Tuesday, February 4, 2014

WHO predicts a 57% rise in cancer cases, over half of which will be preventable...

Today is World Cancer Day, and reports from the World Health Organization are devastating in the projections of a 57% rise in the number of cases, forecasting a human disaster within two decades.
(See WHO: Cancer cases tipped to rise 57% in 20 years in imminent 'human disaster' by Tim Hume, CNN, February 4, 2014, below)
And if it is true that at least half of these cases are preventable, as the report suggests, and that governments will have to take a similar approach to alcohol consumption and sugary drinks as they have to smoking, at a time when, at least in the United States, government interferences in the lives of individuals is considered one of the most insidious threats, that kind of government action will come at a very high price.
Similarly, the prevention of air pollution, another of the significant contributors to the development of cancers, will have to rise to the top of the legislative agenda in most countries, especially those in the developed world, where much of the pollution is generated.
We have been urging common, collaborative approaches to the problems of national security, for sevveral months, without generating much if any support. Russia, for example, has proven especially insular in rejecting U.S. support in providing security for the Sochi Olympic Games, set to open in two or three days. There have, however, been murmurings coming from minor Russian voices urging some move to a common voice on matters of foreign affairs among the major powers.
However, it is not only a myopic and narcissistic commitment to restricting the size and scope of government that will impede progress in implementing the WHO report that calls for aggressive actions on prevention. The world is full of examples in which public policy and action are much more likely to be implemented following a crisis than in cases where it occurred as prevention.
The human being, it seems, either seeks the risk that prevention will not be needed, or it prefers not to have to pay for something that has not yet occurred. We have seen a myriad of examples in the child welfare sector, for example, in which action and policy and implementation followed too many crises in the lives of individual children, when prevention of the crisis in the first place would have made crisis intervention unnecessary.
However, compared with crisis intervention, there is simply no drama, and no excitement and nothing sexy about prevention. It comes when things seem to be going well and when there is no need for public intervention. Governments, traditionally, are rear-guard actions, coming in after the crisis has become full blown, and not before the impending crisis has tipped its hand. And that phenomenon, or that dynamic, will have to be one of the main focuses in any concerted, collaborative and effective response to the WHO report, calculated as it no doubt is, to generate as much public concern as possible.
We commend the WHO for its collective courage even to publish such a report. Sometimes there is a tendency to avoid telling the patient the impending danger of a lifestyle over which the individual seeks to maintain a stubborn and private control. And, we have to acknowledge that, especially in the U.S. but also in other countries, there is a very strong theme of rugged individualism, a kind of keep government out of my life religion keeps the NRA, for example, at the forefront of the public debate on gun control and prevents legislation that would require background checks, and limit the size of clips to ten rounds, rather than the 30 or more rounds that have become evidence in several of the mass killings in the U.S.
Humans have a highly developed capacity to ignore, to deny and obviously then to avoid danger signs, especially those that come from bureaucracies that operate in a different country, with researchers whose credentials are not publicly known and recognized. In fact, we are highly adept, through centuries of practice, at poo-pooing such proclamations as this report contains. And add to that a human resistance even to discuss the subject of an impending threat of death and you have ingredients that will make passing legislation to restrict human choices, treading on the sacred ground of individual human freedom, something that frontier people guard with their AK-47, and you have a breeding ground for considerable civil unrest.
We humans have shown limited acceptance of the dangers of global warming and climate change, protesting even the science of its own foreshadowing as debatable for decades. When it comes to individual human lives being numbered in cases of personal cancer from causes that exist around the world, from consumables that come from sources of income for millions and for corporate dividends in the alcohol and juice businesses, as well as in corporate generation of carbon dioxide in the production processes of those profit-seeking and profit-generating companies, the debate will likely be framed as whose lives are more important to protect.
And once again, as we have witnessed so tragically in the tobacco debate, millions of lives have been lost because a monumental lobby of cash operated to deny the dangerous impact of smoking on human health and delayed by decades the implementation of public bans on cigarette smoking. We can anticipate a similar lobby from both the juice and the alcohol production industries rejecting the science that links their commodities to the generation of individual cancer cases. It is, after all, they will argue, their livelihood that is at stake, and the livelihood of those millions of people who work in those industries that will be impacted by restricting production and consumption of their products.
Currently, a similar lobby is vocal and ubiquitous in support of the retention of coal as an energy for the production of electricity, even though we know that coal emissions contribute significantly to our own restricted intake of oxygen necessary for the sustaining of individual lives.
In the long run, if this report has validity, as we calculate it clearly does or it would not have been released, we are facing what amounts to a real-life in real time (NON) simulation game of whose life is worth protecting. And we have never been very successful in holding public debates in a rational and respectful manner about that kind of question.
We can already see the foreshadowing of that kind of public question in our health care systems with limited resources have to be distrubuted to meet an infinite need and having to prioritize that distribution. Of course, we do not make a big news story of those decisions made every day in every cancer clinic in the world. However, we are already intimately engaged in that process.
A single operating theatre and a single cancer surgeon can only operate on a finite number of serious cases, and those that are deemed less serious have to wait. And that interface will only grow into a full blown public consciousness and conflict as the implications of reports like the one issued today by the WHO continue to march across our computer screens, our headlines and our television newscasts.
And each of us has a significant part to play in how it is played out because each of us knows that our grandchildren will be directly impacted by whatever decisions are taken. We can do our part in paving the way for a healthy and rational and respectful debate with accompanying legislation that attempts to balance competing interests in ways that we have not easily found and implemented so far.

