World Cancer Day - 4 FebruaryCancer is a leading cause of death around the world. WHO estimates that 84 million people will die of cancer between 2005 and 2015 without intervention.Each year on 4 February, WHO supports International Union Against Cancer to promote ways to ease the global burden of cancer. Preventing cancer and raising quality of life for cancer patients are recurring themes.
World Cancer Day is a global observance that helps raise people’s awareness of cancer and how to prevent, detect or treat it. This event is held on February 4 each year.
Cancer is a leading cause of death around the world. WHO estimates that 84 million people will die of cancer between 2005 and 2015 without intervention.
Each year on 4 February, WHO supports International Union Against Cancer to promote ways to ease the global burden of cancer. Preventing cancer and raising quality of life for cancer patients are recurring themes.
What is cancer?
Cancer is a generic term for a large group of diseases that can affect any part of the body. Other terms used are malignant tumours and neoplasms.
One defining feature of cancer is the rapid creation of abnormal cells that grow beyond their usual boundaries, and which can then invade adjoining parts of the body and spread to other organs. This process is referred to as metastasis. Metastases are the major cause of death from cancer.
What do people do?
People, businesses, governments and non-profit organizations work together on World Cancer Day to help the general public learn more about the different types of cancer, how to watch for it, treatments and preventative measures. Various activities and events include:
- Television, radio, online and newspaper advertisements and articles that focus on the fight against cancer.
- Nationwide campaigns targeted at parents to help them minimize the risk of cancer within their families.
- Breakfasts, luncheons or dinners aimed at raising funds for cancer research or projects that help to fight cancer. Many of these events feature keynote speakers or video presentations.
- Public information booths featuring information kits, fact sheets, booklets, posters and other items that promote the cancer awareness, prevention, risk reduction, and treatment.
Some countries use World Cancer Day to promote campaigns on various cancer issues, such as breast cancer, lung cancer, skin cancer, and cancer in children. Much focus goes towards awareness and risk reduction.
The World Health Organization (WHO), which is the United Nations’ (UN) directing and coordinating health authority, works with organizations such as the International Union Against Cancer (UICC) on this day to promote ways to ease the global burden of cancer. Recurring themes over the years focus on preventing cancer and raising the quality of life for cancer patients.
World Cancer Day is a global observance and not a public holiday.
Cancer is a leading cause of death around the world, according to WHO, which estimates that 84 million people will die of cancer between 2005 and 2015 without intervention. Low-income and medium-income countries are harder hit by cancer than the high-resource countries. It is essential to address the world's growing cancer burden and to work on effective control measures.
World Cancer Day is part of the World Cancer Campaign, which responds to the Charter of Paris adopted at the World Summit Against Cancer for the New Millennium on February 4, 2000. It called for a strong alliance between researchers, health-care professionals, patients, governments, industry partners and the media to fight cancer.
The Charter of Paris designated February 4 each year as World Cancer Day. UICC is responsible for coordinating World Cancer Day globally. It receives support from various partners and organizations, including the World Health Organization, the International Atomic Energy Agency, and other international bodies. UICC organized the first World Cancer Day in 2006.
There are different symbols that are used to help promote the fight against different types of cancers. For example, the pink ribbon is a global symbol of breast cancer awareness, while the orange ribbon is associated with child cancer awareness. Another example is the daffodil, which the American Cancer Society sees as a symbol of hope that people share for a future where cancer is no longer a life-threatening disease.
October 2011 -- Breast cancer is currently the top cancer in women worldwide, both in the developed and the developing world. The majority of breast cancer deaths occur in low- and middle-income countries, where most of the women are diagnosed in late stages due mainly to lack of awareness and barriers to access to health services.
National cancer control programmes
A well-conceived, well-managed national cancer control programme lowers cancer incidence and improves the life of cancer patients, no matter what resource constraints a country faces.
A national cancer control programme is a public health programme designed to reduce the number of cancer cases and deaths and improve quality of life of cancer patients, through the systematic and equitable implementation of evidence-based strategies for prevention, early detection, diagnosis, treatment, and palliation, making the best use of available resources.
A comprehensive national cancer programme evaluates the various ways to control disease and implements those that are the most cost-effective and beneficial for the largest part of the population. It places emphasis on preventing cancers or detecting cases early so that they can be cured, and provide as much comfort as possible to patients with advanced disease.
About the Cancer Control Programme
The key mission of WHO Cancer Control Programme is to promote national cancer control policies plans and programmes, integrated to noncommunicable diseases and other related problems. Our core functions are to set norms and standards, promote surveillance, encourage evidence based prevention, early detection, treatment and palliative tailored to the different socioeconomic settings.
