strategy

Preventing cancer

Synonyms:
Preventing carcinomas
Eradicating cancer
Description:
Cancer is largely avoidable.
Context:
Epidemiological evidence points to a strong correlation between diet and certain diseases such as cancer and cardiovascular disease.
Implementation:
Will the 1990s be remembered as "the decade when we measurably turned the tide against cancer"? The US study, [Annual Report to the Nation on the Status of Cancer, 1973-1998] reports an annual decline of 1% per annum. Many find this conclusion misleading. Taking several factors into account, it is not clear that there has been any decrease at all. First, lung cancer, which is in no way due to medical advances, accounts for the lion's share of the cancer rate decline. Take lung cancer out of the equation, and the reported decline in cancer is cut by a third. Second, it overlooks the fact that overall cancer rates rose by more than a factor of ten during the 20th century and increasing over 20% just from 1973 to 1992. The incidences of ten other cancers have increased from 1992 to 1998. These include cancer of the liver, thyroid, oesophagus, small intestine and heart, plus non-Hodgkin's lymphoma, melanoma and breast cancer. Thirdly, certain cancer types are not counted, notably [in situ] carcinomas, which are an early stage of cancer in which the tumour is confined to the organ where it first developed. For example, breast cancer rates have increased 40% from 1975 to 1998. Not included in the statistics are incidences of two types of [in situ] breast cancer, one that develops in the milk passages (ductal carcinoma [in situ] (DCIS)) and another than develops in the milk-producing glands (lobula carcinoma [in situ] (LCIS). Because these tumours have not invaded neighbouring tissue, the standard treatment of surgery (lumpectomy or full mastectomy), radiation and chemotherapy is usually effective in stopping its spread. The incidence of [in situ] breast cancers has surged and continues to increase: The American Cancer Society estimates that 46,400 American women will have been diagnosed with DCIS or LCIS in 2001. Adding these in situ cancers to invasive breast cancers would increase the incidence rate by 24%.

Neither does the survey count [in situ] melanoma skin cancers, with which the American Cancer Society estimates 31,400 Americans will be diagnosed in 2001. Adding these cases would increase the rate for skin cancer by 56%.

Changes in diagnostic procedures also affect incidence rates. In explaining fluctuations in the incidence of prostate cancer, for example, the National Institutes of Health noted that with the advent of Prostate Specific Antigen (PSA) screening in the late 1980s, there was a spike in the incidence of prostate cancer, not because more men were suddenly getting the disease above the normal increase, but because previously undetected cancers were suddenly being diagnosed. Now that the prevalent cancers have been detected, what looks like a decline in incidence in the 1990s, they say, is not due to fewer men getting prostate cancer, but is a decline relative only to the abnormally high number of tests and diagnoses made just previous to that period.

Claim:
1. Appropriations for cancer prevention are currently minuscule and could be raised to achieve parity with diagnosis, treatment and basic research. The cancer establishment should conduct detailed studies of the wide range of avoidable and involuntary carcinogenic exposures and legislators act to remove them from the environment.

2. It should be a crime for any corporation or corporate executive to knowingly introduce a new carcinogen into the environment.

3. With a comprehensive programme of prevention, rather than damage control, we could drive cancer rates back down to the relatively low rates of the 1950s. For example, the budget for occupational cancer in most cancer institutions is under 1 percent of the total budget. Yet occupational cancers comprise at least 10 percent of all cancers and are among the most preventable of all cancers.

Counter Claim:
1. The war against cancer is an out and out failure. Despite decades of basic scientific and clinical research, and numerous trials of 'promising new medical therapies', cancer remains a major cause of sickness and death in the western world. While there have been some success in treating some forms of cancer, especially those of children and young adults, it is not stopping people getting cancer, and the effects of these benefits on overall mortality due to cancer have been more than disappointing. In 1994, death rates from all cancers were actually 6% higher than in 1970.

2. Over the 20 year 1995-2005, in spite of billions of dollars spent on research, cancer has moved from the number 8 killer of people in the USA to the number 2 killer. Since 2003, cancer has been the leading cause of death in people under age 30 in the USA.

Constrains:
Risking cancer
Organizations:
International Psycho-Oncology Society
World Federation of Surgical Oncology Societies
International Society of Paediatric Oncology
International Association for the Study of Lung Cancer
European Society for Hyperthermic Oncology
European Society of Gynaecological Oncology
European Cancer Organisation
International Society for Radiation Oncology
European Cancer Prevention Organization
European Oncology Nursing Society
European Society of Surgical Oncology
International Society for Nurses in Cancer Care
European Association for Cancer Education
Scandinavian Society for Head and Neck Oncology
International Society for Preventive Oncology
European Society for Therapeutic Radiology and Oncology
Nordic Society for Pediatric Hematology and Oncology
European Musculo-Skeletal Oncology Society
International Gynecologic Cancer Society
Nordic Cancer Union
European Group for Breast Cancer Screening
Latin American Society for Pediatric Oncology
Nordic Society for Psychosocial Oncology
Organization of European Cancer Institutes
International Association for Hyperthermic Oncology
International Gastric Cancer Association
European Society for Medical Oncology
Scandinavian Glioma Society
International Society for the Study of Comparative Oncology
European Association for Neuro-Oncology
International Society of Cancer Prevention
Asian Breast Cancer Society
Multinational Association of Supportive Care in Cancer
International Cancer Imaging Society
Balkan Union of Oncology
European Society of Skin Cancer Prevention
European Association of Dermato-Oncology
Nordic Society of Gynecological Oncology
Association of European Cancer Leagues
Connective Tissue Oncology Society
Asian Society for Neuro-Oncology
World Federation of Neuro-Oncology
International Society of Paediatric Surgical Oncology
European Federation of Psychosocial Oncology Societies
International Cancer Information Center
International Academy of Tumor Marker Oncology
Latin American Brachytherapy and Radiation Oncology Group
International Campaign for Establishment and Development of Oncology Centres
European Lung Cancer Working Party
European School of Oncology
Europa Donna - The European Breast Cancer Coalition
Alliance for Cervical Cancer Prevention
International Cancer Microenvironment Society
International Collaborative Group for Hereditary Non-Polyposis Colorectal Cancer
International Alliance of Breast Cancer Organizations
International Bladder Cancer Network
European Cancer Centre for Developmental and Supportive Therapy
International School of Surgical Oncology, Strasbourg
International Cancer League
European Institute of Oncology, Milan
Global Cancer Concern, India
Global Cancer Concern, UK
International Association for Hormones and Cancer
International Institute of Advanced Therapy for AIDS and Cancer
Asia-Pacific Academy for Cancer Biotherapy
Arab Medical Association Against Cancer
European School of Oncology Foundation
Europe Against Cancer Programme
International Association of Cancer Victors and Friends
International Cancer Alliance for Research and Education
European Group for Colorectal Cancer Screening
European Cancer Centre
Europese Alliantie voor Complementaire Kankerbestrijding
Asian Society for Hyperthermic Oncology
Fondation internationale d'applications au cancer et sida
International Conference on the Adjuvant Therapy of Cancer
Nordic Cancer Epidemiological Unit
South American Cancer Chemotherapy Society
Asian Oceanian Clinical Oncology Association
European Action Plan Against Cancer
Société internationale de recherches contre la tuberculose et le cancer
Subjects:
Cancer
Prevention
Destruction
Type Classification:
C: Cross-sectoral strategies