World Cancer Report
World Cancer Report 2014
Edited by Bernard W. Stewart and Christopher P. Wild
MEET THE EDITORS
Professor Bernard W. Stewart, Faculty of Medicine, University of New South Wales, answers a few questions on the new edition of World Cancer Report.
The key highlights of this report are twofold. One is that we have a much clearer knowledge of the burden of cancer, that is the way in which different people and different communities throughout the world are affected by this disease, and that burden varies greatly depending on which community you’re in and in which part of the world you live. More importantly, or as importantly perhaps, we have a far better biological understanding of what cancer is like, especially through what has been called the genomic revolution. This is the sequencing of cancer genomes and related molecular information. And this work is telling us that cancer is much more than simply an isolated cancer cell growing in a laboratory. And that more complex understanding of what cancer is like is underpinning better ways to prevent the disease and better ways of detecting it more early, which in turn will reduce the burden of cancer worldwide.
What is new is largely the way in which we’ve put the volume together. The International Agency for Research on Cancer is uniquely placed to report on cancer in the world because of the manner in which it interacts with cancer professionals, through the IARC Monographs on carcinogenic risks, the study of Cancer Incidence in Five Continents, which looks at cancer distribution throughout the world’s population, and the WHO Classification of Tumours, sometimes called the Blue Books. These methodologies put IARC in touch with a whole network of scientists who by dint of their contact with the Agency are accustomed to working together to present consensus, and in that way we’ve been able to mobilize literally the opinion of hundreds of investigators, specifically including colleagues at WHO, who are involved in cancer control, and this is providing what I think is a unique World Cancer Report. What is also new in this is that we’re not only looking back but we’re looking forward; we have outstanding contributions from individuals of the highest international standing not telling us what happened, but telling us what’s going to happen in the future, and this will give us a unique perspective on how the disease might be controlled in the future and how the burden of this disease might be reduced.
Well, it tells us that cancer is a major killer of humankind worldwide. The situation, as you might expect, is that, by and large, cancer control, the prevention of cancer and the early detection of cancer and, for that matter, the treatment of cancer is best managed in high-income countries. But we now have sufficient knowledge that focused effort by low- and middle-income countries can achieve significant reductions in the cancer burden if certain fundamentals are put in place. And one of the strengths of this edition of World Cancer Report is the involvement of outstanding investigators from low- and middle-income countries who are able to report with authority on the situation in their own countries and how they are implementing measures that have been established in principle to prevent cancer and that can now be put in place on the ground in many countries throughout the world to affect and improve the outlook for many millions of people, and that is probably the single most encouraging aspect of the whole volume.
It’s important because the view from any one country is inadequate to get the whole picture. Even in relation to something like tobacco smoking, which you could say is the scourge of humankind and affects virtually all communities on Earth, the situation is far different here in Australia, where we’ve just moved to totally plain packaging of cigarettes, than it is in China, where you have the highest consumption of tobacco in the world, the prospect of a huge burden of lung cancer, and the need for a completely different approach to the situation of preventing lung cancer. In other cases, such as cervical cancer, we have the scenario of a cancer that’s well controlled in the highly developed countries because they’re able to put in place first of all Pap smears and also vaccination programmes that enable the disease to be diminished in terms of its impact on causing death. But at the same time the same disease in some sub-Saharan African countries is a major cause of cancer deaths amongst women. So the perspective on something like cervical cancer varies dramatically depending on which community is under consideration, and the implementation of means of preventing that particular cancer and other cancers in one locality depends on the experience and expertise from another. And that’s the sort of thing that this report can bring together.