Advancing World Health Day

By Nathan Grey, MPH, National vice president of global health for the American Cancer Society

Cancer is among the most preventable and the most curable of the major chronic life-threatening diseases. Unfortunately, it remains a leading killer worldwide. In 2008, there were an estimated 12.7 million new cases of cancer and 7.6 million cancer deaths (GLOBOCAN 2008, IARC). Cancer accounts for 1 in 8 deaths throughout the world. That's more than HIV/AIDS, tuberculosis, and malaria combined. While this loss of life alone is staggering, the impact on those affected, their caregivers, and society-at-large is also profound. 

Several factors account for the growing global burden ofcancer including aging populations, tobacco use, poor diet and lack of exercise, and exposure to infectious agents associated with cancer. Poverty, gender inequities, and misconceptions about cancer's causes and treatments often exacerbate the situation. In addition, there are large disparities in the capacity of health care systems, governmental programs, and nongovernmental organizations to serve their populations. Many low and middle-income countries have few, if any, early detection and prevention efforts, and treatment options are often limited.

The growth and aging of populations is particularly important because it represents both a remarkable public health triumph and the single greatest driver behind the increases in total cancer cases. During the past 50 years, growing wealth and economic opportunity, better nutrition and housing, safer food and water, improved hygiene and sanitation, changes in reproductive practices, and increased use of antibiotics and vaccines have led to better control of communicable diseases, reductions in childhood mortality, increases in life expectancy, and ultimately growing and aging populations. Simultaneously, tobacco's long tentacles have spread their influence around the world, thanks to globalization and urbanization facilitating the broad and aggressive marketing of tobacco products. This globalization has led to the growth of tobacco use (with 1.25 billion smokers worldwide), tobacco-caused morbidity and mortality, and increased adoption of a "western" lifestyle. People worldwide are eating more high calorie foods and reducing their physical activity, which are contributing to increases in overweight and obesity and the diseases associated with them. There are a staggering 1.6 billion people who are overweight worldwide and 400 million who are obese. The end result of these major trends is an increase in people with chronic (decades-long) exposure to cancer risk factors, and as a result, an increase in the number of cancer cases.

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