Need for political will to rein cancer

Clarity Sibanda, CNS Correspondent, Zimbabwe
The 2016 World Cancer Day comes at a time when the number of those who have been diagnosed with the disease has increased sharply. Cancer diagnosis has induced fear in many communities with several people seeing it as a death sentence, as the majority of those in developing countries can ill afford its treatment. Every year, the 4th of February marks the World Cancer Day and the day aims to raise awareness and promote reflection about what we can do collectively and individually to reduce the global burden of this dreaded disease.

It is jaw-dropping to note that among the many types of cancer, lung cancer is the biggest killer, accounting for 1.59 million deaths every year. The majority of lung cancers cases are caused by tobacco use and despite awareness being raised by governments and taxes being increased  on tobacco products, many are still ignorant of the fatal effects of smoking. Statistics show that many people start smoking at a young age, increasing the risk of developing cancer over the years. The practice is often adopted through socialization, peer pressure, and above all, through misleading advertising by the tobacco industry. The habit is reinforced by the development of psychological dependence derived from the nicotine content of tobacco. Fortunately, cessation of smoking can significantly reduce the risk tobacco associated cancers, including lung cancer.

Zimbabwe‘s first National Cancer Prevention and Control Strategy which advocates for a comprehensive cancer control policy and programme notes that cancer prevention and control requires a population-wide integrated and cohesive approach for prevention. Worldwide, tobacco use is the single largest causative agent of cancer, accounting for 20% of all cancer deaths globally. Tobacco smoke contains approximately 4,000 chemical substances, of which at least 50 are known carcinogens that can lead to cancer. In addition to lung cancer, tobacco consumption increases the risk of cancers of the oral cavity, larynx, oesophagus, pancreas, kidneys and even the bladder.

It must be mentioned that for regular smokers, the relative risk for development of lung cancer is more than 20 times higher than that of non-smokers. Environmental tobacco smoke and passive smoking also  poses carcinogenic risks. According to the 2009 annual report of Zimbabwe National Cancer Registry the five leading cancers among black Zimbabwean men were: Karposi sarcoma(20.8%), prostate cancer(13.7%), cancer of the oesophagus(6.3%),non-Hodgkin’s lymphoma(6.2%) and liver cancer(5.7%). The five most common cancers among Zimbabwean black women were cervical cancer (33.5%), breast cancer (11.7%), Kaposi sarcoma (8.9%), cancer of the eye(6,5%) and non-Hodgikin lymphoma(4.9%). In non-black men the most frequent cancer was non-melanoma skin cancer(50.7%), followed by that of prostate (10.8%),colon (6.9%),melanoma skin cancer (5.4%) and lung (4.9%). In non-black women the most common cancers were: non-melanoma skin cancer(35.4%), breast cancer(17.7%),cervical cancer(7.4%), non-Hodgkin’s lymphoma(5.1%) and colon cancer(3.4%).

Everyone is prone to cancer and even those with a celebrity status have not been spared. Terry Wogan, a television and radio personality, died at the age of 77 because of cancer, Alan Rickma, the Harry Potter star, died of pancreatic cancer. We cannot continue losing lives; therefore there is need for health literacy. These teach ‘ins’ on cancer will assist people to obtain, interpret and understand information. Health services and health care professionals are the critical link in ensuring that people obtain timely cancer screening and reduce their risk of developing cancer.

Prevention

Prevention is the most cost-effective way to curb the disease. 30%-40% of cancers can be prevented by avoiding certain known risks such as tobacco use, unhealthy diets, alcohol use and physical inactivity. Early detection of cancer is also important, but the problem in most developing countries, like Zimbabwe, is that patients may not seek treatment at an early stage due to resource constraints (as costs involved are very high) and general lack of awareness. Factors resulting in delays in early detection of cancers need to be addressed to improve treatment  outcomes.

According to Dr Tara Singh Bam, Regional Advisor (Tobacco Control) at the International Union Against Tuberculosis and Lung Disease (The Union), there is need for political will since the tobacco epidemic will never be solved in the corridors of hospitals and clinics but in the corridors of power. While speaking in a webinar organised by CNS, he argued that preventing initiation of tobacco use in adolescents is the most effective tobacco control strategy.

What still needs to be done

In order to curb this increase, smoke free legislation, which prevents smoking in all public places, must be implemented in order to be effective. Graphic health warnings should also be mandatory on all tobacco products. Increasing taxes on tobacco must not be underestimated since it is one of the most powerful tools for reducing tobacco use. It is also critical that governments move to restrict water pipe tobacco smoking, which is the latest fad spreading its tentacles, especially amongst the youth.

Everyone has a role to play in battling cancer, and as this year tagline reads ‘We can. I can’ we should do all we can to bring cancers, such as lung cancer, to a halt by stopping smoking and decreasing heavy consumption of alcohol.

Clarity Sibanda, Citizen News Service - CNS
February 12, 2016