The International Agency for Research on Cancer announces the launch of the World Cancer Report 2008 . This report provides a comprehensive overview of cancer for all those working in the field of health care and research and the general reader as well. It presents information on cancer patterns, diagnosis, causes and prevention concisely, clearly outlining the growing public health crisis.
The global burden of cancer doubled during the last 30 years of the last century. In 2008, it is estimated that there were over 12 million new cases of cancer diagnosed, 7 million deaths from cancer and 25 million persons alive with cancer within five years of diagnosis. The continued growth and ageing of the worlds population has immediate consequences on the cancer burden. By 2030, it is estimated that there will be over 26 million incident cases of cancer annually.
The burden on society caused by cancer is immense in terms of the human suffering of patients and the impact on relatives, friends and care-givers. The strain cancer produces on health professionals and health systems is substantial and growing rapidly notes Dr Peter Boyle, Director of the International Agency for Research on Cancer, one of the Editors of the Report. The greatest impact of this increase in the global cancer burden will fall on the low- and medium-resource countries. Many of these countries have a very limited health budget and suffer from a high burden of Communicable Diseases. Cancer treatment facilities are out of reach for large sectors of the population and life-saving therapies are seldom available.
The Report highlights the growing global cancer crisis and the contrast between the high-resource and low-resource countries. While cancer deaths rates are falling in the European Union and the United States and other high-resource countries, the great disparities which exist between groups at different levels of deprivation and access to care are masked. In low-resource settings, the great majority of cancers present at a stage when palliation is the only therapy which can be offered.
There are thirty low-resource countries without a single radiotherapy machine. The basis of any semblance of a Cancer Control programme is entirely lacking in the absence of the very basic means to treat cancer. In addition, there are approximately the same number of countries in Africa where opioid drugs (such as morphine) for severe pain control are unavailable. Every terminal cancer patient has the basic human right to all aspects of supportive and palliative care and the absolute right to die a pain-free death with dignity notes Dr Boyle.
The rapid increase in the cancer burden represents a crisis for public health and health systems worldwide. A major issue for many countries, even among high-resource countries, will be how to find sufficient resources to treat all cancer patients effectively and provide palliative, supportive and terminal care for the large numbers of cancers which will be diagnosed in the coming years.
However, the World Cancer Report 2008 provides a clear message of hope: although cancer is a great and growing devastating disease, it is largely preventable and possibilities for prevention exist at present in all resource settings. Understanding of cancer is increasing and new approaches to therapy are being introduced.
Tobacco smoking is the best understood, major human carcinogen and the worst of the tobacco epidemic in low-resource countries has yet to materialise. Tobacco control is a major task for countries, irrespective of their resource setting, and a number of measures have been shown to effectively reduce tobacco consumption, in particular taxation and smoking bans.
In low-resource countries, many common cancers such as primary liver cancer, cervix cancer, nasopharynx cancer, Kaposis Sarcoma and stomach cancer are caused by chronic infections with different agents. In these circumstances, there are now prospects for prevention via vaccination for Hepatitis B (liver cancer) and Human Papillomavirus (cervix cancer), and treatment for Helicobacter pylori (stomach cancer). The major issue in the poorest countries is delivery of the prevention action at a price that is affordable for the countries health systems.
Identification of risk factors and mechanisms for cancer causation is not a simple task and delivering effective prevention can be even more difficult. Prevention research needs to take on a higher profile and importance in cancer research strategies and in those National Cancer Plans currently being developed observes Dr Boyle. An additional advantage of prevention is that many key risk factors for cancer are shared with other common conditions such as vascular disease and diabetes and effective prevention will impact on these common diseases.
In conclusion, the World Cancer Report 2008 highlights the growing global cancer crisis, emphasises the need for a coordinated international approach and provides the scientific basis for what should be undertaken and what could be achieved.