The need for action
The expected rise in the global cancer burden and the significant economic costs associated with cancer can take a heavy toll on those affected. Around 40 per cent of all cancer cases are preventable, so it is crucial that governments prioritise the prevention of cancer.
The updated Cancer Prevention Recommendations in World Cancer Research Fund’s (WCRF) Diet, Nutrition, Physical Activity and Cancer: a Global Perspective (the Third Expert Report) constitute a blueprint for reducing cancer risk through:
- changing dietary patterns
- reducing alcohol consumption
- increasing physical activity
- achieving and maintaining a healthy body weight
Together these factors represent the major modifiable risk factors for cancer after smoking.
However, although well-informed choices are important, many factors, such as the availability of different foods and the accessibility of physical environments for active ways of life, are outside people’s direct personal control. In order to effect change at a population level it is therefore critical to consider the environment within which people make their choices.
Factors that affect the risk of cancer
The economic, social and environmental factors that determine patterns of production and consumption of food and drink, and levels of physical activity (and thus body composition), overlap and operate on global, national and local levels. These factors are experienced at a personal level through their effects on the availability, affordability, awareness and acceptability of healthy foods, drinks and lifestyles – as well as breastfeeding – relative to unhealthy food and drink, alcohol and physical inactivity.
Understanding the determinants of cancer risk highlights opportunities for policy action. Protecting public health, including creating health-enabling environments, is the prime responsibility of government as decision makers and caretakers. Achieving healthy patterns of diet and sustained physical activity over the life course requires concerted and integrated action from all sectors of society, including those in civil society, the private sector, and health and other professions.
A whole-of-government, whole-of-society approach is needed to create environments for people and communities that are conducive to following the Cancer Prevention Recommendations (and improving overall health outcomes).
In order to develop an appropriate and coordinated response, a framework-type approach, as illustrated by our NOURISHING framework, which focuses on promoting healthy diets, is useful. The NOURISHING framework outlines 10 areas in which governments need to take action, across three policy domains: food environment, food system and behaviour change communication.
WCRF has developed a new, broader framework that addresses physical activity, alcohol consumption and breastfeeding, in addition to diet, called Driving action to prevent cancer and other NCDs. Similar policy levers – broadly policy measures that influence availability, affordability, awareness and acceptability – can be used to address these factors. The new policy framework broadens NOURISHING’s three overarching policy domains to health-enhancing environments, systems change and behaviour change communication, and modifies and expands NOURISHING’s 10 policy areas to 11, to include healthy urban design.
The role of public policy is critically important in creating environments for people and communities that are conducive to following the Cancer Prevention Recommendations. Important actions are being taken in countries around the world, but the rising rates of overweight, obesity and cancer demonstrate that action to date has been insufficient. More concerted action is needed to achieve the global target of reducing premature deaths from non-communicable diseases, including cancer, by 25 per cent by 2025 and achieving the related Sustainable Development Goals.
This webpage is a summary.