Lifestyle changes could prevent millions of cancer deaths, says WHO

Cancer is on the rise globally but preventative measures could save millions of lives, according to the latest World Health Organization (WHO) annual cancer report, released on 4 February.

One in six people will develop cancer in their lifetime and the current annual death toll from cancer is estimated to be around 10 million. However, “at least 7 million lives could be saved over the next decade, by identifying the most appropriate science for each country situation, by basing strong cancer responses on universal health coverage, and by mobilizing different stakeholders to work together”, said Dr Tedros Adhanom Ghebreyesus, Director-General, WHO.

Cancer has long been considered the plight of wealthy countries. But the latest report is evidence that this no longer holds true. The analysis predicts a 60 per cent increase in cancer cases over the next 20 years, with the largest increases (up to 81 per cent) in low- to middle-income countries where survival rates are lowest.

The WHO points to a lack of investment in prevention and care as the main culprits. In low-income countries, stretched resources are typically spent on combatting infectious diseases and other more pressing priorities, rather than cancer diagnosis and treatment; whereas comprehensive treatment services for cancer are available in the public health system of more than 90 per cent of high-income countries, as of 2019, compared to just 15 per cent of middle- to low-income ones.

“This is a wake-up call to all of us to tackle the unacceptable inequalities between cancer services in rich and poor countries,” said the WHO’s Assistant Director-General Ren Minghui in the report. “If people have access to primary care and referral systems then cancer can be detected early, treated effectively and cured. Cancer should not be a death sentence for anyone, anywhere”. The main challenge in developing — and indeed, all countries — is balancing cost, feasibility, and effectiveness of cancer treatments.

Prevention measures, early diagnosis, and screening programmes, as well as improved treatments, have drastically reduced the number of deaths from cancers by an estimated 20 per cent between 2000 and 2015.

Nonetheless, the number of people developing cancer in Europe remains startling: In total, 4.6 million new cancer cases are diagnosed in the WHO European Region each year (up to 25 per cent of the population) and 2.1 million people die from cancer. Lung cancer accounts for 20 per cent of those deaths, followed by colorectal (12 per cent), breast (7 per cent), pancreatic (6 per cent), and stomach cancer (5.7 per cent).

It is clear that much more can still be done in terms of prevention and care. Tobacco (responsible for 25 per cent of cancer deaths worldwide) and alcohol are the two most modifiable risk factors. Other important risk factors are obesity, unhealthy diet, and lack of physical activity.

In addition, the report highlights a number of proven interventions that should be implemented worldwide including vaccinating against hepatitis B to prevent liver cancer, eliminating cervical cancer by vaccinating against HPV, improved screening and treatment for other cancers, and implementing high-impact cancer management interventions.

Speaking about the European region, Dr Hans Kluge, the WHO Regional Director for Europe said in a statement: “We know, for example, that cervical cancer kills 28 000 women in the Region annually. Today’s Global Cancer Report shows that our Region lags behind some others in cervical cancer screening – the most effective cancer screening programme we currently have. With screening and the provision of human papillomavirus (HPV) vaccine, most of these deaths are preventable.”