Preventing cancer: the way forward | Prof Luigi Fontana [Video]

A new paper published in April 2024, using GLOBOCAN data, estimates that by 2050, the annual number of cancer diagnoses will reach 35 million, a 77% increase from 2022. Lung cancer, the most common cancer in 2022, accounted for 2.5 million (12.4%) of the 20 million new cases and caused 18.6% of the 9.7 million cancer deaths worldwide. As you know smoking is a leading and preventable cause of lung cancer; air pollution probably plays an increasing role. Indeed, lung cancer was the most frequently diagnosed cancer and the leading cause of cancer deaths in men, while breast cancer held these positions for women.

The Lancet’s Breast Cancer Commission, published on April 15, 2024, predicts that by 2040, global annual breast cancer cases will exceed 3 million, with the largest increase occurring in low- and middle-income countries. Similarly, The Lancet’s Commission on prostate cancer, published on April 4, 2024, forecasts a rise in global annual prostate cancer cases from 1.4 million in 2020 to 2.9 million by 2040, with deaths rising from 375,000 to nearly 700,000 in the same period.

The increase in cancer diagnoses is not solely due to an ageing population. Although around 90% of all cancer cases affect people over 50, younger populations are also seeing rising numbers. A 2023 study covering 204 countries found that cancer diagnoses in individuals under 50 increased from 1.82 million in 1990 to 3.26 million in 2019, outpacing rises in other age groups. Early-onset cancer cases are projected to rise by another 31% by 2030. While breast cancer is the most common in people under 50, colon, prostate, and stomach cancers are also increasing in younger adults in middle- and high-income countries.

Numerous risk factors contribute to the rise in cancer among younger individuals, including genetic predisposition, environmental factors, obesity, physical inactivity, unhealthy diets, smoking, and alcohol consumption. tackling this issue requires a multi-faceted approach that goes beyond conventional medical treatments and interventions.

Firstly, since more than half of global cancer deaths are potentially preventable, according to WHO, there is an urgent need to raise awareness and increase interventions for lifestyle changes and early cancer detection. This includes adequate funding for innovative, preventative primary health practices and health literacy programs in primary, secondary, and tertiary schools. Education is a crucial tool for empowering individuals to make healthier choices and understand the risks associated with certain risky behaviors and environmental factors.

Secondly, better industry regulation against carcinogens is imperative. This includes stricter controls on pollutants, chemicals, and other environmental hazards that contribute to cancer risk. Governments and regulatory bodies must enforce policies that limit exposure to known carcinogens in workplaces, public spaces, and homes.

The healthy food sector also should play a critical role in cancer prevention. Encouraging the production and consumption of nutritious, minimally processed foods can help combat obesity and metabolic related health issues that increase cancer risk. This can be achieved through policy measures such as subsidies for healthy foods, taxes on unhealthy options, and clear labeling to inform consumer choices.

Finally, strong advocacy and collaborative efforts across multiple sectors are needed to drive change. This includes not only health professionals but also governments, the financial sector, and other stakeholders. The societal impact of cancer is vast, and addressing it requires a comprehensive and unified response.