Cancer has become the leading cause of death in Australia, according to a report by the World Health Organization released yesterday to mark World Cancer Day. The global epidemic caused over 8 million deaths in 2012, with 40,000 in Australia, which has the third-highest cancer incidence. Last year, 125,000 Australians were diagnosed. The Cancer Council Australia says that one in three women and two in three men are likely to be diagnosed with cancer before the age of 85.
The number of cancer-related deaths has decreased in the last few years due to improved treatments, but the number of diagnoses has been steadily growing since the 1990s. It’s estimated the number of cases will increase 20% by 2020, reaching 150,000.
In 2008, the WHO created a five-year Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases, which covered cardiovascular diseases, diabetes, cancers and chronic respiratory diseases. The plan aims to tackle four risk factors: tobacco, physical inactivity, unhealthy diets and alcohol abuse. Australia was among the countries that signed up to the plan. The five years is now up, so how did we do?
Tobacco use: good progress
The WHO recommendations include enforcing bans on tobacco advertising, promotion and sponsorship; raising tobacco taxes and prices; protecting people from tobacco smoke in public places; and offering help to people who want to stop using tobacco. Since 2008 Australia has considerably tightened its tobacco regulations. The Tobacco Plain Packaging Act 2011 and the Tobacco Plain Packaging Regulations 2011 require olive green packaging with only minimal labelling, and all cigarette packages must display government health warnings.
Plain packaging laws join older policies like the ban on tobacco advertisements on TV (1976) and a total smoking ban in all enclosed public places, implemented in 2006. These seem to be having an effect. According to the Health Foundation, the number of smokers in the country decreased from 20.1% in 2007-08 to 17.4% in 2011-12. The Department of Health states that Australia has one of the lowest smoking rates in the world.
Healthy diet: mixed progress
The first step to promote a healthy diet is supporting breastfeeding, according to the WHO, which recommends exclusive breastfeeding for the first six months of life. In Australia, only 15% of infants are exclusively breastfed by the age of six months. The Australian Health Ministers’ Advisory Council endorsed the Australian National Breastfeeding Strategy 2010-2015 in 2009.
The WHO’s action plan also encourages states to establish and implement food-based dietary guidelines to: reduce salt levels, eliminate industrially produced trans-fatty acids, decrease saturated fat and limit free sugars. But Australia does not seem to be taking these suggestions to heart, with salt intake nine times higher than it should be, according to the Better Health Channel. High levels of salt is related to stomach cancer.
The government has been trying to reach an agreement with the Australian Food and Grocery Council to reduce the levels of sodium in foods for years. Despite salt reduction targets, the level of sodium in food actually rose by 9% between 2008 and 2011, according to a George Institute for Global Health report. In the same year, a Choice survey revealed that salt-reduced products still contained a high level of sodium, especially the ones consumed by children, like cereals and lunch box snacks.
It’s not mandatory to declare the amount of trans-fat on food labels here. Unless manufacturers declare it voluntarily, consumers are not aware of presence of trans-fats in manufactured food. In 2007 the Food Standards Australia New Zealand declared an intention to reduce the amount of trans-fats in food. Two years later, the FSANZ 2009 review found that intakes of trans-fats from manufactured sources decreased in Australia and New Zealand by around 25% to 45% since 2007, reflecting changes in industry practice.
Physical activity: needs improvement
The government has launched numerous campaigns to promote a healthier and more active lifestyle. On its Healthy and Active website, the government commits to promote healthy spaces and places, learning from successful community obesity initiative, healthy weight information and resources. The results are far below expectations, as almost two-thirds of us are still not getting the recommended amount of activity. Australian Bureau of Statistics figures show that number of people 18 or older who engage in physical activity for less than 30 minutes a day decreased only 2% in four years, from 62% in 2008 to 60% in 2012.
Alcohol consumption: poor progress
Almost half of cancers are preventable and 5% of all cancer incidences are due to alcohol consumption, Cancer Council Australia’s Terry Slevin told the ABC. There was no more than a small reduction in the per capita annual alcohol consumption in five years, from 10.76 litres (pure alcohol) in 2007 to 10.05 litres in 2012, according to the ABS. This is equivalent to 2.2 standard drinks per day per person aged 15 years old and over, considering that an average drink contains 12.5 ml of pure alcohol. Despite the fact that the excise has a significant impact on alcoholic beverages prices, Australians drink more alcohol than the world per capita average of 6.13 litres of pure alcohol per year.
The world average alcohol consumption is an utterly stupid measure to compare against, because it includes countries where everyone is too poor to afford packaged alcohol and countries where large numbers of people are teetotal.
If you take a sensible comparator – e.g. developed countries – Australia is in the bottom half of the table and falling, largely thanks to the efforts of wowsers like Mr (not Dr) Slevin.
Maybe we are reading answers to the wrong questions.
*Why are so many of us contracting cancer? Because relatively few die of infectious diseases or industrial accidents or industrial diseases or blood infections from wounds, etc.
*How did that happen? Public health and safety changes, vaccination, antibiotics, improved medical care – all as a result of research (e.g. antibiotics), political action (e.g. worker health and safety), changing economy (e.g. better access to healthy food), governments taking responsibility for public health (e.g. clean water).
*While the so-called fight against cancer is in this article laid on the backs of individuals to change practices because of either advice or hectoring, nowhere is there a comment on environmental causes of cancer or the brute fact that we all will die of something. Having eliminated the scourges of most of humankind for those in developed countries, it seems unfair to be shocked that a remaining cause seems to be gaining ground in the ’cause of death’ stakes.
*What can be done? Well, primary research about cancer in its many forms and less brutal methods of treatment, cleaning the environment, regulation of foods and food packaging to promote foods that promote health. Stop using the terminology of warfare about a disease state. Cancer, unlike industrial pollution, is not out there. Cancer cells are our own cells doing unexpected things that often cause death when untreated.
Also, let’s have more aid to countries in a less enviable position and help provide clean water (not military aid), better food distribution networks, inexpensive antibiotics and vaccines, and safe working conditions.
So even a couple sharing a bottle of decent wine (7-8 standard drinks) per evening are way over the recommended daily intake.
I often wonder if the increase in allergies & cancer in a first world country has any connection to the excessive use of leafblowers.
They stir up tiny particles of pesticides, herbicides, fertilizers, mold, spores & fecal matter which we would not normally ingest in such high doses.