Mario Dorizas Canada Heading Towards Cancer Crisis

"The number of new cancer cases in Canada is growing twice as fast as the population is growing," says Heather Logan, Director, Cancer Control Policy, Canadian Cancer Society. "Cancer is already straining our healthcare system and it's going to get worse as the number of new cancer cases increases as the baby boom generation ages."

From 2000 to 2004, the population grew about one per cent annually while the number of cancer cases grew by about two per cent per year. Logan adds that if current trends continue with the growing and aging population, it is expected that 5.7 million Canadians will develop cancer and 2.7 million people will die of the disease over the next 30 years.

"This disease causes immeasurable suffering for Canadians," says Dr. Barbara Whylie, CEO, Canadian Cancer Society. "In addition, the direct healthcare costs of cancer will have a severe impact on our economy. Canada urgently needs to implement the Canadian Strategy for Cancer Control. We need to take action to fight cancer in a coordinated way from coast to coast."

Mario Dorizas Prevention is one important way to offset the trend of increasing cancer cases and Progress in Cancer Prevention: Modifiable Risk Factors is the special topic in this year's report.

"There are many risk factors for cancer that we cannot change, such as age, sex and genetic inheritance," says Logan. "But there are also important cancer risk factors that people can change. If we can help more people adopt healthier lifestyles, we'll see fewer Canadians diagnosed with cancer in the future."

Tobacco use, unhealthy diet, physical inactivity, excess body weight, alcohol consumption, overexposure to the sun and exposure to environmental and workplace carcinogens account for a substantial number of cancer diagnoses each year.

The prevention special topic shows that:

- 60 per cent of Canadians do not eat the recommended amounts of fruit and vegetables.

- About half of Canadians (54 per cent of women and 44 per cent of men) are physically inactive.

- Almost half of Canadians (56 per cent of men, 39 per cent of women) are at an unhealthy body weight.

- Rates of physical inactivity are declining slowly but rates of excess body weight are increasing, especially in children.

- 18 per cent of Canadians over 12 years of age are heavy drinkers.

- In 2002, 21 per cent of Canadians over 12 years of age smoked and 18 per cent of youth aged 15-19.

- Tobacco use is declining but is still high in some groups.

"A considerable body of evidence has accumulated over the last 30 years about how to prevent cancer," says Logan. "We've made great inroads in cancer prevention through tobacco control and if we apply these lessons to other areas even greater gains can be made. We have to work harder at both helping Canadians to embrace healthy lifestyles and helping governments to create policies that encourage people to make these changes."

Logan adds that at least 50 per cent of cancers can be prevented through healthy living and policies that protect the public.

"The Canadian Strategy for Cancer Control has an action plan for prevention that, if implemented, would bring about important reductions in cancer incidence," says Whylie.

Whylie adds that over the next 30 years, if a Canadian Strategy for Cancer Control is implemented, there is the potential to prevent more than 1.2 million Canadians from developing cancer and it could save the lives of more than 420,000 Canadians.

The need for a Canadian Strategy for Cancer Control was identified in the late 1990s by four groups - the Canadian Cancer Society, the Canadian Association of Provincial Cancer Agencies, Health Canada and the National Cancer Institute of Canada. The goals of the strategy are to reduce risk of developing cancer, reduce risk of dying of cancer, and to improve quality of life for those diagnosed with cancer.

Data for this year's special topic - Progress in Cancer Prevention: Modifiable Risk Factors - were obtained primarily from the Progress Report on Cancer Control in Canada, published by the Public Health Agency of Canada in 2004.

Canadian Cancer Statistics 2005 is prepared, printed and distributed through a collaboration of the Canadian Cancer Society, the Public Health Agency of Canada, the National Cancer Institute of Canada, Statistics Canada, provincial/territorial cancer registries, as well as university-based and provincial/territorial cancer agency-based cancer researchers.

The Canadian Cancer Society is a national, community-based organization of volunteers whose mission is to eradicate cancer and to enhance the quality of life of people living with cancer. When you want to know more about cancer, visit our website www.cancer.ca or call our toll-free, bilingual Cancer Information Service at 1 888 939-3333.

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Media backgrounder: Canadian Cancer Statistics 2005

Fast Facts

Current incidence and death

- An estimated 149,000 new cases of cancer and 69,500 deaths from cancer will occur in Canada in 2005. This is 3,500 more new cases and 1,200 more deaths than 2004.

- Lung cancer remains the leading cause of cancer death for both men and women.

- Overall, colorectal cancer is the second leading cause of death from cancer.

Probability of developing or dying from cancer

- On the basis of current incidence rates, 38 per cent of Canadian women and 44 per cent of men will develop cancer during their lifetimes.

