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Global cancer has risen, says WHO
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The report cites evidence that dramatically shows the global problem of cancer. In the year 2000, for example, malignant tumors were implicated in nearly 12 percent of the 56 million deaths worldwide, from all causes. In many countries, more than 25 percent of all deaths were related to cancer. Researchers expect that the predicted increase, up from 10 million new cases in 2000, will be mainly attributable to increases in the age of populations, the prevalence of smoking, and unhealthy diets. Another contributing factor is infections that lead to cancers.
Dr. Gro Harlem Brundtland, the Director-General for the WHO, stated in a WHO press release: "The report provides a basis for public health action and assists us in our goal to reduce the morbidity and mortality from cancer, and to improve the quality of life of cancer patients and their families, everywhere in the world."
The report focused on three areas where action could be taken to significantly reduce the current trends. These three areas are the prevalence of tobacco consumption, the lack of a healthy lifestyle, and the dearth of early detection programs. These areas mirror the predicted causes for the upcoming increase.
Tobacco consumption remains the most significant factor related to cancer, the researchers found. It has been estimated that in the 20th century, approximately 100 million people died worldwide as a result of tobacco-related causes.
Half of regular smokers will die from the habit, while a quarter will die prematurely. It was found that the relative risk for acquiring almost any type of cancer is increased in smokers versus nonsmokers, with the risk for cancers more directly related to the digestive process being much higher. Additionally, involuntary smoking, better known as secondhand smoking, is also carcinogenic, and can increase the risk for lung cancer by 20 percent.
While never initiating the practice of smoking is the healthiest by far, evidence has shown that great benefits still exist for those that quit. The greatest effect is seen in those who stop while they are in their early 30s, impressive risk reductions of more than 60 percent are seen even when the habit is quit when the individual is past the age of 50.
The report pointed at the unhealthiness of the "Western lifestyle,' as the next major cause for a variety of health concerns. The "Western lifestyle' was defined as a diet high in calories, fats, refined carbohydrates, and animal protein, while at the same time, low in physical activity. These factors combined to create an overall energy imbalance
Studies indicated that counteracting the "Western lifestyle' with more fruits and vegetables could significantly help to reduce the risks of certain types of cancer. Recent data suggested that a daily consumption of 500 grams of fruits and vegetables could decrease the incidence of cancers of the digestive tract by 25 percent. The report also suggested that people would also gain other benefits from the adoption of healthier lifestyles, since the incidence of other common noncommunicable diseases, such as heart disease and diabetes, share many of the same risk factors related to lifestyle.
The report also noted that infection was a significant cause of cancer, though it has been relatively overlooked in comparison with other causes. Some of the major infectious agents named were hepatitis B and C virus (liver cancer), human papillomaviruses (cervical and ano-genital cancers), and Helicobacter pylori (stomach cancer). In developing countries, the number of malignancies due to infectious agents can be as high as 23 percent, while in developed nations, only about eight percent of all malignancies are attributed to infections.
While vaccinations could be the key to preventing these types of cancers, as trials in high-incidence countries have shown, other problems exist; developing nations may not be able to pay for the vaccinations, leaving the populations who need them most without them.
The obvious discrepancy between incidence of cancer due to infection between developed nations and developing nations can be explained by the much stronger public health infrastructure present in the developed nations.
The incidence of cervical cancer is a prime example of this situation. More than 80 percent of all cervical cancer deaths occur in developing nations, where the PAP smear, an early detection system, has not been widely introduced; this test has led to an impressive reduction in mortality rates in western nations.
In fact, early detection has been cited as the major cause for much of the recent decline seen in many countries. Improvements in imaging techniques, such as mammography, functional magnetic resonance imaging (fMRI), and computed topography (CT), as well as increased levels of disease awareness and educational programs are both responsible for the observed success. Recent trials by an IARC subgroup have shown that in clinical trials, mammography screening can reduce breast cancer mortality by 25 to 30 percent, and a nationwide reduction of 20 percent would not be unthinkable. Similar findings were shown for other cancers.
In order to have the greatest impact on the current trend, the report also calls for the continued, coordinated involvement of the different levels of government with community health organizations. Examples include school-based education programs for tobacco abstinence and healthy dietary habits as an effective method for changing the behavior of the population at an early stage.
As comprehensiveness is one of WHO's major goals, WHO has been consulting with UN Member Nations, other UN agencies, and the civil and public sectors on the report, which will be presented to the World Health Assembly in May 2004.