The Sunday Mail
Maj-Gen (Rtd) Dr Gerald Gwinji
World Cancer Day falls on February 4 annually and unites the global population in fighting cancer.
The day aims to save millions of preventable deaths by raising awareness and education on the disease, pressing governments and individuals to take action.
It was established by the Paris Chapter and adopted at the World Summit Against Cancer for the New Millennium in 2000.
Themed, “We can, I can”, this year’s occasion alerts all people to the fact that everyone has the power to help reduce cancer’s impact on individuals, families and communities.
Whatever you do, “We can, I can”; make a difference and fight cancer.
Zimbabwe observes the day this Sunday, but will hold commemorations at Marondera Provincial Hospital tomorrow.
This year’s theme explores how everyone – as a collective or as individuals – can play their part to reduce the global burden of cancer.
Cancer affects everyone in different ways. As such, we can all take action to make that vital difference by fighting it.
Key messages will, therefore, focus on action that can be taken both collectively and individually.
For example, messages under the “We Can” banner include inspire action,take action, create healthy schools, shape policy change and improve access to cancer care.
For “I can”, the messages include make healthy lifestyle choices, ask for support, make voices be heard; and take control of my cancer journey.
One priority area – convening the global cancer control community – includes holding the annual World Cancer Day, with the aim of ensuring that year-on-year World Cancer Day is seen and heard by more people, presenting an urgent and unified message to global leaders to prioritise the fight against cancer.
Cancer patterns in Zimbabwe
New cancer cases recorded among Zimbabweans of all races in 2015 numbered 7 165, comprising 3 041 (42,4 percent) males and 4 124 (57,6 percent) females.
The cases are rising.
The most frequently occurring cancers among Zimbabweans were cervix uteri (19 percent), prostate (9 percent), breast (7 percent), Kaposi sarcoma (KS) (7 percent), non-melanoma skin cancer (NMSC) (6 percent), non-Hodgkin lymphoma (NHL) (6 percent), oesophagus (5 percent), colo-rectal (4 percent) and stomach.
Other cancers accounted for 34 percent of registered malignancies.
The leading cancers among black Zimbabwean men in 2015 were prostate cancer (22,5 percent), KS (10,8 percent), NHL (7,9 percent), oesophagus (6,9 percent), liver (5,1 percent), stomach (3,9 percent), NMSC (3,6 percent), lung (3,5 percent), colon (2,9 percent) and eye (2,6 percent).
Cervical cancer was the most common malignancy in black Zimbabwean women (34,8 percent), with breast (11,6 percent), NHL (4,7 percent), KS (4,6 percent), oesophagus (4,6 percent), stomach (3,3 percent), NMCS (2,8 percent), ovary (2,6 percent), eye (2,4 percent) and liver (2,1 percent) following.
In 2015, non-melanoma skin cancer was the most predominant cancer among non-black Zimbabwean men (46,5 percent) followed by prostate cancer (10,0 percent), colon (6,7 percent), melanoma skin cancer (MSC) (4,5 percent), lung (3,3 percent), rectum (3,3 percent), bladder (3,0 percent), NHL (2,6 percent), oesophagus (2,2 percent) and pancreas (1,5 percent).
The leading cancers in non-black Zimbabwean women were NMSC (38,2 percent), breast (15,9 percent), colon (4,5 percent), lung (4,1 percent), MSC (4,1 percent), ovary (3,6 percent), cervix uteri (3,6 percent), NHL (3,6 percent), vulva (2,7 percent) and rectum (2,3 percent).
Mean ages of cancer patients diagnosed among Zimbabweans of all races were 56,8 (males) and 52,8 (females).
The World Health Organisation estimates that a third of cancer deaths are a result of the following five leading behavioural and dietary risks:
l High body index
l Low fruit and vegetable intake
l Lack of physical activity
l Tobacco use
l Alcohol use.
Tobacco use was identified as the most important risk factor responsible for approximately 22 percent of cancer deaths.
Cancer-causing infections such as hepatitis and human papilloma virus are also severe issues, with these types of infections responsible for 25 percent of cases in low and middle-income countries.
Regarding prevention, WHO has stated that between 30 and 50 percent of cancers can be prevented by avoiding risk factors and implementing existing evidence-based prediction strategies.
It has also stated that the cancer burden can be reduced through early detection and management of patients, adding that many cancers have a high chance of cure if diagnosed early and treated adequately.
The organisation reports that late-stage presentation and inaccessible diagnosis and treatment are common.
For example, in 2015, only 35 percent of low-income countries reported having pathology services generally available in the public sector.
More than 90 percent of high-income countries reported treatment services were available compared to less than 30 percent of low-income countries.
Reliable data is another critical issue, with only one in five low and middle-income countries reported as having necessary data to drive cancer policy.
WHO predicts new cases will rise by around 70 percent in the next two decades.
Zimbabwe’s Health and Child Care Ministry plans to reduce the burden of cancer and other NCDs. The country is preparing to undertake the NCD Risk Factors Survey that will educate the ministry on the prevalence of common risk factors for NCDs and help shape policy and interventions.
The last and only survey was done in 2005.
Yet, other countries in the region have been doing such surveys every five years.
A new National Cancer Prevention and Control Strategy will be done for the period 2019-2023. The current one is expiring this year and will be reviewed.
New cancer guidelines will also be prepared; the previous ones were prepared in 1992.
Further, we plan to make breast cancer screening routine in the same way we have managed to make cervical cancer screening part of national public health programmes.
The ministry’s NCDs department will strengthen surveillance of cancers as they will undertake to vitalise the Zimbabwe National Cancer Registry and integrate cancer and other NCDs statistics into the HMIS.
Priority will also be given to making cancer medicines and commodities affordable and easily accessible.
Major-General (Rtd) Dr Gerald Gwinji is the Secretary for Health and Child Care. He wrote this article for The Sunday Mail.
