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          China / Cover Story

          Ignorance compounds cancer threat

          By Yang Wanli (China Daily) Updated: 2015-04-17 07:16

          In the past few years, wealthier patients have been happy to pay for tests to determine if they are genetically predisposed to certain forms of cancer, but the cost - thousands of yuan to detect just one form of the disease - means the procedures are far beyond the financial scope of most people, according to Chen of the NCCR.

          "Actually, we really know very little about the genes that can cause cancer. For example, we know that the discovery of mutations in two genes - called BRCA1 and BRCA2 - is helpful in determining a person's likelihood of developing breast and ovarian cancers, but the test is still being assessed in relation to other forms of cancer. So in China, we will focus on early detection, prevention and treatment of those cancers where the patient's life can be prolonged with the treatments available at present," he said.

          A huge burden

          In recent decades, cancer has imposed a huge burden on China's health authorities. The NCCR's 2014 Annual Cancer Report showed that more than 3.3 million new cases were diagnosed in 2011, meaning that one in five cancer patients worldwide that year was Chinese. About 2.1 million Chinese died from cancer in 2011, accounting for a quarter of global deaths from the disease.

          The IARC estimates that the number of deaths from cancer will hit 2.76 million in China by 2020.

          "With a population of almost 1.4 billion, China plays a significant role in the global cancer burden and cancer control effort," said Liu Lihua, director of data utilization at the Los Angeles Cancer Surveillance Program at the University of Southern California.

          "These numbers underline the urgent need for the development of effective cancer-control programs in China, and also underline the significance of such programs on the global effort to curb the rapidly increasing incidence of cancer and mortality, especially in developing countries. In other words, China is an obvious major battlefield in the global fight against the disease," he added.

          He urged the authorities to implement a national program of data collection and related research to help with the formulation of the best plans to control cancer and educate the public about the disease.

          The role played by the NCCR means it is possible to achieve the aims of further standardizing the registry workflow and improving the quality of relevant data by the end of the year. By 2020, the registry is expected to have high-quality, representative national and regional data.

          "Cancer is still one of the leading causes of morbidity and mortality among the Chinese, and they have higher rates of incidence and death for certain cancers, such as liver, stomach, breast, lung and colorectal," said Marion M. Lee, professor emeritus of epidemiology at the University of California's School of Medicine.

          Lee said the best way of reducing the risk of contracting many common forms of cancer is to maintain a healthy lifestyle by avoiding tobacco and alcohol, engaging in regular physical activity and keeping an eye on one's weight. He added that studies have clearly shown that prolonged psychological stress and aging also contribute to the development of cancer.

          "The most urgent problem affecting cancer deaths and general mortality in China is smoking, which can cause death not only from lung cancer, but also by cancers of the mouth, pharynx, larynx, esophagus, stomach, pancreas, liver, kidney, bladder and cervix," he said.

          Tang Lili, director of the Rehabilitation Department at the Beijing Cancer Hospital, said she has seen many patients whose limited awareness of cancer prevention meant they ignored the danger signs and missed the optimum time for treatment. She said that there is an urgent need for better education and greater public awareness of the causes of cancer.

          "Also, a lack of knowledge may lead some people to become unduly pessimistic after diagnosis," Tang said. "A diagnosis of cancer doesn't always equate to a death sentence. The aim of educating the public about cancer isn't to scare people, but to help them be aware of the disease and to react positively."

          Zhao Xu contributed to this story.

          Contact the writer at yangwanli@chinadaily.com.cn

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