Knowledge about the causes of Cancer and interventions to prevent and manage the disease is extensive. Cancer can be controlled and reduced by implementing evidence based strategies for Cancer prevention. Many Cancers have the high chance of cure if detected early. Modifying and avoiding risks factors more than 30% of Cancer deaths could be prevented by modifying or avoiding key risk factors, including:
- Tobacco use
- Being overweight or obese
- Unhealthy diet with low fruit and vegetable intake
- Lack of physical activity
- Alcohol use
- Sexually transmitted HPV-infection
- Infection by HBV
- Ionizing and non-ionizing radiation
- Urban air pollution
- indoor smoke from household use of solid fuels.
Tobacco use is the single most important risk factor for Cancer causing about 20% of global Cancer deaths and around 70% of global lung cancer deaths. In many low-income countries, up to 20% of Cancer deaths are due to infection by HBV and HPV.
Cancer mortality can be reduced if cases are detected and treated early. There are 2 components of early detection efforts:
The awareness of early signs and symptoms (for cancer types such as skin, cervical, breast, colorectal and oral) in order to get them diagnosed and treated at early stage. Early diagnosis is particularly relevant when there are no effective screening methods or as in many low resource settings, no screening and treatment interventions implemented. In an absence of any early detection or screening and treatment intervention, patients are diagnosed at very late stages when curative treatment is no longer an option.
Screening aims to identify individuals with abnormalities suggestive of specific Cancer or pre-cancer and refer them promptly for treatment or when feasible for diagnosis and treatment. Screening programmes are especially effective for frequent Cancer types for which cost-effective, affordable, acceptable and accessible screening tests are available to the majority of the population at risk.
Examples of screening methods are visual inspection with acetic acid (VIA) for cervical cancer in low-resource settings:
HPV testing for cervical Cancer
PAP cytology test for cervical Cancer in middle- and high-income settings;
mammography screening for breast Cancer in high-income settings.
A correct Cancer diagnosis is essential for adequate and effective treatment because every Cancer type requires a specific treatment regimen which encompasses one or more modalities such as surgery, and/or radiotherapy, and/or chemotherapy. The primary goal is to cure Cancer or to considerably prolong life. Improving the patient’s quality of life is also an important goal. It can be achieved by a supportive or palliative care and psychological support.
Potential for cure among early detectable Cancers
Some of the most common Cancer types, such as breast Cancer, cervical Cancer, oral Cancer and colorectal Cancer have high cure rates when detected early and treated according to best practices.
Potential for cure of some other Cancers
Some Cancer types, even though disseminated, such as leukaemias and lymphomas in children, and testicular seminoma, have high cure rates if appropriate treatment is provided.
In 2013, WHO launched The Global Action Plan for the Prevention and Control of Non- communicable Diseases 2013 – 2020 that aims to reduce by 25% premature mortality from Cancer, cardiovascular diseases, diabetes and chronic respiratory diseases by 2025. Some of the voluntary targets are most relevant for Cancer prevention, including target 5 aimed at reducing the prevalence of tobacco use by 30%.