Cancer prevention
February 3, 2014DW: There have been an estimated 14 million new cases of cancer per year. That figure is expected to rise to 22 million annually within the next two decades. Weren't we getting better at treatment and survival rates?
Christopher Wild: I think both aspects are correct, in fact we are getting better at treatment, particularly for some cancers. What we're seeing here is the result of population growth and aging, particularly in the low and middle income countries. As cancer is an age-related disease, and the populations are changing, the number of cancers is increasing globally, but particularly in those low and middle income countries.
You're citing African, Asian, Central and South American countries where up to 70 percent of the world's cancer deaths are accounted for.
Yes. Those regions also have very high numbers of people, they're the most populous regions, but it's a combination of changing demographics and the aging process. But those are also the same countries where survival, if you develop a cancer, is much poorer: The access to cancer services is not as good as in high income countries.
That would be treatment plus after-surgery care - but what about effective prevention strategies?
This is our major conclusion from the World Cancer Report 2014: World Cancer Report 2014 we need to complement the efforts that have been made to improve treatment with more focus on prevention. We've learned a lot about the causes of cancer, and also how to detect it early, but we don't always see that information being translated into effective cancer control policies at a national level.
Do enough people understand that certain cancers can be prevented?
It's a very interesting question. I've been working in the cancer field for 30 years now, and when I tell my neighbors and friends what I do, almost inevitably the next question is, have we found a cure yet? So I think there's a lack of understanding among the general public on the opportunities we have to avoid the disease, like not smoking, exercising, keeping a regular weight.
Some very effective vaccines have also been developed which can prevent liver cancer and cervical cancer, associated with certain viruses. There's a lot of information about the causes of cancer. We just need to have these understood, not only by the public but also by the policy makers and those planning cancer control at a national level.
But, to put it bluntly: is the right kind of research going into the right kind of cancer?
I think what we're lacking actually is research in some areas. For example, if we take the vaccine for the human papilloma virus, there are two problems: the first is getting the vaccine also for the countries where cervical cancer is common, that is, sub-Saharan Africa, parts of Southeast Asia, Latin America. The price is now coming down, so that's increasingly happening.
The second concern is, we need more research on how we actually integrate these preventions into health services, particularly in the developing countries. Often we have something we know in principle will reduce the risk of cancer but we need to understand how best to implement it in an operational sense in order to have the effect on the population.
The International Agency for Research on Cancer (IARC) is the specialized cancer agency of the World Health Organization. Dr. Christopher Wild has been director of the IARC since January 2009.