On the eve of World Cancer Day, Arpana Verma, Julia Mueller, Annet Nakaganda and Angela Spencer lay out the importance of promoting the prevention and early detection of cancer in policy and in practice.
- Nine out of ten cancers are due to the lifestyle choices we make
- Governments need to prioritise public health policies and responsibility deals with food businesses
- We should build on the smoking ban in public spaces with more policies to reduce the demand for tobacco products both at home and globally
- HPV vaccine should be extended to include boys and replicated for other cancers associated with infectious agents
- Public health campaigns that focus on the advances and cure rates from early detection will encourage people to self-test, attend screenings for cancer and seek medical advice for symptoms early on
All of us know of, care for someone with, or live with a diagnosis of cancer. According to research, nine out of ten cancers are due to the choices we make, from smoking to the food we eat and how much exercise we do. Therefore, in order to prevent cancer where possible, we need policies that make ‘the healthy choice the easier choice’ for all people, especially the most vulnerable
Healthy food choices at home, work and schools could be made easier through continuation of the responsibility deals with food and drink manufacturers, employers, businesses and the education sector. The introduction of a levy on sugary soft drinks is a start in the right direction. Ensuring global policies are implemented will protect the most vulnerable.
Though sugar is now ‘the new tobacco’, we must not forget tobacco. The quest for a tobacco-free future is achievable; in the 10 years since the smoking ban in enclosed public places in England, we are seeing the lowest rates of smoking and second hand smoke in recent times. But the highest growths in tobacco products are seen in the low and middle income countries; it is here we see the highest rise in non-communicable diseases like cancer. We need global policies. When simple measures such as a ban on smoking in public places can have such a marked effect, then surely it follows that, with the right policies, we could see an end to tobacco products in our lifetime. These policies need to be global and include increased tobacco taxes, educational campaigns about health risks, smoke-free policies which prohibit smoking in all public places and workplaces, and stricter bans on tobacco related advertising such as plain packaging. The impacts would be huge; in fact, Johann Machenbach argues that eliminating tobacco products would result in the biggest drop in health inequalities of any individual public health measure.
Prevention and Early Detection
Vaccines for cancers related to infections need to be prioritised for research and implementation. The global success of HPV vaccine uptake in girls for the prevention of cervical cancer needs to be extended to the vaccination of boys and replicated for other cancers associated with infectious agents such as Hepatitis B and C and Epstein-Barr viruses. We found that daughters could influence their mother’s screening behavior and reduce inequalities through our studies into HPV vaccine and cervical screening. New diagnostic and screening techniques in our fight against common cancers such as breast, bowel and lung need to be made more accessible, affordable and accurate for a global population.
Early detection is a key component for secondary and tertiary prevention of cancer. Although the UK cancer mortality and morbidity rates are better than they were, they are still behind many of our European neighbours. With cancer survivorship at an all-time high due to new advances in diagnosis and treatment, we need to have policies and public health campaigns that reflect that cancer is no longer a death sentence but like other chronic diseases. Health promotion programmes through cancer champions and survivorship that focus on the advances and cure rates from early detection need to be highlighted further, which will encourage people to no longer be afraid. Encouraging people to self-test, attend screenings for cancer and to seek medical advice for cancer-related symptoms is vital and a clear policy imperative.
For example, this Department of Health funded programme, helping volunteers in deprived communities to lead work on raising awareness and promotion of earlier presentation of cancer symptoms in partnership with primary care and other professionals, is delivering positive early results.
We know countries with organised screening programmes with call-recall systems have the best outcomes. However, within these systems, we know that certain groups have low uptakes such as those from disadvantaged communities and ethnic minorities. This needs to be done through supporting countries to introduce screening programmes and having a centralised programme to make screening tests available and linked to cancer treatment, educating populations about screening opportunities leaving no one behind, ensuring people are aware of signs and symptoms of common cancers, having a timely integrated health information system which includes registries and systematically inviting target populations to local services.
Employers are also a key audience in the prevention and early detection agenda. Policies to ensure healthy workplaces to prevent cancers associated with lifestyle choices could include workplace physical activity policies to make it easier and accessible for employees to exercise in different ways, or could highlight public health messages including early detection. There should also be an emphasis on sympathetic employment practices for carers, cancer survivors and people living with cancer. For example, having clear policies which allows employees who are affected to take time off whilst being kept informed and engaged with working life, be granted additional leave and have the option for flexible work schedules tailored to the employee’s needs and regularly assessed and adapted.
A Whole Society Challenge
Cancer Control is a “whole Society” challenge and government’s support is vital. Policy makers should take their share of the burden, by putting supportive policies in place on an individual, local and national level and, crucially, reinforcing these with the necessary resources that this area demands.
- The University of Manchester are holding an event for World Cancer Day on Friday 3rd February