A greater emphasis on prevention of cancers would reap considerable benefits, the director of the UN’s cancer agency has said.
Christopher Wild, who heads the International Agency for Research on Cancer, said figures vary, “but one can safely estimate that 40 to 50 per cent of cancers could be prevented if the accumulated knowledge about causes could be translated into effective primary prevention.”
Writing a wide-ranging article in the journal Health Management, he said it was a “pivotal time for cancer prevention”, noting: “Prevention and early detection demonstrably work… Estimates of the costs of implementing cancer prevention strategies are difficult to make on a global scale, but are certainly a fraction of the costs of dealing with the consequences of the occurrence of these same cancers.”
Wild added: “Despite proof and promise, prevention remains too often neglected. Prevention typically attracts less than 5 per cent of cancer research funding with vastly greater proportions invested in basic science and clinical translational research.”
Highlighting tobacco usage as the “pre-eminent culprit”, he noted: “Alcohol, excess sunlight, unhealthy diets, environmental contaminants and occupational exposures all contribute.”
The IARC head is critical of the tendency to focus on “individual choices, whereas legislation and policy may be keys to success, offering a sustainable approach and one which contributes to reduced inequalities in society.”
Wild reiterates a theme from a July 2015 article where he wrote the “the necessity of prevention is blindingly obvious.” In Adjacent Government, he also noted: “Improved protection against workplace carcinogens form part of the successes.”
There are concerns IARC may not have fully absorbed its own prevention message. The majority of cancer causes identified in IARC monographs are industrial chemicals or other work-related occupational and environmental exposures.
However, IARC’s own prevention guides are skewed towards lifestyle interventions, with none advocating a reduction in workplace or environmental exposures to carcinogens. The UN agency has also been accused of damaging its reputation through collaboration with the asbestos industry.
A major study published in Nature in December 2015 concluded workplace, environmental and other ‘extrinsic’ exposures are the cause of up to 90 per cent of cancers.
- Christopher Wild. Precision in the fight against the global cancer problem, Health Management, volume 15, issue 4, 2015.