Cancer Control and Global Health:
In conjunction with a high-level United Nations meeting on non-communicable diseases in the developing world, NCI Director Harold Varmus, M.D., and Edward L. Trimble, M.D., NCI, have published a commentary in Science Translational Medicine on “Integrating Cancer Control into Global Health.” The article highlights NCI’s impending launch of a Center for Global Health, to be directed by Trimble, which will coordinate the development of a research program to promote progress against cancer worldwide, through research activities conducted by NCI and by many potential collaborators interested in those shared objectives. The institute’s efforts are based, in part, on the success of current global health programs in communicable diseases. Because cancer is typically one of the more prevalent diseases in older populations, and developing countries are experiencing rising numbers of cancer due to population growth, population aging, and an increased prevalence of risk factors, such as obesity and the use of tobacco and alcohol, this effort takes on a special urgency. For example, in 2008, nearly eight million people died from cancer worldwide, and almost two-thirds of those deaths occurred in developing countries. By 2030, if concerted efforts are not put in place, the number of cancer deaths may top 13 million, with close to 70 percent of deaths occurring in developing countries.
The authors note that distinctions between traditional approaches to global health and those required to combat non-communicable diseases are not always clear-cut. For example, nearly a quarter of life-threatening cancers in the developing world result from infections with viruses (HPV and cervical cancer, for example), bacteria, and parasites. The authors also note that prevention strategies for control of tobacco and alcohol abuse, which entail behavioral changes, can offer multiple, long-term health benefits, generally at low cost. Additionally, they point out that components of cancer care extend well beyond inexpensive anticancer drugs and simple surgeries, and can include analgesics and anti-emetics for symptom control and other methods for palliative care. In conclusion, Varmus and Trimble note that NCI’s new Center for Global Health will not be NCI-centric, but rather will promote a collaborative effort to reduce the burden that cancers impose on people and countries around the world. To view the commentary, please go to http://stm.sciencemag.org/content/3/101/101cm28.full.