World Cancer Congress, July 8-12, 2006, Washington, DC
Report by Ann Fonfa, President, The Annie Appleseed Project
The title for this conference was Bridging the Gap: Transforming Knowledge into Action.
The introduction to the schedule states the problem – “this year alone, seven million people will die from cancer and close to eleven million will be diagnosed. Complacency and inaction on the part of the international community will effectively contribute to more than 10 million deaths each year by 2020”.
Further it states “worldwide cancer control can only be effective if it is given priority at the highest decision-making levels. Innovative science in tandem with sound, evidence-based policies can reduce the global cancer burden”.
Ann’s NOTE: Many times during this conference speakers referred to what could be done with $200 million dollars. I could not help but think of the $200 billion+ we have spent in Iraq pursuing war, death and destruction. Okay now you know my politics – I HATE war!
The American Cancer Society was a large factor in this event, which was held in conjunction with the World Conference on Tobacco. Their volunteers provided services that ranged from media center- management to guides throughout the halls, to speakers, and moderators of sessions.
Unfortunately there were no special lower fees for advocates to attend these meetings. English was the official language for the Congress with all plenaries simultaneously translated into Spanish and French.
The Congress featured five separate tracks – Cancer Research, Detection, and Treatment; Public Health, Prevention, and Education; Cancer Supportive Care; Building Capacity in Cancer Organizations; Tobacco and Cancer.
The first plenary on Sunday, July 9 entitled Changing Behavior – Changing Environment (under the Public Health track) featured David Hill, PhD, from Australia.
From his abstract: “Of the 7 million deaths from cancer worldwide, 35% have been estimated to be due to 9 potentially modifiable factors. Nearly all of these avoidable deaths can be attributed to the behavior of individuals.
“Cancer-related behavior” is any behavior which increases or decreases the probability of occurrence, or effects of, cancer in oneself or in those for whom one has responsibility, such as patients, pupils, employees or family, or evn, in the case of elected representatives, one’s constituency”.
And further: “Whilst interventions can be directed at population target groups, it is in individuals that cancer occurs, and so individual ways of responding to an intervention always need to be considered. Interventions to change environments usually work to reduce cancer because they lead to change in individual behavior”.
He told the audience that people act on how they feel (intuitive/adaptive), not just on what they know (analytical), and that both are needed for rational decisions. Thus public health messages need to be crafted to fit both knowledge and feelings.
There is an overdependence on efficacy trials in cancer control interventions – fine with trials of drugs or bench science but people are not controllable and attempts to distill best practice are generally disappointing.
“Any intervention is more likely to succeed to the extent that it maximizes the number and intensity of behavior change principles applied. The choice of principles to use and the emphasis will vary according to nature of the target behavior itself, in particular whether it is habitual (smoking, diet, physical activity) intermittent (screening) or one-off (vaccination)
The next speaker Stella Aguinaga Bialous, RN, MScN, DrPH discussed “Preventing 30% of the World’s Cancer: Tobacco Control”.
Smoking is down 17% per capita in the 35 most developed countries in the last decade, “during the same period, tobacco consumption in developing countries increased 15% and continues in an upward trend in most of these countries”.
Dr. Bialous made many points on the tobacco issues – her eleventh point was “The tobacco industry has waged massive public and political campaigns to influence the development of tobacco policies, including attempts to influence the work of WHO (World Health Organization) and IARC (International Agency on Research for Cancer).
In addition the tobacco industry has manipulated the media to confuse public understanding of the health effects of tobacco. Worldwide, governmental spending on tobacco control is OUTWEIGHED by the tobacco industry’s spending in marketing and political strategies”. (Ann’s emphasis)
She also made the point that many universities take tobacco money and she named a few – Penn State College of Medicine, Case Western, NYU, Oak Ridge National, Albert Einstein College of Medicine, etc. She also compared the ability to combine smoking cessation messages in (medical) practice to the resistance to pain care that still needs to be overcome in some quarters.
From her abstract: “Recognizing the worldwide spread of the tobacco-related epidemic, and the multinational reach of the tobacco industry, the WHO took the lead in sponsoring the first public health treaty, the WHO Framework Convention on Tobacco Control (WHO FCTC). The treaty entered into force in February 2005 and as of March 20, 2006 had 124 countries which are parties” - not including the UNITED STATES (Ann’s emphasis)
Craig Sinclair, B’Ed (Sec), MPPM spoke about “Skin Cancer Prevention: A Case for Action”. He asked if sun safety messages were doing more harm than good and suggested that the media had that message – but a balance is needed. He pointed out that research on vitamin D has revealed the benefits from the sun (including protection against osteoporosis and bone fracture), and therefore some public health messages may need to be changed. He suggested that some evidence also points to possible beneficial sun exposure for prevention of breast, prostate, bowel, non-Hodgkin lymphoma and autoimmune diseases such as multiple sclerosis.
Artificial tanning beds are posing significant challenges as well from the other side.
Sun protection is required when the UV index is greater than 3, unless one lives at a high altitude or near water, and is probably not needed all year around. His examples: Washington, DC where some protection is necessary from March to September; or Melbourne, Australia, September to April; Glasgow, Scotland, June and July.
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