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The need for preventive drugs and vaccines in global cancer

The need for preventive drugs and vaccines in global cancer...

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The need for preventive drugs and vaccines in global cancer control: a challenge for public health and for industry Harri Vainio International Agency for Research on Cancer, Unit of Chemoprevention, 150 cours Albert-Thomas, 69372 Lyon Cedex 08, France Ten million new cancer patients are diagnosed worldwide each year. There will be a dramatic increase over the next 20 years in the number of people contracting cancer, especially in the developing, poorer part of the world. Many types of cancer vary in incidence and mortality by more than an order of magnitude between different populations, and every type is rare in some part of the world, suggesting that cancers are in principle preventable. Many speci®c causes of cancer are known, from factors related to lifestyle, diet, infections and occupations. The remarkable advances in molecular understanding of the carcinogenesis process over the past 25 years have transformed the approaches in cancer control. About 15% of cancers worldwide are caused by known infectious agents. Human papillomavirus vaccines, which are already being tested, may, in the long run, be able to prevent almost all cervical cancers. New promising disciplines in prevention, such as chemoprevention, have emerged. Chemoprevention has been successfully achieved in numerous animal experiments, and has been validated in several clinical trials. But more effective and safer chemopreventive agents and vaccines are needed. Rising prices of medicines and vaccines are putting them beyond the reach of many people, even in rich countries. Future enhanced efforts on an international basis are needed to guarantee access to these lifesaving drugs and vaccines. Putting prevention high on the agenda requires political courage and a long-term perspective. Toxicology and Industrial Health 2002; 18: 84 ¡ / 90. Key words: cancer prevention; chemoprevention; health economics; immunization; pharmaceuticals; vaccines The global burden of cancer is still increasing. In 2000, 5.3 million men and 4.7 million women developed a malignant tumour and altogether 6.2 million died from the disease. Malignant tumours were responsible for 12% of the nearly 56 million deaths worldwide from all causes, but in many countries more than 25% of deaths are attributable to cancer (WHO, 2003). Cancer, especially the part attributable to infec- tious diseases and `poverty’, disproportionately affects populations in developing countries. In rich countries, some 50% of cancer patients die of the disease, while in developing countries, 80% of cancer victims already have late-stage incurable tumours when they are diagnosed, pointing out, on one hand, the need for better early detection programmes, but above all, the vital need to have Address all correspondence to: Dr Harri Vainio, International Agency for Research on Cancer, Unit of Chemoprevention, 150 cours Albert- Thomas, 69372 Lyon Cedex 08, France E-mail: [email protected] Toxicology and Industrial Health 2002; 18: 84 ¡ / 90 www.tihjournal.com # Arnold 2002 10.1191/0748233702th136oa
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cost-effective cancer prevention programmes (WHO, 2003).
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