Cancer Research for cancer prevention

Key areas and resources of cancer prevention

The following three sections provide access to publications describing key observations in the areas of cancer prevention linked to: describing the occurrence of cancer, identifying the causes of cancer, and evaluating preventive interventions and their implementation.

Describing the occurrence of cancer
A primary aim of IARC in describing the occurrence of the disease is the collection, analysis, interpretation and dissemination of global cancer indicators, in alliance with population-based cancer registries worldwide. The Agency has sought innovation in the dissemination of global statistics via the recent development of the Global Cancer Observatory (GCO, http://gco.iarc.fr/), an interactive web-based platform based on key projects within the Section of Cancer Surveillance. The GCO will link to related activities, including epidemiological research that documents global cancer transitions, as well as progress in the Global Initiative for Cancer Registry Development (http://gicr.iarc.fr), a partnership that aids countries to develop high-quality cancer registry data for cancer control action.

Cancer statistics
  • GLOBOCAN provides access to the most recent estimates (for 2012) of the cancer incidence, mortality, and prevalence for 28 cancers in 184 countries worldwide. The website enables users to consult information on cancer occurrence and to extract information for the creation of presentations and reports.
  • Cancer Incidence in Five Continents (CI5) provides access to detailed information on the incidence of cancer recorded by individual cancer registries (regional or national) worldwide. Data available through CI5 are provided by the highest-quality cancer registries and, among other features, permit the trends in cancer incidence over time to be examined.
  • Global cancer transitions according to the Human Development Index (2008-2030): a population-based study. This research, led by scientists from the IARC Section of Cancer Surveillance and published in The Lancet Oncology, reveals how human development is central to the changing cancer burden worldwide. Strikingly, the study demonstrates not only how the increasing cancer burden will fall predominantly on those countries that are in the process of social and economic transition but also that the type of cancers that are most common is changing.
  • Global burden of cancer in 2008: a systematic analysis of disability-adjusted life-years in 12 world regions. This paper, published in The Lancet by Dr Isabelle Soerjomataram of the IARC Section of Cancer Surveillance and colleagues, shows the disability-adjusted life years (DALYs) for 27 cancers in 184 countries in 12 world regions. DALYs is an indicator that integrates the commonly used measures of cancer burden (incidence, mortality, and survival) with measures of disability due to cancer.
  • Global estimates of cancer prevalence for 27 sites in the adult population in 2008. This paper published by IARC scientists in the International Journal of Cancer estimates that 29 million people worldwide were living with cancer in 2008 (cancer prevalence). Estimates are provided for 27 cancers and 184 countries. This knowledge is vital to help determine the cancer care requirements for patients in different regions of the world.

Cancer survival
  • Cancer Survival in Africa, Asia, the Caribbean and Central America (IARC Scientific Publications No. 162)
    Improvement in survival from cancer is one of the yardsticks to measure progress in cancer control and the success of early detection and cancer treatment. Long-term survival reflects cure from cancer and is of most interest to patients, their families, the general public, and health‐care planners.
    Population-based cancer survival rates based on all cancer patients diagnosed by all means in a given geographical region or country reflect the general efficiency of cancer health services and provide a key indicator of progress in cancer control in a given region. The cancer survival data from 14 countries and 27 populations in Africa, Asia, the Caribbean, and Central America included in this publication provide valuable insights for improving survival outcomes in low- and middle-income countries and a stimulus to efforts to ensure that all cancer patients have the best possible chance to survive the disease.

Developing cancer registries
  • Global Initiative for Cancer Registry Development (GICR): Only 1 in 5 low- and middle-income countries have the necessary data from cancer registries on which to base the development of informed cancer control policy. GICR is a coordinated, multipartner approach created to deliver the required change and is endorsed by WHO as a support to Member States in responding to the cancer incidence indicator in the NCD Global Monitoring Framework.
  • Planning and Developing Population-Based Cancer Registration in Low- and Middle-Income Settings: This IARC Technical Publication, available in electronic format, provides essential guidance on the key steps in planning a cancer registry, including accessing sources of information, monitoring the quality of the data, and reporting results.

