2020 WHO Report on Cancer: Setting priorities, investing wisely and providing care for all
Saving 7 million lives from cancer by 2030 is what is achievable by implementing the public policies recommended in the first-ever WHO Report on Cancer: Setting priorities, investing wisely and providing care for all, launched on 4 February 2020, for the 20th anniversary of World Cancer Day.
The WHO Report on Cancer was launched together with the World Cancer Report: Cancer Research for Cancer Prevention by the International Agency for Research on Cancer (IARC), the specialized cancer agency of the WHO. The IARC report provides the most up-to-date science on cancer, while the WHO report indicates how that science can be translated into public policies. The WHO report fullfils the mandate from the 2017 WHO Cancer Resolution for WHO to produce in collaboration with IARC and other stakeholders a public health and policy-oriented world report on cancer that can support governments to implement the goals of the Cancer Resolution including the reduction of deaths from cancer and working towards the 2030 UN Sustainable Developement Goal of universal health coverage.
The WHO Report on Cancer: Setting priorities, investing wisely and providing care for all contains its main messages in its title – set priorities, invest wisely, provide care for all. It aims to raise awareness that cancer is a preventable and controllable public health priority globally, and there are effective public health strategies for evidence-based decision-making. The report launches an urgent call for all stakeholders to act now to save lives. To achieve this, governments need to choose wisely, and avoid misallocation of resources, concentrating on evidence-based programmes, robust information systems, and population-based registries to track progress made. Priority interventions include strengthening tobacco control to reduce cancer deaths by 25%, vaccination against HPV and Hepatitis B, screening for cervical cancer, early diagnosis and treatment, an increase in capacity - including a well-trained and equipped cancer workforce - to manage an additional 200 million cancer cases in the next 10 years, as well as to provide everyone with palliative care services. The WHO report emphasizes the importance of funding and implementing comprehensive National Cancer Control Plans, which can clearly set these objectives and plan how to scale-up cancer services in a logical, stepwise manner. In this way, countries can focus on priority interventions that are feasible and adequately address their country’s epidemiological burden of cancer. The report underlines that the daunting task that WHO Member States have committed to of decreasing deaths from cancer by 25% by 2025 and 33% by 2030 as country’s work towards achieving universal health coverage by 2030, requires global collaboration by all stakeholders.
The WHO report highlights one example of how ESMO and WHO are working together for sustainable cancer care, citing the case study of the joint project with the Ministry of Health of Kazakhstan within the context of universal health coverage
‘Kazakhstan has made a strong political commitment to cancer control and UHC founded on strong primary health care. After an imPACT mission in 2016, WHO was requested to review the cancer programme and to identify interventions that would maintain or increase coverage of cancer services, provide value for money and ensure financial protection. WHO and the Ministry of Health reviewed the country's screening programmes and concluded that focusing on three evidence-based programmes would have more impact than six. In reviewing the country's cancer treatment standards, WHO enlisted support from the European Society for Medical Oncology (ESMO), which analysed 20 cancer disease settings (over 300 protocols) using the WHO Essential Medicines List (EML), the European Medicines Agency's medicine indications, the ESMO Clinical Practice Guidelines, the ESMO-Magnitude of Clinical Benefit Scale version 1.1 and expert peer review. The assessment supported the Ministry of Health in optimizing its cancer treatment protocols and linking them to the national EML. Screening coverage increased from 60% to 90% for breast and cervical cancer, and treatment coverage increased from 85% to 89%. By incorporating the recommendations into the Kazakhstan national cancer control plan 2018-2022, the country maintained its long-standing commitment to offer its citizens evidence-based comprehensive cancer care as part of universal health coverage.’
The WHO Report on Cancer is accompanied by the data on the global burden of cancer and individual country profiles which are downloadable and provide information on the current situation of cancer.
2020 IARC World Cancer Report: Cancer Research for Cancer Prevention
The 2020 IARC World Cancer Report: Cancer Research for Cancer Prevention, notes that cancer is the ‘first or second cause of premature death (ages 30-69) in 134 of 183 countries’. According to the IARC Global Cancer Observatory cancer is expected to increase from 2018 to 2040, from an incidence of 18.1 million to 29.5 million with growth in the number of deaths from 9.6 million to 16.4 million. A main message of the IARC report is that prevention offers the most cost-effective long-term strategy for the control of cancer. The report offers a wealth of knowledge including ‘the most comprehensive overview of relevant research available to date, ranging from descriptive etiology, cellular and molecular biology, toxicology and pathology through to behavioural and social science. Key chapters include discussions on the impact of inequalities in cancer, vaccination and screening, genomic individual susceptibility to cancer and the finer identification of those at risk, which may allow ‘precision cancer prevention’.’ The section on ‘inequalities that affect cancer prevention’ is new in the 2020 edition and explains how socioeconomic inequalities can limit cancer prevention impact. The IARC report is complemented by other publications such as the WHO Classification of Tumours series (also known as the WHO Blue Books); the IARC volumes of Cancer Incidence in Five Continents, and the associated GLOBOCAN database document data on incidence, prevalence, mortality, and trends for multiple cancer types accessible online through the IARC Global Cancer Observatory.
The WHO and IARC reports provide a reliable resource for ESMO members for evidence-based data on the burden of cancer, its prevention, and public policy recommendations governments can implement to save lives.