creates a critical obstacle to the control of the disease and the care of sufferers. This makes it particularly difficult to detect cancers at earlier and more treatable stages.

The final message is from Marilyn Gentry, President of the World Cancer Research Fund Global Network. She points out that her organisation is calling on world leaders to urgently implement the commitments in the UN Political Declaration on the prevention and control of non-communicable diseases, including cancer and to tackle the challenges of these diseases around the world.

"World Cancer Day," she says, "is the ideal opportunity to banish the myths and get the facts about cancer so we, and those we love, have the best chance of stopping cancer before it starts."

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