Joachim Schüz - A Review of the European Code against Cancer


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Joachim Schüz, Head of the Section of Environment and Radiation at the International Agency for Research on Cancer, spoke about the latest review of the European Code against Cancer at the European Week Against Cancer in Dublin, Ireland on May 29th, 2013.

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Joachim Schüz - A Review of the European Code against Cancer

  1. 1. A REVIEW OF THEEUROPEAN CODE AGAINSTCANCERJoachim Schüz2013 Official Conference for the European Week against CancerDublin, Ireland May 29-30
  2. 2. RATIONALE Leading cause of death worldwide – 12.7 millions new cases and7.6 millions of deaths in 2008 2.5 million people were diagnosed with cancer in the EU27 in 2008 Cancer mortality accounts for nearly 20% of all deaths Second most common cause of death in the EU after cardiovascular diseases Mostly breast (women), colorectal, prostate and lung (men) cancers At least 1/3 of all cancers are preventable(tobacco = 71% of global lung cancer deaths) In 2010 new cases estimated to cost US$ 154 billion in medical expenses
  3. 3. A) Certain cancers may be avoided –and health in general can be improved –by adopting healthier lifestyle:1) Do not smoke; if you smoke, stop doing so. If you fail tostop, do not smoke in the presence of non-smokers;2) Avoid obesity;3) Undertake some brisk, physical activity every day;4) Increase your daily intake and variety of vegetables andfruits: eat at least five servings daily. Limit your intake offoods containing fats from animal sources;5) If you drink alcohol, whether beer, wine or spirits,moderate your consumption to two drinks per day if youare a man and one drink per day if you are a woman;6) Care must be taken to avoid excessive sun exposure. It isspecifically important to protect children and adolescents.For individuals who have a tendency to burn in the sunactive protective measures must be taken throughout life;7) Apply strictly regulations aimed at preventing anyexposure to known carcinogenic substances. Follow allhealth and safety instructions on substances which maycause cancer. Follow advice of national radiationprotection offices.B) Cancers may be cured, or theprospects of cure greatly increased, ifthey are detected early:8) Women from 25 years of age should participate incervical screening. This should be within programmes withquality control procedures in compliance with EuropeanGuidelines for Quality Assurance in Cervical Screening;9) Women from 50 years of age should participate inbreast screening. This should be within programmes withquality control procedures in compliance with EuropeanUnion Guidelines for Quality Assurance in MammographyScreening;10) Men and women from 50 years of age shouldparticipate in colorectal screening. This should be withinprogrammes with built-in quality assurance procedures;11) Participate in vaccination programmes againstHepatitis B Virus infection.European Code against CancerThird edition, published in 2003
  4. 4. WHAT?- Key prevention tool to reduce cancer riskand to improve health in general- Concrete, science-based guidelinesWHY?- Science is dynamic- Improvement in communication- 12 new Member States in the EU since 3rdrevision, in 2003 (Croatia in 2013)HOW?- Update of the Code (recent scientific data)(1) Confirm existing recommendations(2) Potential additional recommendations(3) Interventions proven to be successful,assessed by scientific evidenceWHO?- Supported by the European Commission- Led by the IARC- Actors:(1) Scientific Secretariat (IARC)(2) Scientific Committee (external expertsfrom the EU)(3) Expert working groupsECACUpdate
  5. 5. UPDATE Update of scientific evidence Focus on target group (European individual) Explanations and additional guidance as public health messages Recommendations on how to implement individual interventions
  6. 6. "I want to do somethingto reduce my cancer risk,what can I do myself?"EUROPEAN CODE AGAINSTCANCERTarget group
  7. 7. New structure and interventions
  8. 8. Recommendations# 1 Do not smoke.....# 2.................................ICODEIIPublic Health Messages (FAQ style)Definitions What is smokeless tobacco?Target groups What is the benefit of cutting downsmoking in the elderly?Effectiveness of interventions Which is the most effectiveintervention to stop smoking?(Source..........)IIIScientific justification andevidence base
  10. 10. WG TobaccoWG UV & RadiationMajor single cause of cancerPassive smoking – how to point out?Other forms of tobacco use?Which interventions to stop smoking work?Natural and man-made exposure to UVREmphasis protection of children?Define what too much exposure meansRadon exposure at home and at work?Impact of diagnostic radiation?Perceived risks related to radiation
  11. 11. WG Physical activity, Obesity, Nutrition & AlcoholAlcohol – set the limitsPhysical activity – definitionHealthy body weight compared to obesity?Diet: encouragement of fruits and vegetables,discouragement of meat and saltSugary drinks? „Fast Food“?
  12. 12. WG Environment and OccupationWG Infections and VaccinationsParticipate inHepatitis B vEnvironmental and occupational chemicalsHow much protection can the individual do?Perceived environmental risksVaccinations against hepatitis BVaccination against HPV?Other infections: other forms of hepatitis,HIV, heliobactor pylori?Target groups for vaccinations and testing?Primary prevention: „safer“ sex?
  13. 13. WG ScreeningCervical screeningBreast screening – age group?Colorectal screeningProstate cancer screening?Lung cancer screening?Melanoma screening?Early signs of cancer?
  14. 14. A REVIEW OF THEEUROPEAN CODE AGAINSTCANCERAcknowledgements:Dr Lawrence von Karsa (Co-PI)Dr Carolina Espina Garcia (Coordinator)WG Chairs & IARC Project Management:Dr Rolando HerreroDr Maria Leon RouxTracy LigniniDr Silvia MinozziDr Isabelle RomieuDr Nereo SegnanDr Patricia VillainDr Jane Wardle