Developing a global strategy for cancer

Over the next 25 years there will be a dramatic increase in the number of p eople developing cancer. Globally, 10 million new cancer patients are diagn osed each year and this will be 20 million by the year 2020. Cancer is now the public's most feared disease. Billions of dollars are spent annually on cancer research by the drug industry, cancer charities and governments, bu t a cure for cancer appears elusive. And yet, we are in the midst of a revo lution in our ability to image parts of the body, painlessly and in fine de tail. We also now understand the intricate workings of the human genome - u ltimately responsible for controlling all biological processes in health an d disease. By the year 2003 the entire DNA sequence of the human genome wil l be determined. Powerful computer networks will allow detailed comparisons of genetic structure, so identifying new risk factors. Gene chips will det ect minute code changes of considerable relevance. Novel screening technolo gies will allow us to detect just a few cancer cells in a patient. Robotica lly guided destructive processes will target abnormal cells in patients lon g before any cancer-related symptoms develop. And all this is likely by the first quarter of the next century. How are people, society and healthcare systems going to deal with these tremendous technological advances for canc er? Detailed information will be available in every home through easily und erstandable computer links. Choices now made by professionals will be equal ly understandable to all. Public education on health will be strengthened a llowing a more critical and realistic assessment of media reports on new te chnologies. But as technology becomes more complex, the gap between the glo bal rich and poor could widen. The export of unhealthy lifestyles-cigarette smoking, dietary habits and sedentary occupations will disproportionately increase cancer in many developing countries, which can least afford the tr eatment costs. The WHO Cancer Programme is developing a strategy to identif y priorities in cancer prevention, detection and treatment in a wide range of epidemiological and economic settings. (C) 1999 Elsevier Science Ltd. Al l rights reserved.