Cancer
WHO Fact Sheet No 297
February 2011
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Cancer : key facts
Cancer is a leading cause of death worldwide and accounted for
7.6 million deaths (around 13% of all deaths) in 2008.
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Tobacco use is a major risk factor for cancer. Harmful alcohol use,
poor diet and physical inactivity are other main risk factors.
Certain infections cause up to 20% of cancer deaths in low- and
middle- income countries and 9% of cancer deaths in high-income
countries.
More than 30% of cancer deaths can be prevented.
Cancer arises from a change in one single cell. The change may be
started by external agents and inherited genetic factors.
Deaths from cancer worldwide are projected to continue to rise to
over 11 million in 2030.
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Cancer
Cancer is a generic term for a large group of
diseases that can affect any part of the body.
Other terms used are malignant tumours
and neoplasms. One dening feature of
cancer is the rapid creation of abnormal
cells that grow beyond their usual
boundaries, and which can then invade
adjoining parts of the body and spread to
other organs. This process is referred to as
metastasis. Metastases are the major cause
of death from cancer.
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Cancer: the problem
Cancer is a leading cause of death worldwide and accounted
for 7.6 million deaths (around 13% of all deaths) in 2008.
The main types of cancer are:
LUNG (1.4 million deaths)
STOMACH (740 000 deaths)
LIVER (700 000 deaths)
COLORECTAL (610 000 deaths)
BREAST (460 000 deaths).
More than 70% of all cancer deaths occurred in low- and
middle-income countries. Deaths from cancer worldwide
are projected to continue to rise to over 11 million in 2030.
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What causes cancer ?
Cancer arises from one single cell. The transformation
from a normal cell into a tumour cell is a multistage
process, typically a progression from a pre-cancerous
lesion to malignant tumours. These changes are the result
of the interaction between a person's genetic factors and
three categories of external agents, including:
physical carcinogens, such as ultraviolet and ionizing
radiation;
chemical carcinogens, such as asbestos, components of
tobacco smoke, aatoxin (a food contaminant) and
arsenic (a drinking water contaminant); and
biological carcinogens, such as infections from certain
viruses, bacteria or parasites.
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Cancer and ageing
Ageing is another fundamental factor for the
development of cancer. The incidence of
cancer rises dramatically with age, most
likely due to a build up of risks for specic
cancers that increase with age. The overall
risk accumulation is combined with the
tendency for cellular repair mechanisms to
be less effective as a person grows older.
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Risk factors for cancer
Tobacco use, alcohol use, unhealthy
diet, and chronic infections from
hepatitis B (HBV), hepatitis C virus
(HCV) and some types of Human
Papilloma Virus (HPV) are leading risk
factors for cancer in low- and middle-
income countries. Cervical cancer,
which is caused by HPV, is a leading
cause of cancer death among women in
low-income countries.
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How can the burden of
cancer be reduced ?
Knowledge about the causes of cancer,
and interventions to prevent and
manage the disease is extensive.
Cancer can be reduced and controlled
by implementing evidence-based
strategies for cancer prevention, early
detection of cancer and management of
patients with cancer.
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Cancer: modifying and
avoiding risk factors
More than 30% of cancer could be prevented by
modifying or avoiding key risk factors, including:
> tobacco use
> being overweight or obese
> low fruit and vegetable intake
> physical inactivity
> alcohol use
> sexually transmitted HPV-infection
> urban air pollution
> indoor smoke from household use of solid fuels.
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Cancer:
Prevention strategies
Increase avoidance of the risk factors listed
above.
Vaccinate against human papilloma virus
(HPV) and hepatitis B virus (HBV).
Control occupational hazards.
Reduce exposure to sunlight.
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Cancer:
Early detection
Cancer mortality can be reduced if cases are
detected and treated early. There are two
components of early detection efforts: Early
diagnosis and Screening
Early diagnosis is the the awareness of early
signs and symptoms (such as cervical, breast
and oral cancers) in order to facilitate diagnosis
and treatment before the disease becomes
advanced. Early diagnosis programmes are
particularly relevant in low-resource settings
where the majority of patients are diagnosed in
very late stages.
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Cancer:
Screening
The systematic application of a screening test in an
asymptomatic population. It aims to identify individuals with
abnormalities suggestive of a specic cancer or pre-cancer and
refer them promptly for diagnosis and treatment. Screening
programmes are especially effective for frequent cancer types
that have a screening test that is cost-effective, affordable,
acceptable and accessible to the majority of the population at
risk.
Examples of screening methods are:
> Visual inspection with acetic acid (VIA) for cervical cancer in low-
resource settings;
> PAP test for cervical cancer in middle- and high-income settings;
> Mammography screening for breast cancer in high-income
settings.
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Cancer treatment
Treatment is the series of interventions, including
psychosocial support, surgery, radiotherapy, chemotherapy
that is aimed at curing the disease or considerably
prolonging life while improving the patient's quality of life.
Treatment of early detectable cancers
Some of the most common cancer types, such as breast cancer,
cervical cancer, oral cancer and colorectal cancer have higher
cure rates when detected early and treated according to best
practices.
Treatment of other cancers with potential for cure
Some cancer types, even though disseminated, such as leukemias
and lymphomas in children, and testicular seminoma, have high
cure rates if appropriate treatment is provided.
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Cancer: palliative care
Palliative care is treatment to relieve, rather
than cure, symptoms caused by cancer. Palliative
care can help people live more comfortably; it is
an urgent humanitarian need for people
worldwide with cancer and other chronic fatal
diseases. It is particularly needed in places with
a high proportion of patients in advanced stages
where there is little chance of cure.
Relief from physical, psychosocial and spiritual
problems can be achieved in over 90% of advanced
cancer patients through palliative care.
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Palliative care strategies
Effective public health strategies,
comprising of community- and home-based
care are essential to provide pain relief and
palliative care for patients and their families
in low-resource settings.
Improved access to oral morphine is mandatory
for the treatment of moderate to severe cancer
pain, suffered by over 80% of cancer patients in
terminal phase.
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Cancer: WHO response
In 2008, WHO launched its
Noncommunicable Diseases Action Plan.
WHO and the International Agency for Research
on Cancer (IARC), the specialized cancer agency
of WHO, collaborate with other United Nations
organizations and partners in the areas of
international cancer prevention and control to:
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WHO-IARC efforts aim to:
increase political commitment for cancer prevention and control;
generate new knowledge, and disseminate existing knowledge to
facilitate the delivery of evidence-based approaches to cancer control;
develop standards and tools to guide the planning and implementation of
interventions for prevention, early detection, treatment and care;
facilitate broad networks of cancer control partners at global, regional
and national levels;
strengthen health systems at national and local levels;
provide technical assistance for rapid, effective transfer of best practice
interventions to developing countries; and
coordinate and conduct research on the causes of human cancer, the
mechanisms of carcinogenesis, and develop scientic strategies for
cancer prevention and control.
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