Cancer - Know the Numbers

This information in this post was gathered from the most recent version of Cancer Facts and Figures 2013, published by the American Cancer Society.
    New cases of cancer projected for 2013 are primarily of the lung, breast, colon/rectum and prostate. The biggest killers, based on my quick scanning of the number projected to occur and the number projected to cause death, are lung, colon and pancreas.  The number of new cases of pancreatic cancer are a quarter that of lung cancer, and 13% them will die.  Half the lung cancer patients will also die (slightly more men than women).  Tobacco is expected to contribute to 174,100  of the 2013 cancer deaths (most will be from lung cancer).  In the American Cancer Society report, a chart showing the trends for cancer death rates  is remarkable in its depiction of lung cancer.  It trends up for both men and women, hitting a peak for men about ten years earlier - and has been declining in men from about 1990 and more recently for women.  A review of the research on smoking suggests that these trends are related to when men and woman started to smoke (different era) and when they started to quit.  It is the kind of graph that smoking friendly countries need to consider.  The incidence of cancer comes some ten to twenty years after smoking rates pick up.
   We lack effective treatments for pancreatic, lung and colon cancers.  However, colon cancer is one that can be prevented, like cervical cancer, by regular screenings which identify pre cancerous lesions that can be removed.  (Breast cancer is one that continues to occur but kills less people because of treatment options)
   What is most important from my position in public health is that as much as 33% of the projected new cancer cases could be prevented because they are associated with poor diet, overweight/obesity and lack of physical activity.  
   Cancers that are caused by infections, such as HPV, HBV, and HCV may be avoided with vaccines.  HIV related cancer can be reduced by preventing the transmission of HIV through safer sexual contact.
   Other risks for cancer include genetic and environmental.  Usually a series of events occur before cells mutate into cancer.  We are getting better at finding cancer sooner, but it can be as many as ten years from an exposure to a diagnosis (think smoking, suntanning, CT scans, phthalates in plastic, etc).
   There is so much more to tell you, and I regret not having the time to really dive into this report - as I have in years previous. Instead, I strongly encourage you to open this document.  The introduction alone is worth its length in gold.  It explains what cancer is, what may lead to it,  how it is diagnosed and staged and what certain terms like life time risk and relative risk mean.  
   Briefly, the life time risk of developing any type of cancer is about 44% for men and 38% of women.  This is in general and does not take into account any of your individual risks or protective factors (i.e., it could be higher or lower for you).  The life time risk for a certain cancer maybe higher or lower than those numbers as well.  Relative risk, as explained in the document, is when you compare a persons risk to someone elses - someone who may be different.  For example, the relative risk of lung cancer between smokers and non smokers, or colon cancer between those who eat a plant based diet and those who eat a meat based diet.
   Please take the time to look at the document.  I know you have heard about this on the news lately - or seen newspaper articles, but its not the same as "being there".

Let's Make Prevention the Priority

   At the end of August, the World Cancer Congress 2012 was held in Canada.  The congress is a meeting of professionals - research and practice - that occurs every two years.  The purpose is to share experience and knowledge to impact change in cancer occurrence and outcomes (death). 
   Once again, but with growing unity and urgency, people who study cancer in labs, communities and patients and those who treat patients, tell us that at the very least 50% of cancer can be prevented.  
   Prevented by what we do, what we are exposed to, whether or not we are immune to viruses (HPV, HCV, HBV) and the screenings we complete (PAP, sigmoidoscopy). 
   Graham Colditz, PhD, DrPH was one of the presenters.  He notes smoking as the cause of 30% of all cancer and said that reducing smoking rates to 11% (like in Utah) would reduce smoking related cancers by 75%.  He also noted that being overweight accounts for about 20% of cancers (and that to prevent cancer the BMI range should be between 21 to 23).  Physical inactivity and poor diet ( defined as a diet that does not include the better foods in adequate amounts and does not limit others (salt, trans fat, sat fat, sugar) each cause about 5% of cancer and if improved would reduce the new cases of cancer substantially.
   I have no doubt that this is true.  Therefore, I have strong reservations on spending my money (donations) or the governments money to explore treatment/cures when we are doing nothing to stop the cases from coming.  It is like this familiar health care story.  Do we keep training EMTs, buying ambulances and expanding hospital ER rooms to treat drowning victims - or do we fix the hole in the bridge. Public health folks, like me, want to fix the bridge. {some people would do neither and just educate people to stop falling into the hole!}
    I would like money to be spent on improving our environment so that eating well, moving more, consuming the right amount of calories, getting appropriate and evidence based health screenings and vaccinations is EASY.  (even if this means some kind of regulation)
   We are fools to keep treating things that we can prevent.  (I in no way place blame on cancer or heart disease patients and I am not suggesting that we not treat their illnesses. [the pharmaceutical industry would never have that!] I just want to point out the futility on a population level.   I see the environment and health care system as places to intervene, and when situations are truly conducive to good health, then I view personal responsibility as a possible nationwide focus.) 

 See more about the World Cancer Congress and the UICC here.
{note when looking at studies or speeches like this - there are two sets of numbers to explore - the percent of cancer that is accounted for by a factor and the amount that can be prevented if that factor is addressed}