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SPECIAL FEATURECancerBy Allan R. HandysidesWorldwideWhat’s the story in your region?Cancer is a major globaldisease. It’s estimated thatabout 13 million new casesand 7.6 million deaths from canceroccurred in 2008. This is an increasefrom 2003, when the World HealthOrganization’s World Cancer Reportnoted about 10 million new casesand some 6 million deaths. 1No region of the world is cancerfree.Age-standardized cancer ratesallow identification of particular geographicvariations, but not all databasesare of the same quality. Generalizations,however, can usually be madewith some degree of reliability.Regional differences in cancer ratesare very distinct. The United Statesrates high, with some 334 cases ofcancer per 100,000 men. Australia andNew Zealand, with 356.8 per 100,000,has worse statistics. Northern Europeat 303.5 and Western Europe at 337.4per 100,000 also have high rates. Therisk of dying from cancer is evenhigher in Central and Eastern Europe.Women in the same regions also havehigh rates of cancer, particularlybreast cancer.The lowest cancer rates occur inCentral and West Africa, and South-Central Asia for men and Central andNorth Africa for women. 2Affluent societies carry a higherburden of cancer, usually related totobacco smoking and other factorsassociated with a Western lifestyle.In developing countries, 25 percentof tumors are associated with chronicinfections such as hepatitis B (livercancer), human papilloma viruses(cervical cancer), and Helicobacterpylori (stomach cancer).In some Western countries therehas been a decline in cancer mortalityrates, because fewer people are smoking.Worldwide, lung cancer is themost common, followed by breastcancer and then colon cancer.Cancer deaths are most oftenrelated to lung, stomach, and livercancer. The increase in the world’spopulation is responsible for some ofthe gross increase in cancer statistics.Because some cancers are moreamenable to treatment, cancer ofbreast, prostate, and uterine/cervix,for example, are the cause of death inonly a minority of patients so affected.Causes of CancerMany factors impact the prevalenceof human cancer. These rangefrom cancer-inducing agents, or carcinogens,to chronic infections,dietary and lifestyle factors, alcoholconsumption, and genetic susceptibility.Some 20 percent of cancers areassociated with chronic infections.The most hazardous human carcinogensinclude tobacco, asbestos,aflatoxins, and ultraviolet light.TobaccoTobacco smoke is irrefutably causallyassociated with lung cancer. Lessrecognized is the association oftobacco with laryngeal, pancreatic,kidney, bladder, and—in conjunctionwith alcohol—oral and esophagealcancer.The age a person begins to smokeaffects incidence of cancer. Adultsaged 55 to 64 who smoke 21 to 39 cigarettesper day and commencedsmoking before age 15 are three timesmore at risk to die of lung cancer thanthose who started after age 25.Certain varieties of tobacco (e.g.,black tobacco) may be more dangerousthan others, but there is no safetobacco. 3AlcoholThe World Cancer Report 2003listed alcohol as second in its summaryof cancer causes. Heavy alcoholconsumption causes cancer of theoral cavity, pharynx, larynx, esophagus,and liver, and increases the riskof breast and colorectal cancer. Acausal relationship between alcoholand colon and rectal cancer is alsostrongly suggested, and the risk ofhead and neck cancers in heavydrinkers is some five to 10 timeshigher than in nondrinkers.The risk correlates to the amountof alcohol consumed. Changing pat-December 2012 | Adventist World 11