Q&A with Cancer Prevention Advocates: Policies Must Support Healthful Choices; Report: Every Nation Must Address Growing Burden of Cancer

Article excerpt

Tim Byers, MD, MPH, and APHA member Shiriki Kumanyika, PhD, MPH, RD, are members of the international expert panel that authored the 2007 report, "Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective." The report, published by the American Institute for Cancer Research and the World Cancer Research Fund, weighed the collected scientific evidence linking various aspects of diet, weight and physical activity to cancer risk.

In February 2009, the two organizations published a follow-up report, "Policy and Action for Cancer Prevention." The report, authored by an expanded expert panel, including Byers and Kumanyika, placed the 2007 report's conclusions in a global policy context and called on all sectors of society to make "public health, and cancer prevention in particular, a higher priority."

With nearly 11 million people worldwide diagnosed with cancer every year and 8 million losing their lives to the disease, a new report is calling on policy-makers to make prevention a top priority.

Among the many recommendations included in the 2009 policy report, "Policy and Action for Cancer Prevention," which notes that about one-third of the most common cancers could be prevented in the United States alone, is for health professionals to take the lead in educating the public about cancer prevention. And because cancer risk is tied to diet and exercise, the policy report also called on government, industry, schools and other stakeholders to do their part to encourage and support physical activity and healthy eating. For a copy of the report, visit www. aicr.org/policy. A Q&A with two of the report's panelists follows.

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According to the report, the worldwide cancer burden is expected to increase, despite many cancers being preventable. Are we failing in our efforts to confront cancer?

Byers: Progress in cancer is varied, both across specific cancer sites and across countries. In the United States, we are now making good progress, with death rates declining about 2 percent per year for the past 18 years for those cancers we have learned how to prevent, diagnose early or treat, such as lung, colorectal, breast and prostate cancers. For other cancers, progress has been slower.

In most other countries, particularly in the developing nations, cancer trends are not favorable because of the unbridled tobacco epidemic, coupled with insufficient resources to detect cancers early or to provide state-of-the-art treatments. We could do much better both in the United States and in all other countries if we were to get more serious about tobacco control, reduce obesity, increase physical activity and improve diet quality.

Many developing nations are struggling against serious disease threats ranging from malaria to HIV to childhood diarrhea. What priority should cancer prevention take in such a context?

Byers: Cancer is increasing its rank of importance in developing nations, as many recent World Health Organization reports have concluded. Developing nations are now facing the double burdens of infectious and chronic diseases, and will clearly need to address both. The challenge is the scarcity of resources. The high financial cost of cancer screening and treatment necessitates that a high priority be placed on cancer prevention as the principal strategy for developing countries. Effective tobacco control is clearly the most important need.

In addition, however, as we point out in this report, reducing the adverse trends in obesity and poor diet quality in developing nations will reduce risk of not only cancer but also other chronic diseases.

As cancer is often related to individual behaviors, such as exercise and eating habits, how important is it that healthy behaviors begin in early childhood?

Kumanyika: The main message of this new report is that policies and other actions across multiple sectors are needed to reshape environments to make more healthful choices available for people of all ages. …