February 25, 2005

Cancer prevention in Canada

Are we doing all we can?

by Andrea Smith

The Dominion - http://www.dominionpaper.ca

Approximately 68,000 people will die this year from cancer in Canada, and an estimated 1 in 3 will be diagnosed with the disease during their lifetime, a situation that has drawn the concern of many. Yet according to the National Cancer Leadership Forum (NCLF), an organization representing cancer care and advocacy agencies across the country, the federal government has yet to implement a cancer control strategy.

In 2002, the federal government announced it had devised the Canadian Strategy for Cancer Control, a plan to improve the coordination and delivery of treatment, prevention, palliative services and research in Canada. Proponents of the strategy state that it is unique because all major cancer players in Canada sat at the table during its development, including provincial cancer agencies, major charities, research agencies, professional associations, patient advocacy groups and pharmaceutical companies. The strategy was developed after numerous consultations with representatives from the cancer care sector, who saw it as a means of meeting the need for a more coordinated and concerted effort to address cancer.

To date, the Canadian Strategy for Cancer Control is still an idea on a shelf. Fed up with the federal government's lack of action, the National Cancer Leadership Forum launched its Canadian Campaign to Control Cancer (CC2C). The campaign aims to inform the public of what the National Cancer Leadership Forum sees as the government's lack of commitment to the treatment, detection and prevention of cancer. Mobilizing public support through circulating a petition, they hope to impress upon politicians the urgency of taking action.

While focusing on palliative care and treatment, the campaign also addresses the need for prevention. People are urged to quit smoking, improve their diet, increase their physical activity, and avoid overexposure to the sun, activities which can reduce an individual's risk of developing cancer.

Yet not all have received the Canadian Campaign to Control Cancer with open arms. Numerous health and environmental activists have argued that the prevention strategies suggested by the CC2C aren't what Canadians need. "Yes, more funding and action are needed on cancers linked to smoking, diets poor in fruits and vegetables, obesity, and over-exposure to sunlight," says cancer prevention activist Liz Armstrong. "However, there also needs to be much more focus and action on cancer hazards over which Canadians personally have no control." While the Canadian Campaign to Control Cancer addresses those activities that increase an individual's risk of developing cancer, it does nothing to address the causes of the rising prevalence of cancer within the population as a whole. Environmental health activists point to the role of the approximately 500 new chemicals being used in commercial processes each year, on which no or minimal toxicological information is available. And as the ecosystem becomes more and more permeated with chemicals from agricultural, industrial and residential uses, so to do the human residents. Scientists have called the chemical contamination of humans "body burden." Armstrong points out that "Every Canadian carries such a burden, from the moment of conception throughout life. With more and more evidence that childhood and other cancers begin in utero, this ought to be at the top of the cancer prevention agenda at every level of government." To make the situation more troubling, cancer is only one of the potential negative health outcomes resulting from exposure to environmental contaminants.

Some have also questioned whether the omission of environmental contaminants is to defend the interests of the several major pharmaceutical companies sponsoring the campaign. Dr. Bell, from the Canadian Association of Physicians for the Environment (CAPE) notes "drug companies, like all corporations, never involved themselves in a project unless it will enhance their bottom line." Drug companies have a vested interest in detection and treatment, as they profit from the sale of their products. Prevention on the other hand, particularly the type that would reduce the overall cancer rate, isn't a profitable affair. Anne Rochon Ford of the national working group, Women and Health Protection questions the companies' role in the Canadian Campaign to Control Cancer. Ford says "there is both a real and perceived conflict of interest present when the funders will profit financially from the success of this campaign." Such criticism is not meant to detract from the importance of ensuring adequate resources for the treatment of cancers, but instead to highlight the need for prevention strategies that will protect the public's health, in the present and future.