Cancer rates could rise by 50%, health body warns

Cancer rates across the world are likely to rise by 50% in the next 20 years unless Europe and the US check their junk food consumption, smoking, and sedentary lifestyles, and poorer countries improve their screening and infection controls.

A third of the predicted 15m cases in 2020 could be prevented, the World Health Organisation said yesterday, releasing a report on cancer which has taken three years to compile.

A further third could be successfully treated, and better palliative care would improve the quality of life of the remaining third.

But as cancer rates rise in developing countries it will become increasingly evident that there is a divide between the rich and poor when it comes to treatment, and a senior WHO official raised the prospect of a new front in the battle with the multinational drug companies to give poor countries access to medicines.

Rafael Bengoa, its director of management of non-communicable diseases, said that if the industry would not bring down the price of cancer drugs voluntarily he could envisage a political battle similar to that now being fought for Aids drugs.

The World Cancer Report makes it clear that people bring many cancers on themselves by an affluent lifestyle heavy in fat and light in fruit and vegetables and physical exercise.

Heavy drinking and, most of all, cigarettes are the immediate cause of many tumours. Those habits are spreading in some developing countries, bringing a recognisable pattern of prostate, breast, lung, colorectal and other cancers in their wake.

"Cancer is a disease that affects all of humankind," said Bernard Stewart, an adviser to the WHO's International Agency for Research on Cancer and co-editor of the report.

"Cancer is a preventable disease and something can be done about it.

"We have, with our low intake of fresh fruit and veg and high intake of fatty foods, together with a lack of exercise, managed to pull down on our heads a spectrum of diseases of which colorectal and breast cancer are just two.

"We should be eating about 500g of fresh fruit and vegetables a day. Our lifestyle will determine the diseases of the future."

Infections such as hepatitis (in the liver), human papilloma viruses (cervix), and Helicobacter pylori (stomach) are responsible for the increase in cancers in developing countries.

Vaccination against hepatitis and Helicobacter pylori is possible, and screening has significantly cut the number of deaths from cervical cancer in countries such as the UK.

"Perhaps that is the simplest thing that could be done by so-called 'barefoot doctors' across the world," Dr Bengoa said.

Too few people in poor countries had access to cancer drugs, particularly for palliative care, he said.

Pharmaceutical companies should introduce differential pricing so that their drugs could be sold for less in poor countries than in affluent ones.

If the drug companies did not reduce the price of cancer drugs to the poor the next stage would be to suggest that they should offer voluntary licences to allow generics companies in the developing world to make them at an affordable price.

Dr Bengoa raised the spectre of a battle with the multinational drug companies similar to that for Aids drugs. "If differential pricing does not work and voluntary licensing approaches are not working, one would have to get into stronger political agendas in order to get cancer drugs to the right place," he said.

Tobacco use is the greatest single cause of cancer, responsible for most of the world's 1.2m new lung cancer cases each year. Half of those who smoke regularly are killed by the habit, which is implicated in many other cancers as well as chronic lung disease, cardiovascular diseases and stroke.

Male cancer deaths in Finland have fallen from about 112 in 100,000 to about 75 in 100,000 since it introduced tough legal restrictions on smoking in 1976.