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          10 January 2019 - 16:40

          War against cancer

          The importance of promoting international collaboration in cancer research

          While the battle against smoking has by now spread to every corner of the globe, tobacco use is still hanging tough, with lung cancer today being the main cause of death among women battling cancer in no fewer than 28 countries. The surprise is also that some of the countries hit most are those where the war against tobacco has a long history: the United States, for example, or Denmark. The USA, Hungary, Denmark, China and New Zealand are the nations where this type of disease kills the most, according to the latest estimate of the global diffusion of cancer made by the International Agency for Research on Cancer (IARC), a specialist sector of the World Health Organisation.

          IARC’s goal is to promote international collaboration in cancer research. It is an interdisciplinary agency that brings together expertise in epidemiology, laboratory sciences and biostatistics to identify the causes of tumours, so as to be able to adopt preventive measures and reduce the related impact of the disease and suffering. A distinctive feature of the Agency is its ability to coordinate research between different countries and organisations. Plus, its independent role as an international organisation favours this activity. IARC provides a sort of a regularly-updated snap-shot of the incidence of tumours on a global scale and examines 36 different types of cancer in 185 nations.

          Emerging from the 2018 report are over 18 million new cases of cancer and 9.6 million people fatally hit by the disease. Lung cancer, breast cancer and colon cancer are the top three types in terms of incidence and are ranked among the top five in terms of mortality (first, fifth and second, respectively). Together, these three types of cancer are responsible for one third of cancer deaths on a global level. One man out of five and one woman out of six will develop this disease at some point during their lives.

          While there is cause for alarm, worrying about getting cancer is by no means the best solution: the main increase in cancer cases (14.1 million with 8.2 million deaths in 2012) is partially due to growing and ageing population. Secondly, diagnoses are increasing with better health care services. Lastly, being aware of the problem also indicates the means to prevent it. Lifestyle, for example: paradoxically, even though countries are getting richer and more prosperous, more people are getting sick. What was once a problem linked to poverty is now partially linked to the way we consume. If breast and colon cancer are the cause of one third of all cancer cases and deaths on a global level, it is necessary to start there, and with tobacco use in particular if, as researchers explain, lung cancer is today the main cause of female death in 28 countries.

          George Butterworth, from Cancer Research UK charity, explains to the British broadcaster BBC that “tobacco is the main reason why an increasing number of women all over the world have lung cancer more than ever before”. In the United Kingdom, for example, “smoking among women has become more widespread than it is among men. So, it is no surprise that we are witnessing an increase in the rates of female lung cancer in the last few years”. Moreover, according to Butterworth, “cigarettes have become even more popular among women in medium to low income countries, and aggressive marketing by tobacco companies is making a considerable difference”. According to IARC researchers, estimates highlight the need to keep implementing targeted and effective tobacco control measures in all countries around the world. Be they rich or poor.

          According to the report, almost half of all cases and most cancer-related deaths in the world this year will occur in Asia, partly due to the high number of people living on that continent (60% of the world’s population) and also because certain tumours with higher death rates are more common in those areas. This includes, for example, high liver cancer rates, very common in China. There is an “incredible diversity” in the types of cancer and in disease models, so prevention should be focused on lifestyle. “The data collected – says the IARC director Christopher Wild – make it clear that there is still a long way to go in dealing with the alarming increase in cancer on a global level, and that prevention can play a key role. Prevention policies and early diagnosis must therefore be urgently implemented”.