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Some Thoughts on World Cancer Day

It’s time for change.

As we hopefully begin to see some light at the end of the oh-so-long pandemic tunnel, it’s time to begin to focus on the many other diseases that by necessity took a back seat these last two years.

Today is World Cancer Day. It’s a day to reflect on the current state of the disease, and to look at what we can do to improve care and outcomes.

Cancer kills 10 million people each year. To put this in perspective, that’s more than malaria, tuberculosis and HIV/AIDS together. At the time of writing, COVID-19 has killed 5.7 million worldwide in nearly two years.        

Experts predict 3 million additional cancer deaths by the end of the decade. If we don’t act.

And if we do act? Thirty to 50 percent of cancer cases can be avoided entirely. Another third could be cured with early detection and treatment.

Social determinants. Again.

Sixty-five percent of cancer deaths occur in emergent nations. Childhood cancer survival rates are over 80% in wealthy countries and as low as 20% in poorer ones. But there are also shocking inequalities in the most-developed countries. In the US, as we see so often, Social Determinant of Health (SDoH) cause huge disparities in prevalence and outcomes.

Inequities exist for indigenous people, immigrants, refugees, those living in rural areas (15-19% of Americans). Bias affects Black, Indigenous and People of Color, women, non-heterosexuals, older people and those with disabilities. Some of these demographics are also more likely to be at risk from poor nutrition, tobacco and substance abuse, and lower education leading to lower-incomes leading to poor access to healthcare. The list goes on and the cycle continues.

Ironically, after all this grim news, cancer rates have been declining in the US overall, largely due to lower rates of smoking over the last 20 years. But this is little comfort if you are in one of the groups above. Blacks have a lower five-year survival rate than Whites. Black women are 4% less likely to get breast cancer yet, shockingly, 41% more likely to die of the disease. Black women have the highest cancer death rate of any group.

So, what can we do?

Change needs to happen at both the policy and personal levels.

We need more fiscal and human resources devoted to treatment and cures, but also to quantifying the cost of cancer to the healthcare system and society as a whole, so that future allocations can be intelligently considered.

Education about prevention is key, both in school and community environments. Providers need access to the tools and knowledge necessary to recognize and address inequities brought about by unconscious (and conscious) bias.

Governments need to step up, with quantifiable programs that really start to move the needle on the social and economic causes of healthcare inequality.

On a personal level, there is much that you can and should do to reduce your risks. And avoidance sure beats treatment.

Get an annual physical with your primary care provider and, depending on your age, screenings for breast, skin colorectal, cervical, lung, prostrate and testicular cancers. It’s good to know your genetic risk factors, but don’t obsess if some of your relatives have had cancer—genes are a major factor in only about 5-10 percent of all cancers.

As citizens, we should be educating ourselves and others, making healthy lifestyle choices, and keeping up with primary care visits and screening. But we must also be a loud voice for the less fortunate, advocate change and call out inequality wherever we see it. Let’s look forward to a time when where you live doesn’t determine if you live.