|Year : 2016 | Volume
| Issue : 3 | Page : 95-96
Mainstreaming cancer control in non-communicable disease agenda
Department of Radiotherapy and Oncology, PGIMER, Chandigarh, India
|Date of Web Publication||18-Jan-2017|
Department of Radiotherapy and Oncology, PGIMER, Chandigarh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Kapoor R. Mainstreaming cancer control in non-communicable disease agenda. Int J Non-Commun Dis 2016;1:95-6
The incidence of cancer is increasing worldwide, and this is more so in developing countries.  There were around 356,860 new cases of cancer in 2014, that's 980 cases diagnosed every day. In males, there were around 181,000 cases of cancer diagnosed, and there were around 176,000 cases in females. Since the late 1970s, incidence rates for all cancers combined have increased by almost a third (30% increase) in Great Britain. The increase is larger in females where rates have increased by almost two-fifths (37%), than in males where rates have increased by less than a fifth (17%). We all know that cancer registries are not fully operational in many developing regions of the world. Hence, the global picture regarding the overall incidence and prevalence may need some more careful thoughts. As regards the causative agents for cancer, there are defined risk factors, and most of them share common grounds with other non-communicable diseases (NCDs).
Cancer is not just a health matter. It has wide-reaching social, economic and human rights implications and is a significant barrier to achieving inclusive and equitable development. Inequality is deepening social and environmental factors, and many low- and middle-income countries are fighting the double burden of disease exposures, chronic poverty and threatening national economies. Broadening the internationally agreed development goals to include proven economically sound interventions that span the entire cancer control and care continuum can strengthen health systems and increase capacity to respond to all of the challenges to sustainable development. Positioning cancer in the post-2015 global health and sustainable development agenda, for the first time, all Member States of the United Nations have agreed that NCDs constitute a major challenge to socioeconomic development, environmental sustainability and poverty alleviation. The UN Political Declaration in 2011 committed governments to strengthen and integrate NCD policies and programmes into health planning processes and national development agendas. Further to this declaration, in June 2012, the Rio Declaration on Sustainable Development acknowledged that the global burden of NCDs constitutes one of the today's major challenges for development, and in 2013, the World Health Organization (WHO) adopted the Global Action Plan for the Prevention and Control of Non-communicable Diseases 2013-2020, which declared that the prevention of NCDs including cancer is a precondition for, an outcome of and an indicator of all three dimensions of sustainable development: economic development, environmental sustainability and social inclusion. As the 2015 development agenda gains momentum till 2030, it is imperative that cancer and other NCDs are mainstreamed within development cooperation initiatives. Interventions at the primary healthcare level restrict women in developing countries from accessing essential cancer services including education on cancer prevention and early detection programmes. In addition, more than 70% of the world's children with cancer lack access to treatment. The result is an unacceptably low survival rate of ~10% in some low- and middle-income countries compared to ~90% in some high-income countries.
There is a dire need for all people to have access to effective cancer treatment and services on equal terms, and without suffering economic hardships. Cancer prevention efforts, including access to information and education about cancer at the primary healthcare level, early detection programmes and affordable, quality medicines, vaccines and technologies, will reduce cancer deaths and disability. The risk that cancer poses to economic growth and development is still not perceived despite the fact that we know that this risk can be managed effectively and that a return on investment in health is possible. The cost of cancer is estimated to reach $458 billion in 2030, and the WHO estimates that a basic package of cost-effective strategies to address the common cancer risk factors (tobacco, alcohol, diet and physical activity) would cost only $2 billion a year. Investing in prevention and early detection of cancer is cheaper than dealing with the consequences. A diagonal approach that focusses on the integration of health services including integrating cancer prevention and management with broader NCDs into primary healthcare will tackle cancer-specific priorities while addressing the gaps within the health system, optimising the use of resources and increasing capacity to respond to many diseases and population groups. In India, National Cancer Control Programme was integrated into broader National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke since 2010;  however, it is yet to be mainstreamed and effectively implemented. Challenges include poor health system, lack of capacity of staff, functional integration and poor focus on cancer prevention. In addition, a wide range of environmental causes of cancer, encompassing environmental contaminants or pollutants in air and water, occupation-related exposures such as asbestos, radiation and excessive sunlight, together make a significant contribution to the cancer burden and may further strengthen the case for mainstreaming.
A comprehensive, integrated approach that promotes multisectoral action and partnerships including the private sector is essential to develop and implement evidence-based policies, legislation and NCD programmes that reduce the level of exposure to risk factors for cancer and strengthen the capacity of individuals to adopt healthy lifestyle choices. Such approaches may be possible if cancer control is mainstreamed into broader NCD agenda. This approach is definitely going to help in tackling the increasing incidence of cancer, which is perceived to be the Emperor of all Maladies.
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