Cancer: the world’s biggest killer

Being obese increases your risk of a number of common cancers. CGP Grey/Flickr

The World Cancer Report 2014, the first global snapshot of cancer since 2008, shows the disease is now the world’s biggest killer. In 2012, there were 8.2 million cancer deaths and 14.1 million new cancer cases worldwide. Worse, those numbers are predicted to rise to 13 million deaths and 22 million cases per year by 2025. There is real reason for concern.

The report, released today, was produced by more than 250 experts from around the world and was edited and led by Australia’s own Professor Bernard Stewart from University of NSW, along with International Agency for Research on Cancer Director Dr Chris Wild.

Nothing can be discussed in health these days without considering cost. Those numbers are pretty frightening too. The report estimates that the cost of dealing with cancer around the world is in the vicinity of $US1.16 trillion. They suggest that equates to 2% of total global gross domestic product.

The numbers are mind-boggling. But what does it mean? What is the story in Australia and what do we do about it?

Well, it means cancer, along with cardiovascular disease, remains one of the biggest health challenges we face. Australia has the third-highest cancer rate in the world, behind Denmark and France.

Perversely, on a population level, a high rate of cancer could be considered a marker of a relatively healthy population.

Australia enjoys among the greatest life expectancy in the world. The longer we live, the greater our chance of being diagnosed with a degenerative disease such as cancer. That longevity is generally considered to be linked to improved safety (fewer road deaths and deaths at work), and improved management of big killers like cardiovascular disease and infectious diseases.

And while there is always room for improvement, by any international comparison Australia enjoys a very high quality health care system. These things are all good news.

The longer we live – the greater our chance of being diagnosed with a degenerative disease like cancer. Jan Ramroth/Flickr, CC BY

The second factor in having high cancer rates is that we actively look for cancer in the form of cancer screening programs. The idea is obviously to find cancer early enough to successfully treat it. When we systematically go looking for more cancer (or most disease for that matter) we tend to find it.

So why are the number of deaths for cancer going up?

There are more people in Australia, and in the world. And there is still work to be done on the treatment front. Our treatments for breast cancer, prostate cancer and bowel cancer are getting better and more effective. We are not able to claim such success in relatively common cancers like lung cancer. And treatment is not so readily available in many countries.

But in Australia, like most developed countries, the death rate from cancer is actually coming down.

Prevention

The best cancer is the one you don’t get, so prevention remains vital.

We are making great progress on tobacco and Australia’s smoking rates are down to about 15%. But that still means there are too many million Australians smoking. So the first port of call for cancer prevention is giving up the fags.

On the tobacco front, Australia’s success should be shared internationally where we have some responsibility to pass our experience to nations where smoking rates remain high or are even increasing. Government action such as increasing tax on tobacco, plain packaging and supporting hard-hitting social marketing campaigns are the key.

Sun exposure and obesity increase the risk of cancer. Kyle May/Flikr, CC BY

For non-smokers, the most important way to reduce cancer risk is achieving or retaining a healthy weight – through healthy diet and being physically active. Healthy food and lots of movement are both thought to help reduce cancer risk, although the detail on diet remains challenging. But there is no doubt being obese increases your risk of developing a number of common cancers.

We also need government action to make healthier choices easier choices. Reducing the out-of-control marketing of unhealthy food, particularly that aimed at kids, might be a useful step.

Being SunSmart and cutting down on the booze are other well-established cancer prevention strategies.

International snapshot

No-one should look at the World Cancer Report 2014 just through Australian eyes.

It is no surprise that there is an enormous gap between the haves and the have-nots. Less than 5% of the populations of Africa, Asia and Latin America are covered by formal cancer registries. So the data drawn upon for reports of this kind are sketchy for a big proportion of the world.

The data available suggests that while these folk report 60% of the world’s cancer cases, they account for 70% of the world’s cancer deaths.

It also shows that more than half the children diagnosed with cancer in Africa and Asia die as a result of the disease compared with less than 20% in the developed world.

We have a lot of knowledge and capacity to share. World Cancer Day is an initiative of the Union for International Cancer Control (UICC) made up of around 800 member cancer organisations from around the world. They rightly focus their efforts on a Robin Hood approach of taking (technologies and solutions) from the rich and trying to give (facilitate, communicate, support) to the poorer resourced parts of the world.

As Dr Margaret Chan wrote in the foreword of the WCR14:

Many developing countries find themselves in the grip of cancers from two vastly different worlds. Those associated with the world of poverty, including infection–related cancers, are still common, while those associated with the world of plenty are increasingly prevalent, owing to the adoption of industrialised lifestyles, with increasing use of tobacco, consumption of alcohol and highly processed foods, and lack of physical activity.

A report which aims to sum up the new information on cancer around the world over the past five years is going to have an enormous amount of vitally important material to battle cancer over the next five years. All involved should be proud of their effort. So now onto action!

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