Fewer people in the EU may be dying of cancer, but its incidence rose by almost 20% from 2002 to 2008, reports a special issue of the European Journal of Cancer (EJC) published on 13 September. Studies presented in the EJC, which is the official journal of the European Cancer Organisation (ECCO), received funding from the EUROCADET ('The impact of key determinants on the current and future burden of cancer in Europe') project, which received more than EUR 987 000 under the 'Research for policy support' cross-cutting activity of the Sixth Framework Programme (FP6). In one of the papers presented in EJC, Dr José M. Martin-Morena of the University of Valencia in Spain said the current economic crisis in Europe could potentially impact upon the incidence of this disease in myriad areas. For example, governments and pharmaceutical companies could be inclined to slash research and development (R&D) budgets; public donations to cancer research funded by charitable organisations could drop; and occupational exposure to carcinogens is likely to increase. 'Both private companies and governments tend to take shortcuts in occupational safety controls during periods of economic hardship,' Dr Martin-Moreno explained. 'This is especially true for small companies and in developing countries.' A study from South Korea, conducted in the late 1990s, found that health and safety cost cuts were directly linked to one's capacity to avoid bankruptcy. 'This exemplifies the terrible choice businesses have to make in times of economic downturn - reduced safety for workers or economic ruin,' Dr Martin-Moreno said. 'For industries with potentially high levels of carcinogenic contamination such as mining this effect is compounded.' Researchers have pointed out that cancer prevention encompasses various factors such as genetics, the environment, employment, lifestyle choices, infections, and access to preventive healthcare. So ideally, efforts to control this disease would coincide with efforts to control hypertension as well as to curb greenhouse gas emissions. According to the researchers, people must step up to the plate and act in order to prevent the further spread of cancer. When cancer grows, people pay the price. Health systems also feel the pressure, as costs surge and treatment and care resources are overstretched. Experts believe however that, with a little effort, cancer prevention could be strengthened during times of crisis, rather than the reverse.. Cutting costs by adopting healthier lifestyle habits could help many avoid cancer. 'Governments could also play their part by taking the opportunity to levy higher taxes on tobacco, alcohol and other unhealthy goods like trans fats or processed sugar and channelling the revenue thus derived towards job-creating disease prevention and social welfare programmes,' Dr Martin-Moreno commented. In another study, Dr Esther de Vries of the Erasmus Medical Centre Rotterdam in the Netherlands investigated with colleagues how preventing weight gain and promoting physical activity impacts colon cancer incidence in seven European countries (Czech Republic, Denmark, Spain, France, Latvia, Netherlands and UK). Since 1975 the colon cancer incidence in Europe has risen, so that it accounted for more than 13% of the cancer burden by 2008. Colon cancer ranks second in cancer mortality in Europe. 'Yet we know that large numbers of colon cancer cases could be avoided by reducing exposure to risk factors, two of the most easily controllable of which are related to physical inactivity and excess weight,' explained co-author Dr Andrew Renehan of the University of Manchester in the UK. Physical inactivity triggers a bigger body mass index (BMI), while increased physical activity helps people avoid weight gain. It should be noted that increased physical activity does not necessarily result in weight loss for overweight people. On the whole, researchers realise that making lifestyle changes is not easy. 'We can safely say increasing physical activity across Europe to the level already achieved in the Netherlands, where everyone cycles, would be of substantial benefit,' explained Professor Jan-Willem Coebergh from Erasmus University, one of the editors of the special issue. 'But we will always need sound evidence before prevention strategies can be implemented.' For his part, Professor Michael Baumann of the University Hospital and Medical Faculty, Dresden, Germany, and ECCO President said: 'Cancer prevention may not be foremost in the policymakers' minds at present, but right now it is more relevant than it has ever been before. We hope that the evidence so amply provided in this special issue of the EJC will help make them decide to follow the right road and take a major step towards reducing the incidence of cancer in Europe over the years to come.'
Czechia, Denmark, Spain, France, Latvia, Netherlands