Prevention, Anyone?

Elise Miller, MEd
CHE Director

Elise Miller, MEdYesterday, I attended the memorial service of another friend who died from cancer. For most of his career (which was still very much in full gear), he went around the world working with governments and other agencies to reduce pollution from mining operations. He was dedicated to improving the health of those working in the mines, their families, and their communities. As I sat with his family and dear friends, I wondered whether the heavy metals and other toxins he had been exposed to on those trips might have contributed to the onset of his cancer. We’ll never know, but the World Cancer Report released last week by the World Health Organization stating that cancer rates are expected to increase by 57% worldwide in the next 20 years gave me pause.

The report indicated that within two decades cancer cases will rise from 14 million annually to 22 million, and deaths from cancer could rise from 8.6 million to 13 million annually. This could mean that health care systems around the world, many of which are already stretched to the point of breaking, will need significantly more resources to respond to this looming crisis. This could also mean that many, many more people will be attending funerals and memorial services and will carry the grief of losing loved ones too soon.

In response to last week’s WHO report, Dr. Christopher Wild, director of the International Agency for Research on Cancer, said, “We cannot treat our way out of the cancer problem. 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.”

Notably, another report released by WHO some years ago stated that environmental risk factors play a role in more than 80% of all diseases, including cancer. In addition, nearly one quarter of all deaths related to the total disease burden can be attributed to the environment, and for children, that percentage increases to slightly more than one-third.

In the US, we can point to decreasing mortality rates from cancer because improved medical treatments allow people to live longer. But the incidence of certain cancers such as childhood leukemia and brain cancer, as well as other disease endpoints like diabetes and obesity, continue to rise alarmingly. As poorer countries become more developed, those populations are also expected to experience an increase in the burden of diseases associated with industrialized lifestyles.

Clearly this means that investing in prevention is more urgent than ever. We know that if preventable contributors to disease, such as environmental contaminants, are not addressed, some of us may live a bit longer if we’re fortunate enough to have access to good health care, but even then, the quality of those years may be sorely undermined by the struggle to manage the symptoms of chronic disease—not to mention the exorbitant medical expenditures and the emotional and social toll on the individual, their family, and community.

Will another report by WHO shift our global obsession with treating disease to a greater emphasis on prevention? Very likely not. Will we immediately implement prevention-oriented regulations in the wake of horrific chemical spills like the one in Charleston, West Virginia, a month ago? Probably not.

But I do believe that the dedicated efforts by each of us to press for prevention in health care, to press for stronger public health policies, to press for healthy environments for our children, and much more, do build a collective momentum in ways we cannot always see or understand. We will never know when the tipping point may come (or if it will happen in our lifetimes), but our work at every level of society can move us towards a world in which another WHO report might finally state that cancer rates have dropped by 57% and all chronic diseases are steadily on the decline.

I look forward to continuing to collaborate with all of you with that goal in mind.

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