2.8 Million Cancer Cases Worldwide Could Be Prevented

Roxanne Nelson

September 09, 2011

September 9, 2011 — Around 2.8 million cases of cancer worldwide are preventable, and are largely linked to diet, physical activity, and weight, according to the World Cancer Research Fund (WCRF).

"The policy of simply relying on identifying and treating these cases when they occur is simply not a sustainable solution" in any country, said Martin Wiseman, FRCP, FRCPath, project director at WCRF International. "We need to focus on preventing disease in the first place, so that we have the resources to detect and treat the cases that do occur."

"That's how high the stakes are," he explained. "If we continue down the same path and do nothing more — with people being less and less physically active and relying more and more on highly processed and energy-dense foods, the problem is only going to get worse."

Coming up with new solutions is not the main problem, Dr. Wiseman emphasized. "The problem is having the world implement what we already know."

"Once-in-a-Generation" Opportunity

In 2 weeks, there will be a "once-in-a-generation" opportunity to prevent a public health disaster, the WCRF announced at a press conference this week.

On September 19 and 20, the United Nations (UN) will hold the historic Summit on Non-Communicable Diseases (NCDs), which aims to raise the profile of NCDs and mobilize the international community to take action to reduce the global burden of NCDs. The summit will focus on the 4 most prominent NCDs: cancers, cardiovascular diseases, chronic respiratory diseases, and diabetes.

"Globally, 2 of every 4 deaths are caused by NCDs," said Kate Allen, PhD, director of science and communications at WCRF International, during the press conference. "NCDs are a serious problem in all regions of the world, and affect high-, middle-, and low-income countries."

"Taken together," she continued, "these 4 diseases exact an enormous global health toll and have a similarly massive death toll. They are one of the biggest health challenges that the world faces today."

Unless something changes, Dr. Allen added, "the direction that all of these diseases is taking is up."

Dr. Allen pointed out that much is known about these 4 diseases, and they share a number of common risk factors, such as tobacco use, obesity, unhealthy diets, and physical inactivity. "This is potentially a very big opportunity, but it's only going to be an opportunity if something concrete comes out of the summit," she said.

Gathering Steam

Currently, 35 heads of state will be attending. The WCRF is calling on British prime minister David Cameron to attend the summit in person to demonstrate his commitment to tackling NCDs in the United Kingdom and the world. In addition, major cancer organizations have been stepping up the pressure to bring attention to the global cancer crisis and calling on world leaders to attend the upcoming summit.

The American Society of Clinical Oncology, the Union for International Cancer Control, and the American Cancer Society have all announced new efforts to respond to the cancer epidemic occurring in low- and middle-income countries.

The upcoming meeting is only the second UN summit of its kind to focus on a global health issue. The first high-level UN meeting was the HIV/AIDS summit in 2001, which ultimately led to the creation of the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

Prevention Is Key

The number of global cancers has increased by 20% in less than a decade. It is now estimated that there will be 12 million new cases a year, which is more than 4 times the annual 2.6 million new HIV infections. Of these cancer cases, an estimated 2.8 million are preventable, and are largely linked to diet, physical activity, and weight. That number is expected to rise dramatically over the next 10 years.

This is a "best guess, rather than an estimate," noted Dr. Wiseman, who pointed out the difficulty in estimating the overall number of cases of cancer globally and the proportion of those that are largely preventable. "The number is always going to be inexact," he said at the press conference. "But even if its not an exact number, I think we can be sure that it's in the right order of magnitude."

The 2.8 million was calculated using the findings of the preventability estimates — that about 25% of all cancer could be prevented in high-income countries and 20% in medium- and low-income countries.

But prevention is key in curtailing what UN secretary general Ban Ki-moon has referred to as a "public health emergency in slow motion."

Not Going Far Enough?

The statistics are sobering: 63% of all global deaths are due to NCDs, the majority of which are the 4 targeted disease conditions. And 80% of those deaths occur in low- and middle-income countries, said Cary Adams, chief executive officer of the Union for International Cancer Control.

The impact of NCDs goes far beyond being a health issue, he emphasized. "They have far-reaching social, economic, development, and human rights implications."

Hardest hit are the most socially vulnerable and economically disadvantaged people, and most people living in low- and middle-income countries pay for healthcare out of pocket. "Every year an estimated 100 million people are pushed into poverty because they have to pay for health services," said Mr. Adams.

NCDs are also a significant barrier to achieving the UN millennium goals in 2015, particularly the targets related to health, education, and gender equality. One half of those who die from NCDs are in their productive years, so the economic consequences and social cost in terms of productivity are considerable, he noted at the press conference.

Although the upcoming summit will bring attention to the issue of NCDs, "not everything we wanted is covered in the current draft," Mr. Adams pointed out. "The document lacks text with specific targets, including no overall goal for reducing preventable deaths. Our generation is sending a message to future generations that we don't have a goal to help them."

"It would be good to see governments commit to reducing preventable deaths by 25% by 2025," he said. "This is a target that [the World Health Organization] believes can be achieved."

The current language on additional resources for NCDs is weak in some areas, with no commitments to increase the proportion of development assistance devoted to health outcomes, he added.

Mr. Adams emphasized that, despite some of the disappointments, a great deal of progress has been made. The summit, however, is only the first step. "We view the UN summit as a start point, and not an end," he said.

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