Cancer is a disease that knows no boundaries. Each one of us could be directly or indirectly affected at some point in our life. It could be us, a relative or a friend.
Just as cancer affects everyone in different ways, we can all take various actions to reduce the impact it has on individuals, families and communities.
Every year on February 4, the world marks World Cancer Day, which unites the world’s population in the fight against cancer with a ‘We can. I can’ tagline.
The global cancer epidemic is big and progressing at a fast rate, affecting a high proportion of the population. Currently 8.8 million people worldwide die from cancer every year, out of which four million are premature deaths in people aged 30 to 69. Over the next 10 years, cancer deaths are projected to increase to over 14 million a year.
In Malta, approximately 2,000 people are being diagnosed with cancer each year, while almost 900 deaths (about 30 per cent of all deaths) are attributed to cancer annually. Additionally, the number of people in Malta diagnosed with cancer since 1994 and surviving this disease is estimated to have surpassed 12,000 individuals – amounting to about three per cent of the total population.
Over the years, we have seen changes in the way we live that are detrimental to our health. More people are exposed to cancer risk factors, such as smoking, a poor diet and sedentary lifestyles. Tobacco is the number one risk factor for developing cancer.
Lung cancer is the leading cause of cancer death, and most of the cases result from cigarette smoking. When you compare current smokers to non-smokers, the former are about 25 times more likely to die from lung cancer than the latter.
It is estimated that smoking causes about 80 to 90 per cent of lung cancer deaths. Smoking-related cancers are not limited to lung cancers but smoking can also cause cancer of the mouth and throat, oesophagus, stomach, colon, rectum, liver, pancreas, larynx, trachea, bronchus, kidney and renal pelvis, urinary bladder and cervix, and acute myeloid leukaemia.
Currently 8.8 million people worldwide die from cancer every year; four million are premature deaths in people aged 30 to 69
Research has shown that being overweight or obese can increase the risk of getting some forms of cancers, including uterine cancer, breast cancer in postmenopausal women and colorectal cancers. Hence, it is important to maintain a healthy weight.
Diets high in processed meats have also been linked to cancer, so following a healthy diet – with plenty of wholegrains, pulses, vegetables and fruits, as well as limiting high-calorie foods (foods high in sugar or fat), red meat, foods high in salt, sugary drinks and processed meat – is recommended.
Physical activity in turn is a protective factor. There is strong evidence which suggests that physical activity can reduce the risk of several cancers, including breast and colon cancers. Around 10 per cent of breast and colon cancer cases worldwide are linked to a lack of physical activity.
A large number of studies provide strong evidence that drinking alcohol is a risk factor for primary liver cancer. In fact, more than 100 studies have found an increased risk of breast cancer with increasing alcohol intake. The link between alcohol consumption and colon cancer has also been reported in more than 50 studies.
Exposure to UV rays from the sun is the highest environmental risk for developing skin cancer. To help prevent skin cancer, one should avoid being out in the sun as much as possible, especially between 11am and 4pm, and when outside seek shade, apply sunscreen and wear sun-protective clothing.
There are some cancers that are related to infectious diseases. Vaccines can also help lower cancer risk. The human papillomavirus (HPV) vaccine helps prevent most cervical cancers and several other kinds of cancer. This is provided free to girls at the age of 12. The hepatitis B vaccine, which is on the free national schedule for children, can help lower liver cancer risk.
An important step in cancer control is early diagnosis. Diagnosing cancer isn’t always easy because not all cancers show early signs and symptoms, and other warning signs can appear quite late when the cancer is advanced.
However, some cancers can be picked up early and timely treatment has been shown to improve survival. Screening for cervical and colorectal cancers, as recommended, helps prevent these diseases by finding precancerous lesions so they can be treated before they become cancerous.
Screening for cervical, colorectal and breast cancers also helps spot these diseases at an early stage, when treatment works best. The national health screening services administers screening for breast cancer, colorectal cancer and cervical cancer.
It has been predicted that cancer will increase from 14.1 million in 2012 to 19.3 million cases per year by 2025. Educating and informing people on the links between lifestyle and cancer risk is the first step towards effective prevention. More than one third of cancers can be prevented by adopting healthy behaviours.
Dr Charmaine Gauci is Superintendent of Public Health.