- On the basis of current death rates, 24 per cent of women and 29 per cent of men, or approximately one out of every four Canadians, will die from cancer.

Prevalence

- 2.4 per cent of Canadian men and 2.7 per cent of Canadian women have had a diagnosis of cancer in the previous 15 years.

Age and sex distribution of cancer

- 44 per cent of new cancer cases and 60 per cent of cancer deaths occur among those who are at least 70 years old.

- Cancer incidence and death rates are higher in women than men during the reproductive years, although men have higher rates at all other stages of life.

- Cancer death rates are declining for men at all ages and for women under 70. Declines are most rapid in children and adolescents (ages 0-19).

Media backgrounder: Canadian Cancer Statistics 2005

Highlights

Canadian Cancer Statistics 2005 reports that, in general, incidence and death rates for the majority of cancer sites have stabilized or declined during the past decade. "While the number of new cancer cases is increasing because of Canada's aging and growing population, a person's individual risk of developing or dying of cancer has not changed significantly," says Heather Logan, Director, Cancer Control Policy, Canadian Cancer Society.

Progress

- Among Canadian men, the cancer death rate, after reaching a peak in 1988, is declining slowly as a result of decreases in death rates for lung, colorectal and other cancers.

- Among Canadian women, the rising incidence rate may be stabilizing, and death rates have declined slightly.

- Prostate cancer (see related ebook on prostate cancer) death rates are dropping. There was a significant drop in death rates from 1992 to 2001 (two per cent decline annually). It is not clear whether the decline is due to earlier detection, better treatment, or both. Prostate cancer is the most common cancer among Canadian men.

- Since 1993, incidence rates for breast cancer have stabilized and death rates have declined steadily. Improved survival is likely due to both organized mammography screening programs and additional therapies following surgery. Breast cancer is the most common cancer among Canadian women.

- Canadian women

- Incidence rates continue to decline for stomach, cervical, ovarian, bladder, pancreatic and laryngeal cancers, and Hodgkin's disease.

- Besides breast cancer, death rates are also declining for leukemia, colorectal, stomach, pancreatic, cervical and ovarian cancers.

- Canadian men

- Incidence rates continue to decline for stomach, laryngeal, oral, bladder, lung and pancreatic cancers, and Hodgkin's disease.

- Death rates are declining for stomach, colorectal, lung, oral, pancreatic, esophageal and laryngeal cancers, and Hodgkin's disease.

Challenges

- Among women, lung cancer incidence and death rates continue their rapid increase and are three times as high as rates in 1976. Among women, smoking rates only began to decline slightly in the mid-1980s and, as a result, declining lung cancer rates have yet to become apparent.

- Of all the cancers analyzed in the new report, the incidence rates of three cancers among men and one among women have increased at an average rate of greater than two per cent annually since 1992. These are melanoma and cancer of the thyroid and prostate in men, and thyroid cancer in women.

- Melanoma incidence rates are increasing for both men and women. Death rates are increasing for men.

- Cancers showing a significant increase, but of less than two per cent annually, are non-Hodgkin's lymphoma and testicular cancer in men, and lung cancer and melanoma in women.

These patterns were detected by analyzing age-standardized rates, which refer to the number of people per 100,000 who are diagnosed, or die of, cancer. Age-standardization allows comparisons among the different years since it accounts for changes that have occurred over time in the age distribution of the population.

Media backgrounder: Canadian Cancer Statistics 2005

Prevention

Following are highlights from the special section in Canadian Cancer Statistics 2005 - Progress in Cancer Prevention: Modifiable Risk Factors.

Tobacco

- Tobacco use accounts for about 30 per cent of cancer incidence (excluding skin cancer); 30 per cent of cancer deaths; and 85 per cent of lung cancer.

- Exposure to tobacco increases the risk of several types of cancer including cancers of the mouth, throat, larynx, cervix, pancreas, esophagus, colon, rectum, kidney and bladder.

- Steady progress has been made in reducing the prevalence of smoking: half of Canadians 15 years of age or older smoked in 1965, but in 2002 this had dropped to 21 per cent.

- Smoking among Canada's Aboriginal people is more than twice as common as among Canadians overall.

- Non-smokers who are exposed to second-hand smoke have about a 20 per cent greater risk of lung cancer than people who are unexposed, and there is increasing evidence of an effect on risk of other cancers. There has been progress in measures to protect non-smokers from exposure to second-hand smoke. Sixty-six per cent of workers had workplaces with complete restrictions on smoking in 2003, compared to 40 per cent in 1994.

- Several factors have contributed to progress in tobacco control, including

- higher tobacco taxes - curbs on tobacco advertising and promotion - smoking restrictions in workplaces and public places - larger picture-based health warnings on cigarette packages - providing support for people who wish to quit - government programming initiatives, including mass media campaigns

Unhealthy diet, physical inactivity and excess body weight

- Unhealthy diet, physical inactivity and excess body weight are powerful determinants of cancer risk.

