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Section of Early Detection and Prevention

Prevention and Implementation Group

Rationale

Every year about 8 million people die from cancer worldwide, and about 65% of new cancer cases occur in low- and middle-income countries. This proportion is increasing rapidly with the ageing of the population in those countries. By using what is already known about cancer etiology and effective interventions, it is possible to prevent up to 50% of premature deaths from cancer and to cure the disease or prolong survival in a further 30% of cases through early detection and proper treatment.

Some examples of preventive interventions include smoking cessation efforts, promotion of healthy diets, exercise and weight control programmes, vaccination against hepatitis B virus (HBV) to control liver cancer, and vaccination against human papillomavirus (HPV) to prevent cervical, anal, and possibly oropharyngeal cancer. In addition, screening programmes for cervical, colorectal, and breast cancer have been shown to be effective when implemented on a large scale. In the case of cervical cancer, for example, important advances in both primary and secondary prevention have been made in recent years. Several new preventive interventions offer enormous hope for reducing the incidence of and mortality from this disease, which has been extremely difficult to control in low- and middle-income countries, where it remains one of the leading causes of cancer death.

For many cancer types, there is still a need to develop safe and affordable preventive interventions. In the case of stomach cancer, another common malignancy, despite ample knowledge about the role of Helicobacter pylori in its etiology and the success of expensive endoscopy-based programmes, there is a clear need to investigate the potential of more affordable interventions, such as screening with markers of atrophic gastritis or eradication of H. pylori infection. For most interventions, research needs to be conducted on how best to implement them in different socioeconomic and cultural settings.

Many low- and middle-income countries have been unable to establish adequate cancer prevention programmes, because of a lack of technical assistance and resources. There is a need to disseminate information on how to apply current knowledge to cancer prevention, to generate new data to improve available interventions, and to investigate new approaches to control the major cancer types. In particular, implementation studies should be conducted to define the best approaches to establish cancer-preventive interventions in different cultural and socioeconomic settings.

 

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