At least one-third of all cancer cases are preventable. Prevention offers the most cost-effective long-term strategy for the control of cancer.
Tobacco use is the single greatest avoidable risk factor for cancer mortality worldwide, causing an estimated 22% of cancer deaths per year. In 2004, 1.6 million of the 7.4 million cancer deaths were due to tobacco use.
Tobacco smoking causes many types of cancer, including cancers of the lung, esophagus, larynx (voice box), mouth, throat, kidney, bladder, pancreas, stomach and cervix. About 70% of the lung cancer burden can be attributed to smoking alone. Second-hand smoke (SHS), also known as environmental tobacco smoke, has been proven to cause lung cancer in nonsmoking adults. Smokeless tobacco (also called oral tobacco, chewing tobacco or snuff) causes oral, esophageal and pancreatic cancer.
- Tobacco and cancer: evidence and monitoring
- Implementation tools
- Tobacco Free Initiative
Physical inactivity, dietary factors, obesity and being overweight
Dietary modification is another important approach to cancer control. There is a link between overweight and obesity to many types of cancer such as oesophagus, colorectum, breast, endometrium and kidney. Diets high in fruits and vegetables may have a protective effect against many cancers. Conversely, excess consumption of red and preserved meat may be associated with an increased risk of colorectal cancer. In addition, healthy eating habits that prevent the development of diet-associated cancers will also lower the risk of cardiovascular disease.
Regular physical activity and the maintenance of a healthy body weight, along with a healthy diet, will considerably reduce cancer risk. National policies and programmes should be implemented to raise awareness and reduce exposure to cancer risk factors, and to ensure that people are provided with the information and support they need to adopt healthy lifestyles.
- WHO global strategy on diet, physical activity and health
Alcohol use is a risk factor for many cancer types including cancer of the oral cavity, pharynx, larynx, oesophagus, liver, colorectum and breast. Risk of cancer increases with the amount of alcohol consumed. The risk from heavy drinking for several cancer types (e.g. oral cavity, pharynx, larynx and oesophagus) substantially increases if the person is also a heavy smoker. Attributable fractions vary between men and women for certain types of alcohol-related cancer, mainly because of differences in average levels of consumption. For example, 22% of mouth and oropharynx cancers in men are attributable to alcohol whereas in women the attributable burden drops to 9%. A similar sex difference exists for oesophageal and liver cancers (Rehm et al., 2004).
- Global strategy to reduce harmful use of alcohol
Infectious agents are responsible for almost 22% of cancer deaths in the developing world and 6% in industrialized countries. Viral hepatitis B and C cause cancer of the liver; human papilloma virus infection causes cervical cancer; the bacterium Helicobacter pylori increases the risk of stomach cancer. In some countries the parasitic infection schistosomiasis increases the risk of bladder cancer and in other countries the liver fluke increases the risk of cholangiocarcinoma of the bile ducts. Preventive measures include vaccination and prevention of infection and infestation.
- Infectious diseases health topics
Environmental pollution of air, water and soil with carcinogenic chemicals accounts for 1–4% of all cancers (IARC/WHO, 2003). Exposure to carcinogenic chemicals in the environment can occur through drinking water or pollution of indoor and ambient air. In Bangladesh, 5–10% of all cancer deaths in an arsenic-contaminated region were attributable to arsenic exposure (Smith, Lingas & Rahman, 2000). Exposure to carcinogens also occurs via the contamination of food by chemicals, such as afl atoxins or dioxins. Indoor air pollution from coal fires doubles the risk of lung cancer, particularly among non-smoking women (Smith, Mehta & Feuz, 2004). Worldwide, indoor air pollution from domestic coal fires is responsible for approximately 1.5% of all lung cancer deaths. Coal use in households is particularly widespread in Asia.
More than 40 agents, mixtures and exposure circumstances in the working environment are carcinogenic to humans and are classified as occupational carcinogens (Siemiatycki et al., 2004). That occupational carcinogens are causally related to cancer of the lung, bladder, larynx and skin, leukaemia and nasopharyngeal cancer is well documented. Mesothelioma (cancer of the outer lining of the lung or chest cavity) is to a large extent caused by work-related exposure to asbestos.
Occupational cancers are concentrated among specific groups of the working population, for whom the risk of developing a particular form of cancer may be much higher than for the general population. About 20–30% of the male and 5–20% of the female working-age population (people aged 15–64 years) may have been exposed to lung carcinogens during their working lives, accounting for about 10% of lung cancers worldwide. About 2% of leukaemia cases worldwide are attributable to occupational exposures.