Classifying cancer
  • The WHO Classification of Tumours series establishes the pathological and genetic classification and grading of human tumours that is accepted and used worldwide. This series (currently in its fourth edition) has a substantial impact on pathology communities, cancer registration, epidemiology studies, clinical trials, and cancer research in general.
  • The International Classification of Diseases for Oncology (ICD-O) is internationally recognized as the definitive classification of neoplasms. The third edition of ICD-O (ICD-O-3) and its 2011 update (ICD-O-3 First Revision, or ICD-O-3.1) are available from IARC as fully searchable electronic resources
Identifying the causes of cancer
  • The IARC Monographs identify environmental factors that can increase the risk of human cancer, including chemicals, complex mixtures, occupational exposures, physical agents, biological agents, and lifestyle factors. The Monographs website provides searchable information on nearly 1000 agents evaluated over a 40‐year period. National health agencies can use this information as scientific support for their actions to prevent exposure to potential carcinogens.
  • Global burden of cancer caused by infections. This study published in The Lancet Oncology, led by Dr Catherine de Martel and Dr Martyn Plummer of the IARC Section of Infections, addresses one of the major causes of cancer worldwide, chronic infections. The authors estimate that 2 million (16.1%) of the total of 12.7 million new cancer cases in 2008 were attributable to infections; the fraction was far higher in less developed countries than in more developed countries.
  • Global burden of cancer linked to overweight and obesity. This study, led by Dr Isabelle Soerjomataram of the IARC Section of Cancer Surveillance and published in The Lancet Oncology, examines the worldwide burden of cancer linked to overweight and obesity. An estimated 481 000 or 3.6% of all new cancer cases in adults (aged 30 years and older after the 10-year lag period) in 2012 were attributable to this risk factor.
  • The Cancer and Obesity website provides a variety of interactive tools for analysing and visualizing data on the estimated global burden of cancer in 2012 attributable to excess body weight.
  • World-wide Relative Contribution of Hepatitis B and C Viruses in Hepatocellular Carcinoma. In this meta-analysis published in Hepatology, Dr Catherine de Martel and colleagues from the IARC Infections and Cancer Epidemiology Group report on an extensive review of hepatocellular carcinoma, the most common form of liver cancer, based on reports on 119 000 cases published in 260 studies from 50 countries. They show that at least 60% of these cancers are attributable to either hepatitis B virus (HBV) or hepatitis C virus (HCV) in most countries, with an overall predominance of HBV and substantial variations between different countries. They underscore the growing fraction of liver cancers attributable to HCV in several countries.
  • Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. In this review published in The Lancet Oncology, Dr Catherine de Martel, Dr Martyn Plummer, and colleagues from both the IARC Infections and Cancer Epidemiology Group and the IARC Section of Cancer Surveillance provide an estimate of the fraction of cancers worldwide that could be attributed to carcinogenic infectious agents. They show that targeting prevention efforts on four main agents (i.e. Helicobacter pylori, human papillomaviruses, and hepatitis B and C viruses) could significantly reduce the worldwide burden of cancer, especially in less developed countries.
Evaluating preventive interventions and their implementation
  • The IARC Handbooks of Cancer Prevention provide evaluations of various approaches to primary and secondary cancer prevention. Available volumes provide information on the cancer-preventive activity of chemopreventive agents, the effectiveness of screening, and the effectiveness of tobacco control.
  • The European Code Against Cancer consists of 12 recommendations that people can follow to lower their risk of cancer. It has been estimated that almost half of all deaths due to cancer in Europe could be avoided if everyone followed the recommendations. The scientific justification for the 12 cancer prevention recommendations has been published as a special supplement of Cancer Epidemiology.
  • Costs, affordability, and feasibility of an essential package of cancer control interventions in low-income and middle-income countries: key messages from Disease Control Priorities, 3rd edition. This report, published in The Lancet and co-authored by Dr Rengaswamy Sankaranarayanan and Dr Freddie Bray from IARC, outlines an essential package of potentially cost-effective cancer control measures for low- and middle-income countries. Interventions included in the package are evaluated in relation to cost, and the authors conclude that implementation of an appropriately tailored package could substantially reduce suffering and premature death from cancer.
  • Managing the changing burden of cancer in Asia. This report published in BMC Medicine, authored by R. Sankaranarayanan, K. Ramadas and Y.Qiao, discusses the changing burden of cancer in Asia, a region that accounts for half the global burden of disease. The paper calls for promoting strategies such as healthy ageing, tobacco and alcohol control measures, hepatitis B virus (HBV) and human papillomavirus (HPV) vaccination, cancer screening services, and vertical investments in strengthening cancer healthcare infrastructure to improve equitable access to services to control cancer in this vast continent.

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