WHO: Cancer cases tipped to rise 57% in 20 years in imminent 'human disaster'
By Tim Hume, CNN website, February 4, 2014
CNN) -- Cancer cases are expected to surge 57% worldwide in the next 20 years, an imminent "human disaster" that will require a renewed focus on prevention to combat, according to the World Health Organization.
The World Cancer Report, produced by the WHO's specialized cancer agency, predicts new cancer cases will rise from an estimated 14 million in 2012 to 22 million annually within two decades. Over the same period, cancer deaths are tipped to rise from 8.2 million a year to 13 million annually.
The rising incidence of cancer, brought about by growing, aging populations worldwide, will require a heavier focus on preventive public health policies, said Christopher Wild, director of the International Agency for Research on Cancer.
"We cannot treat our way out of the cancer problem," he said. "More commitment to prevention and early detection is desperately needed in order to complement improved treatments and address the alarming rise in cancer burden globally."
The report notes that the rocketing cost of responding to the "cancer burden" -- in 2010, the economic cost of the disease worldwide was estimated at $1.16 trillion -- is hurting the economies of rich countries and beyond the means of poor ones.
The report said about half of all cancers were preventable, and could be avoided if current medical knowledge was acted upon. The disease could be tackled by addressing lifestyle factors, such as smoking, alcohol consumption, diet and exercise; adopting screening programs; or, in the case of infection-triggered cancers such as cervical and liver cancers, through vaccines.
Cutting smoking rates would have a significant impact, as lung cancer remained the most commonly diagnosed cancer (1.8 million cases a year, or 13% of total cancer diagnoses) and the deadliest, accounting for about a fifth (1.6 million) of all cancer deaths worldwide.
The report's authors suggested governments take similar legislative approaches to those they had taken against tobacco in attempting to reduce consumption of alcohol and sugary drinks, and in limiting exposure to occupational and environmental carcinogens, including air pollution.
According to the report, the next two most common diagnoses were for breast (1.7 million, 11.9%) and large bowel cancer (1.4 million, 9.7%). Liver (800,000 or 9.1%) and stomach cancer (700,000 or 8.8%) were responsible for the most deaths after lung cancer.
"The rise of cancer worldwide is a major obstacle to human development and well-being," said Wild. "These new figures and projections send a strong signal that immediate action is needed to confront this human disaster, which touches every community worldwide."
The report said the growing cancer burden would disproportionately hit developing countries -- which had the least resources to deal with the problem -- due to their populations growing, living longer and becoming increasingly susceptible to cancers associated with industrialized lifestyles.
More than 60% of the world's cases and about 70% of the world's cancer deaths occurred in Africa, Asia, and Central and South America.
Governments needed to appreciate that screening and early detection programs were "an investment rather than a cost," said Bernard Stewart, co-editor of the report -- and low-tech approaches had proven successful in some developing countries.
The World Cancer Report, which is published about once every five years, involved a collaboration of around 250 scientists from more than 40 countries. Tuesday is World Cancer Day.

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