Ionizing radiation is carcinogenic to humans. Knowledge on radiation risk has been mainly acquired from epidemiological studies of the Japanese A-bomb survivors as well as from studies of medical and occupational radiation exposure cohorts. Ionizing radiation can induce leukaemia and a number of solid tumours, with higher risks at young age at exposure. Residential exposure to radon gas from soil and building materials is estimated to cause between 3% and 14% of all lung cancers, making it the second cause of lung cancer after tobacco smoke. Radon levels in homes can be reduced by improving the ventilation and sealing floors and walls. Ionizing radiation is an essential diagnostic and therapeutic tool. To guarantee that benefits exceed potential radiation risks radiological medical procedures should be appropriately prescribed and properly performed, to reduce unnecessary radiation doses, particularly in children.
Ultraviolet (UV) radiation, and in particular solar radiation, is carcinogenic to humans, causing all major types of skin cancer, such as basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and melanoma. Globally in 2000, over 200 000 cases of melanoma were diagnosed and there were 65 000 melanoma-associated deaths. Avoiding excessive exposure, use of sunscreen and protective clothing are effective preventive measures. UV-emitting tanning devices are now also classified as carcinogenic to humans based on their association with skin and ocular melanoma cancers.
Screening and early detection of cancer
Early detection of cancer
Early detection of cancer greatly increases the chances for successful treatment. There are two major components of early detection of cancer: education to promote early diagnosis and screening.
Recognizing possible warning signs of cancer and taking prompt action leads to early diagnosis. Increased awareness of possible warning signs of cancer, among physicians, nurses and other health care providers as well as among the general public, can have a great impact on the disease. Some early signs of cancer include lumps, sores that fail to heal, abnormal bleeding, persistent indigestion, and chronic hoarseness. Early diagnosis is particularly relevant for cancers of the breast, cervix, mouth, larynx, colon and rectum, and skin.
Screening refers to the use of simple tests across a healthy population in order to identify individuals who have disease, but do not yet have symptoms. Examples include breast cancer screening using mammography and cervical cancer screening using cytology screening methods, including Pap smears. Screening programmes should be undertaken only when their effectiveness has been demonstrated, when resources (personnel, equipment, etc.) are sufficient to cover nearly all of the target group, when facilities exist for confirming diagnoses and for treatment and follow-up of those with abnormal results, and when prevalence of the disease is high enough to justify the effort and costs of screening.
Based on the existing evidence, mass population screening can be advocated only for breast and cervical cancer, using mammography screening and cytology screening, in countries where resources are available for wide coverage of the population. Several ongoings studies are currently evaluating low cost approaches to screening that can be implemented and sustained in low-resource settings. For example visual inspection with acetic acid may prove to be an effective screening method for cervical cancer in the near future. More studies that evaluate low cost alternative methods to mammography screening, such as clinical breast examination, are needed.
Treatment of cancer
Cancer treatment programmes
The main goals of a cancer diagnosis and treatment programme are to cure or considerably prolong the life of patients and to ensure the best possible quality of life to cancer survivors.
The most effective and efficient treatment programmes are those that: a) are provided in a sustained and equitable way; b) are linked to early detection; and c) adhere to evidence-based standards of care and a multidisciplinary approach.
Such programmes also ensure adequate therapy for cancer types that, although not amenable to early detection, have high potential for being cured (such as metastatic seminoma and acute lymphatic leukaemia in children), or have a good chance of prolonging survival in a significant way (such as breast cancer and advanced lymphomas).
The first critical step in the management of cancer is to establish the diagnosis based on pathological examination. A range of tests is necessary to determine the spread of the tumour. Staging often requires substantial resources that can be prohibitive in low-resource settings. Because of late diagnosis, however, a consequence of poor access to care, most patients have advanced disease in such settings.
Once the diagnosis and degree of spread of the tumour have been established, to the extent possible, a decision must be made regarding the most effective cancer treatment in the given socioeconomic setting.
Major treatment modalities
This requires a careful selection of one or more of the major treatment modalities – surgery, radiotherapy and systemic therapy – a selection that should be based on evidence of the best existing treatment given the resources available. Surgery alone, and sometimes radiation alone, is only likely to be highly successful when the tumour is localized and small in size. Chemotherapy alone can be effective for a small number of cancers, such as haematological neoplasms (leukaemias and lymphomas), which can generally be considered to be widespread from the outset. Combined modality therapy requires close collaboration among the entire cancer care team.