“Cancer prevention requires the vision, courage, and political leadership to make long term decisions”
Christopher Wild has been the Director of the International Agency for Research on Cancer (IARC), the cancer agency of the World Health Organization (WHO), since 2009. Married to a neuroscientist and father of three, this epidemiologist and Man United fan came to the PRBB in March to give the 3rd Global Health session co-organised by ISGlobal, CRESIB, and CREAL.
How has the burden of cancer changed over recent years?
The incidence of cancer globally has increased: there were 14 million new cases in 2012 and it is expected we will reach 24 million new cases by 2035. Also, about 70% of the world’s cancer deaths occur in low- and middle-income countries. This is due to the rise in population sizes and average life expectancy in general, particularly in these countries, but also because they are shifting towards ‘industrialised’ lifestyle habits such as increased smoking, alcohol consumption, unhealthy diets, obesity and lack of physical exercise, which we know are linked to cancer.
Who should ensure decisive action is taken against these known risks?
First the researchers need to provide reliable scientific evidence on which to base decisions. Once the scientific evidence is available it is down to national authorities to make informed regulatory decisions. However, scientists can probably explain the interpretation of their findings more clearly when presenting them to decision-makers.
Why is prevention so hard?
There are different elements involved. First, intervention may require co-ordination across different parts of government and society. Second, there are often infrastructural, economic or cultural barriers. For example, in some developing countries, vaccinating against human papilloma virus to prevent cervical cancer might be interpreted as a signal of sexual promiscuity. This is why I think much more research has to be conducted on the factors which affect the implementation of prevention in routine healthcare settings. This is an often neglected area.
Finally, sometimes the case is not made politically and there is a failure to translate scientific evidence into guidelines. One of IARC’s important jobs is to evaluate prevention strategies, to find out what works. This research must be independent of vested interests, and here the position of the Agency within the UN has a major advantage. It also gives us the opportunity to improve the translation of knowledge into action at the level of individual countries.
Where do we need to invest more in the fight against cancer?
Prevention is central to reducing the rising trend of cancer, and we know that more than 50% of cases could be prevented if what is currently known were to be implemented efficiently; if governments took strong action, such as enforcing anti-tobacco controls, ensuring vaccination against HBV and HPV, promoting healthier lifestyles and improving access to health care including the early detection of breast, cervical, and colorectal cancers. But investment in prevention requires the vision, courage, and political leadership to make decisions and financial commitments that will bear fruit, often many years in the future.
You can read a related post here.