Preventing Cancer: How do you protect yourself from 200 diseases? Kathy Redmond, Editor, Cancer World Magazine

What are cancers?

Cancer types Common –Lung, prostate, breast and colorectal Rare –About a quarter of all cancers Solid tumours Blood and lymphatic system tumours

Breast cancer subtypes based on hormone receptor and HER-2 expression levels and Ki-67 staining.Abbreviations: ER, estrogen receptor; HER-2, human epidermal growth factor receptor 2; PR, progesterone receptor. Hortobagyi G N The Oncologist 2012;17: ©2012 by AlphaMed Press

One third of EU citizens are smokers

Tobacco use in the EU

About one third of all cancers can be prevented

European Code Against Cancer 1)Do not smoke; if you smoke, stop doing so. If you fail to stop, do not smoke in the presence of non-smokers. 2)Avoid Obesity. 3)Undertake some brisk, physical activity every day. 4)Increase your daily intake and variety of vegetables and fruits: eat at least five servings daily. Limit your intake of foods containing fats from animal sources. 5)If you drink alcohol, whether beer, wine or spirits, moderate your consumption to two drinks per day if you are a man or one drink per day if you are a woman. 6)Care must be taken to avoid excessive sun exposure. It is specifically important to protect children and adolescents. For individuals who have a tendency to burn in the sun, active protective measures must be taken throughout life. 7)Apply strictly regulations aimed at preventing any exposure to known cancer- causing substances. Follow all health and safety instructions on substances which may cause cancer. Follow advice of national radiation protection offices. /

European Code Against Cancer There are Public Health programmes which could prevent cancers developing or increase the probability that a cancer may be cured: 1)Women from 25 years of age should participate in cervical screening. This should be within programmes with quality control procedures in compliance with “European Guidelines for Quality Assurance in Cervical Screening”. 2)Women from 50 years of age should participate in breast screening. This should be within programmes with quality control procedures in compliance with “European Guidelines for Quality Assurance in Mammography Screening”. 3)Men and women from 50 years of age should participate in colorectal screening. This should be within programmes with built-in quality assurance procedures. 4)Participate in vaccination programmes against hepatitis B virus infection. /

Food, nutrition and physical activity and the prevention of cancer Be as lean as possible - maintain body weight within normal range Be physically active every day Limit consumption of energy-dense foods and sugary drinks Eat mostly foods of plant origin Limit consumption of: –Red meat –Processed meats –Alcohol –salt Avoid mouldy cereals or pulses Avoid dietary supplements for cancer prevention Breastfeed children for at least six months

Cancer chemoprevention

Challenges faced in preventing cancer

Global survey on knowledge and beliefs about cancer Survey carried out by UICC in 2007 Findings were aggregated according to three World Bank income categories The total sample size for the preliminary report was 29,925 –5,521in low-income countries –15,746 in middle-income countries –8,658 in high-income countries

Perceived risk of smoking

Perceived risk of being overweight

Perceived risk of drinking alcohol

Perceived risk of viruses

Perceived risk of stress

Beliefs: causes of cancer Lord et al. (2012) Clinical Oncology. 24, 4-12

Beliefs: causes of cancer by ethnic group Column 1: British White; Column 2: British South Asian Lord et al. (2012) Clinical Oncology. 24, 4-12

Cancer Stigma Lance Armstrong Foundation conducted a survey on cancer stigma in 2008 –Japan, Mexico, Russia, Argentina, Brazil, China, France, India, Italy, South Africa –About 500 people polled in each country Survey showed that –Stigma continues to persist across countries, cultures and communities –Caused by misinformation, lack of awareness, deeply engrained cultural myths and fear –Opportunities to capitalise on shifting perceptions –Mass media are key resources for facilitating more positive attitudes

Perceptions about cancer

Journalists have a role to play in raising awareness about modifiable cancer risks and counteracting fatalistic cancer attitudes

Effects of newspaper coverage on public knowledge about modifiable cancer risks Health Communication (2008) 23:4,

Effects of newspaper coverage on public knowledge about modifiable cancer risks Health Communication (2008) 23:4,

DISCUSSION Why is cancer prevention not covered well by the media? What can be done to address this? How can the mass media help counteract myths and misconceptions about cancer?