World Cancer Day 2013. Cancer – Did you know? Dr Christopher Wild, IARC Director

Dr Christopher Wild, IARC Director, answers a few questions on the occasion of World Cancer Day 2013. 

Dr Wild, people speak of the cancer burden: what does the phrase cancer burden mean?

The cancer burden can be thought of in quite a broad way as the total number of people affected by the disease and you can think of this from different aspects actually, first of all perhaps the number of people who develop the disease and there are over twelve and a half million new cancer cases a year at the moment. You could also think of the number of people that are dying from the disease, between seven and a half and eight million people worldwide a year, or indeed the number of people living with cancer and our best estimate is currently that there are almost thirty million people at any one time worldwide living with this disease. But it is not just the numbers really it is also the personal, social and economic costs that this disease carries with it and if we think of an example like a young mother in Africa or Asia affected by cervical cancer because of infection with human papillomavirus, her premature death has an enormous effect on the family, not just because she is no longer there, but also because of the economic burden on the family and the loss of structure to that family.


How can the cancer burden be measured?

The way we try to measure this is through cancer registries so this is where we capture all the individuals that have developed a cancer within a given population, that might be a city or a region or a country, over a given time period. From this information, we can really build up a picture of the total number of cancers and the types of cancers in that population. So it is cancer registration, it is not an easy task to accomplish but it is actually a very valuable one in terms of combatting cancer.


What value is there in gathering such statistics?

The value of these statistics and this information is enormous because you really need to have this type of information in order to plan for the care and treatment of cancer patients. If you imagine looking at the different types of cancers these vary enormously in different countries for example worldwide. So in some countries you may have lung cancer being the most common cancer but in other countries, for example in South-East Asia, it may be cancer of the mouth and in other countries, perhaps in East Africa, we see mostly cancers of the oesophagus being a very common cancer among men. So, first of all, you’ve got the different types of cancer occurring but also what we see are different patterns of cancer over time because the population is aging, also because our lifestyles are changing, perhaps the smoking rates are going up in some countries or other risk factors such as obesity are continuing to increase. These changing demographics and the changing risk factors, are all contributing to increases in cancer burden; and we really need to be able to measure those increases and really project them so that the governments and other health care providers can plan for that future burden so that we are ready for it and able to provide the best care to people in the community.


What does this information tell us about cancer across the world? Is it a myth that this is a disease of the developed countries?

What the data is showing across the world, is that cancer is increasing everywhere, and that it is particularly increasing in the developing countries, and that is where we are going to see the biggest increases in the number of new cases per year in the next 20 years. In fact, in many of the poorest countries, we’re going to see almost twice as many new cancer cases every year in just twenty years’ time as we’re seeing currently. Even though that is a projection forward, we’re actually already seeing more total cancer cases in the developing countries than in the more developed ones. So it is a problem already, but it is one that is going to get worse in the more developing regions.


What does IARC plan to do in response?

IARC has a number of roles: first of all in collaboration with a lot of partners worldwide, we are working with cancer registries to try and improve the quality of the information that we’ve got and by better quantitating the types of cancer and the numbers of cancers we can provide a good foundation for governments to try and combat this disease. But as well, it is just describing the patterns of cancer: we are also using those patterns as clues as to what might be causing the disease. So if we can understand the causes, we can then start to think about the best approaches to prevention, and to evaluate those approaches. And in this way, we hope that we can provide the right information to the decision-makers to really reduce the burden of this disease in the future, and try to, in that way, reduce some of the suffering to what is really a terrible disease across all parts of the world.


What would be your take-home message for World Cancer Day 2013?

My message would be, first of all, that we know cancer is a problem in the developing countries and it will become more of a problem, and I would like to encourage the governments in those regions to really start looking at the action they can take now to preventing this increase in burden that is projected currently.

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