- The International Agency for Research on Cancer attributes about 25-33 per cent of cancers of the breast, colon, esophagus, kidney and uterus to excess body weight and physical inactivity. A number of other cancers are related to poor diet, including bladder, lung, and oral cavity.

- The American Institute for Cancer Research estimates that about 30 to 40 per cent of all cancer cases could be prevented over time by a combination of following recommended diets and maintaining physical activity and appropriate body weight.

- Fruit and vegetable consumption has increased by about 40 per cent since the 1960s. These changes have probably contributed to reduced risk of some cancers, especially of the gastrointestinal tract. The Canadian Cancer Society recommends that people eat 5 to 10 servings of vegetables and fruit a day. However, most Canadians still do not follow the recommendation. In 2001, more than 60 per cent of Canadians consumed less than the recommended amount.

- Physical inactivity rates have been gradually declining since 1994, but in 2000-2001, more than half of Canadians over 12 years of age were still considered physically inactive (according to the 2000-2001 Canadian Community Health Survey).

- Prevalence of unhealthy weight is increasing in all ages, particularly among children. In 1981, 18 per cent of children were overweight and five per cent obese. In 1998-1999, the National Longitudinal Study of Children and Youth found 37 per cent of children aged two to 11 overweight and 18 per cent obese.

- Almost 50 per cent of all Canadians are overweight and 15 per cent are obese.

Alcohol

- Alcohol consumption is implicated in many types of cancer. Drinking two standard drinks per day raises risk of cancers of the mouth, pharynx, esophagus, larynx and oral cavity. It is a risk factor for breast cancer in women and colorectal cancer (particularly in men).

- Cancer risk increases with the amount of alcohol consumed.

- In 2003, according to the Canadian Community Health Survey, 18 per cent of the population aged 12 and over were heavy drinkers (five or more drinks on one occasion, 12 or more times per year)

Sun exposure and ultraviolet radiation

- Exposure to the sun is associated with all forms of skin cancer, including lip cancer.

- Tanning beds and lamps, like the sun, emit ultraviolet radiation and are considered carcinogenic.

- Skin cancer is the most common cancer in Canada, accounting for about one-third of all new diagnosed cancers. It ranks much lower as a cause of death. The most common forms of skin cancer - basal cell carcinoma and squamous cell carcinoma - are non-lethal. The most serious form - melanoma - is the least common.

- Reduction of sun exposure has the potential to substantially reduce the number of cancers.

Other modifiable risk factors

- Other potentially modifiable risk factors for cancer include some infections (for example, some types of human papilloma virus) and exposure to carcinogens in the workplace or environment. Despite evidence that some of these exposures are causally related to cancer, ongoing registry or other surveillance data are needed to track population trends and assess their impact.

The Canadian Cancer Society's recommendations for reducing cancer risk are on: www.cancer.ca; in the Prevention section (click on Seven Steps to Health).

Media backgrounder: Canadian Strategy for Cancer Control

Background

Work on developing a national strategy to fight cancer began in Canada in the late 1990s. More than 700 cancer experts and survivors came together to work on a plan to ensure that Canada's health system would be ready to meet the growing cancer challenge. Organizations, including the Canadian Cancer Society, have been advocating for the implementation of the Canadian Strategy for Cancer Control since 2002.

Why a national strategy is needed:

- Over the next 30 years, it is expected that more than 5.7 million Canadians will develop cancer and 2.7 million Canadians will die from the disease.

- Every seven minutes, two Canadians are diagnosed with cancer and one dies from it every 7.5 minutes. In 20 years, because of our growing and aging population, two Canadians will be diagnosed with cancer and one will die every five minutes.

- Cancer is the leading cause of premature death in Canada and will soon become the leading cause of death.

- At least 50 per cent of cancers are preventable, yet there is an inadequate infrastructure to support cancer prevention activities across the country.

- Cancer is expected to have a significant impact on the economy of Canada over the next 30 years. The federal and provincial governments combined are expected to lose over $248 billion in tax revenues as a result of cancer disability (as measured in 2004 dollars).

- The direct healthcare costs associated with cancer are expected to exceed $176 billion over the next 30 years.

Implementing a national strategy would mean, over the next 30 years:

- preventing over 1.2 million Canadians from developing cancer

- saving the lives of more than 420,000 Canadians

- saving more than $39 billion in direct healthcare costs

- preventing the loss of more than $101 billion in wage-based productivity

- preventing the loss of more than $34 billion in total government tax revenues To learn more on this topic, be sure to also read the related article, Mammograms cause breast cancer (and other cancer facts you probably never knew)