Cancer deaths 'to double in next 40 years'

Cancer deaths 'to double in next 40 years'

Professor warns that alarming rate of obesity across the world will trigger huge rise in disease

• David Smith
• The Observer, Sunday 22 February 2009

Department of Health: 'Obesity is the biggest health challenge we face'. Photograph: Dave Thompson

Cancer cases are now rising at such a rate in Britain and the rest of the world that the disease poses a threat to humanity comparable to climate change, a leading scientist has warned.

The growing obesity epidemic in industrialised countries will be highlighted this week as a leading cause of cancer in a policy report led by Sir Michael Marmot, professor of epidemiology and public health at University College London.

About seven million people die from cancer worldwide each year, according to the most recent estimate by the World Cancer Research Fund, expected to rise to more than 10 million by 2020. The estimated number of new cases annually is set to increase from 10 million now to 16 million by 2020. Overall the toll is predicted to double in the next 40 years.

"It's enormous, it's catastrophic," said Marmot, who said the crisis demanded urgent action. "The numbers are just frightening on a global scale. After cardiovascular disease, it's the next highest cause of death in this country."

Just as global warming requires a quick and concerted international response, so Marmot believes that cancer now requires intervention on a similar scale. "With the same sense of urgency that at long last we're now starting to address the climate change agenda, let's address the cancer agenda because we think a large proportion of those cancer deaths are preventable or could be delayed. It's urgent to be taking action now," he said.

Marmot chaired a panel of 23 experts from around the world to make recommendations for the World Cancer Research Fund's Policy and Action for Cancer Prevention report. A report by the same panel in 2007, the biggest undertaken into lifestyle and cancer, found that a third of cancers are caused by diet and lack of exercise. The experts urged people to stay slim and abstain from too much fast food, red meat and preserved meat, such as ham and bacon, as well as alcohol.

The new report, to be published on Thursday, will not dwell on the issue of smoking because the science is now so well established. Instead its focus is on weight gain and obesity, which leads to around 13,000 cancer cases in the UK every year. Marmot said: "When we look at what's happened to obesity levels in this country, it's growing at an alarming rate. Anybody looking at the evidence would say there must be social and economic causes of that. It can't be that 20 million people individually said, 'I'll think I'll get fat.'"

Marmot acknowledged the extra challenge posed by the recession, which has led to booming sales for fast food chains. "It is going to be difficult, but in a way it's even more urgent to ask what needs to be done, because if you do nothing and the recession forces people into cheaper, unhealthier options, that only highlights that the unhealthy options tend to be the cheaper ones."

The panel will call on individuals to take responsibility for themselves and their children, while stressing the need for action from governments, multinational corporations, civil society, industry, workplaces, schools, the media and health professionals. Marmot cited the provision of cycle lanes, gyms and swimming pools as measures encouraging people to exercise. He welcomed the congestion charge in London as having prompted more people to cycle to work.

Marmot, who is also chair of the World Health Organisation's Commission on Social Determinants of Health, is braced for the charge that he is advocating a nanny state approach. He cited two examples of communicable diseases, smallpox and water-borne diseases, which collective social action have largely eliminated. "We didn't say at the time, 'Oh, this is the nanny state providing clean water for people - people should decide for themselves whether they want to drink water with cholera in.' Nobody would say that today. Diet is a bit more complicated but we want the availability of a nutritious supply of food."

Obesity has social and economic causes, he added, and therefore social and economic solutions. "We're worried in this country, but it's also Egypt, Mexico, Brazil, middle-income countries. In Egypt two thirds of women are overweight or obese. Mexico has frightening levels of obesity in middle-class kids ... they've gone from fajitas to fast food, with nothing in between. "

A Department of Health spokesperson said: "Obesity is the biggest health challenge we face and many people simply don't know that being overweight can lead to major health problems, including cancer. The UK is leading the world when it comes to facing up to the problem and tackling obesity."

http://www.guardian.co.uk/science/2009/feb/22/cancer-obesity-link