New Cancer Report offers hope for Patients and Communities
28 June 2002 - Geneva/Oslo - Millions of lives could be saved each year if countries made use of existing knowledge and the best cost-effective methods to prevent and treat cancer.
In a landmark report launched today, the World Health Organization (WHO) presents the latest information on how countries can build and run effective programmes to fight cancer. The report launch coincides with the 18th International Union Against Cancer (UICC) International Cancer Congress in Oslo, Norway.
The report, titled National cancer control programmes: policies and managerial guidelines,
states that one third of the 10 million new cases of cancer that are diagnosed globally every year can be prevented and another third can be effectively treated, given early detection and treatment. It also points to how suffering can be greatly relieved through effective palliative care for the last third of cases.
"No matter what the resource-constraints of a country, a well-conceived, well-managed programme can improve the national situation and the lives of those living with cancer," said Dr Gro Harlem Brundtland, WHO’s Director-General. "We cannot allow ourselves to become overly reliant on treatment options at the expense of prevention efforts and palliation," she added.
In far too many cases, primary prevention, early detection and palliative care are neglected in favor of treatment-oriented approaches, regardless of whether they are actually cost-effective or whether they improve patients' quality of life. A lack of public support, cultural and religious factors, limited access to medicines, like oral morphine, compound these problems.
Every year, the world is witness to more than 6 million cancer deaths. Of the 10 million new cases each year, more than half occur in developing countries. Responsible for 12% of all deaths in the world, cancer is the second most common cause of death in industrialized countries (second only to cardiovascular disease).
Among men, lung and stomach cancer are the most common cancers worldwide, while prostate cancer is largely seen in more developed countries. For women, the most common cancers worldwide are breast and cervical cancer, although cervical cancer is primarily seen in less developed countries. Lung, colorectal and stomach cancer are among the five most common cancers for both men and women, in both industrialized and developing countries.
WHO estimates that these figures will only worsen in the next twenty years; increasing to 10 million deaths and 15 million new cases annually.
A national cancer control programme is designed to reduce the incidence and mortality of cancer as well as to improve the quality of life of patients. A good programme would assess how to best use available resources to achieve effective and equitable outcomes. This would mean finding the right balance between prevention, early detection, diagnosis, treatment and palliation.
Evidence and advances in cancer control over the last six years inform this report. New findings in screening and prevention issues are discussed—from recommendations about screening for cervical and breast cancer, to the role of diet and alcohol in causing cancer, to WHO’s first international treaty, the Framework Convention on Tobacco Control, currently being negotiated by the 191 Member States of the Organization.
Tobacco is the single largest preventable cause of cancer and action to prevent people from starting to smoke as well as helping people quit smoking go far in the fight against cancer.
On Monday, 1 July, Dr Brundtland will present the international super-prize of US$ 10 000 to the winner of the Quit and Win 2002 smoking cessation contest. Over 700 000 smokers in more than 80 countries tried to quit smoking as part of the contest, organized in partnership with WHO.
"Curbing the global tobacco epidemic is a high priority for WHO. Effective interventions are needed on global, national and local levels. Population-based smoking cessation efforts, like the Quit and Win contest, are a cost effective way to help a large number of smokers to quit. The projected increase in tobacco-related diseases in the next 30-40 years can be prevented only by intensive efforts to help current smokers stop," says Dr Brundtland.
Despite advances like these in prevention and progress in treatment, the majority of people diagnosed with cancer will, at some stage, need palliative care. Pain relief is an essential element of palliative care, Although such care is not expensive, many developing countries are not able to provide such pain relief to most patients.
A comprehensive approach to palliative care should also embrace the psychological, emotional and spiritual needs of the patient, taking into account the needs of family and caregivers as well.
The report and its guidelines are a part of WHO’s ongoing programme to translate new knowledge into action. The report provides countries with practical advice and examples for setting up cancer control systems in different resource settings. "Faced with the complex, ever-increasing burden of cancer, a comprehensive cancer control programme is the best strategy any country can adopt," says Cecilia Sepúlveda, Coordinator of the Programme on Cancer Control at WHO headquarters.
Both industrialized and developing countries currently face several obstacles in setting up the recommended cancer control systems. Only a few countries have developed nationwide, comprehensive cancer control programmes. Some countries have developed initiatives at the state or provincial level, but these efforts tend to be fragmented and lack sustainability. Others still focus only on one or two priority areas. Alarmingly, some countries report doing no work on cancer control at all at the national level.
This second edition of National cancer control programmes: policies and managerial guidelines will be posted at www.who.int/cancer. Bound copies can be ordered at email@example.com.