by Michael Woodhead
Forget about the smog scare - if you want to tackle cancer in China, you need to focus on smoking, diet and physical activity. That's the message from the Asian regional representatives for the World Health Organisation in the Lancet this week. Cherian Varghese and Shin Hai-Rim urge China to act on the obvious causes of cancer and implement practical programs that will achieve the greatest change with the least resources.
In their commentary they note that China has a huge burden of cancer, but there is still a lot that is not known about the causes of cancer and the types of cancer in China. They note there is a lot of concern about very evident environmental factors such as air pollution, but they say this is a minor contributory factor compared to factors such as infectious diseases, smoking, poor diet, alcohol consumption and lack of physical activity. Therefore they say much could immediately be done to prevent and reduce cancers by implementing policies such as smoking cessation and vaccinating against hepatitis B and HPV. They also stress the need for a more skilled health workforce and system to deal with cancer, such as by identification of early-stage disease, referral, and palliative care. They warn against the temptation to put resources into expensive new cancer drugs, which would probably have only minimal effect on cancer survival rates.
"A set of very cost-effective interventions are provided in the [WHO] Global
Action Plan to reduce tobacco and harmful alcohol use, improve unhealthy
diets, and increase physical activity. These measures are mostly
regulatory, legal, and fiscal interventions, and will affect rates of
non-communicable diseases (including cancer) in large populations," they say.