Prevention of Cancer and Non-Communicable Diseases

Abstract

Cancer is a leading cause of death worldwide, accounting for approximately 7.6 million deaths (13% of alldeaths) in 2008. Cancer mortality is projected to increase to 11 million deaths in 2030, with the majority occurringin regions of the world with the least capacity to respond. However, cancer is not only a personal, societal andeconomic burden but also a potential societal opportunity in the context of functional life – the years gainedthrough effective prevention and treatment, and strategies to enhance survivorship. The United Nations GeneralAssembly Special Session in 2011 has served to focus attention on key aspects of cancer prevention and control.Firstly, cancer is largely preventable, by feasible means. Secondly, cancer is one of a number of chronic, noncommunicablediseases that share common risk factors whose prevention and control would benefit a majorityof the world’s population. Thirdly, a proportion of cancers can be attributed to infectious, communicable causalfactors (e.g., HPV, HBV, H.pylori, parasites, flukes) and that strategies to control the burden of infectious diseaseshave relevance to the control of cancer. Fourthly, that the natural history of non-communicable diseases, includingcancer, from primary prevention through diagnosis, treatment and care, is underwritten by the impact of social,economic and environmental determinants of health (e.g., poverty, illiteracy, gender inequality, social isolation,stigma, socio-economic status). Session 1 of the 4th International Cancer Control Congress (ICCC-4) focusedon the social, economic and environmental, as well as biological and behavioural, modifiers of the risk of cancerthrough one plenary presentation and four interactive workshop discussions. The workshop sessions concerned 1)the Global Adult Tobacco Survey and social determinants of tobacco use in high burden low- and middle-incomecountries; 2) the role of diet, including alcohol, and physical activity in modifying the risk of cancer and othernon-communicable diseases; 3) the role of infections in modifying the risk of cancer; and 4) the public policiesand actions that can be implemented to effectively reduce the risk of cancer at population levels. Workshopdiscussions highlighted the need for high quality data on the prevalence of modifiable factors in different settings,as well as the social, economic and environmental drivers of these factors, in order to inform prevention andcontrol programs. For some factors, further work needs to be done to develop simple and valid measurementtools. Given that many of these factors are common to both cancer and other non-communicable diseases, cancerprevention should be viewed within the broader perspective of the prevention of non-communicable diseases andshould engage all relevant actors, including the general public, health and other professionals, workplaces andinstitutions, the media, civil society, schools, governments, industry, and multinational bodies. Many policies andplans have been implemented in various settings to control the drivers of modifiable factors and promote healthand well-being. Mapping, analysis, and contextualization of those policies that are relevant would be helpful topromote action around cancer prevention in different settings.