World Cancer Day – ‘Close the Care Gap’

Cancer awareness has become exceedingly important in the 21st century. While there have been numerous advancements in the understanding, diagnosis, and treatment of cancer—these being factors that should contribute to the decline of the disease—the number of new cancer cases diagnosed each year has globally continued to increase. There were 8.1 million new cases diagnosed in 1990, 10 million in 2000, 12.4 million in 2008, and 14.1 million in 2012. The number of annual deaths worldwide from cancer has also increased—from 5.2 million people in 1990 to 8.2 million people in 2012 to an estimated 9.6 million in 2018. According to the World Health Organization (WHO), if the incidence of cancer continues to grow at the reported rate, the number of deaths worldwide from cancer will increase to more than 16.3 million by 2040. However, also according to WHO, as many as 40 per cent of deaths from cancer are preventable. As a result, raising awareness of cancer prevention has become a prominent goal of many cancer and health organizations around the world, and World Cancer Day has come to represent an annual reaffirmation of the importance of this goal.

About World Cancer Day

According to the World Health Organization, Cancer is one of the leading causes of deaths worldwide. The Union for International Cancer Control (UICC) was established in 1993. Based in Geneva, it is a membership-based society working towards the eradication of cancer around the world while simultaneously advancing medical research. Under its direction, the first International Cancer Day was celebrated in Geneva, Switzerland in the same year. Several well-known organizations, cancer societies, and treatment centres also supported this initiative.

World Cancer Day was made official at the first World Summit Against Cancer in 2000. The event took place in Paris and was attended by members of cancer organisations and prominent government leaders from around the world. A document titled the ‘Charter of Paris Against Cancer,’ featuring 10 articles, was signed, outlining a global commitment to improving the facilitation and quality of life of cancer patients. Advancement and increased investment in researching, preventing, and treating cancer was also highlighted.

Cancer has numerous types, so there are various colours and symbols used to mark a specific type of cancer and promote the fight against it. For example, the orange ribbon is for creating awareness of cancer in children, while the pink ribbon is globally associated with breast cancer awareness. As a symbol of hope for patients and survivors, the daffodil flower is used by the American Cancer Society for a future where this life-threatening disease no longer exists.

On this day, hundreds of events and fundraisers take place around the world each year, to bring individuals, communities, and organizations together in hospitals, schools, businesses, markets, community halls, parks, etc. to campaign and deliver the powerful reminder that those hit by cancer are not alone, and we all share a responsibility in reducing the global impact of this disease.

The Need for a World Cancer Day

The need for a day that is dedicated to the cancer community and its prevention is many fold. Especially because it is a threat that cannot be annihilated, but can only be dealt with more efficiently. So, let’s have a close look at these reasons to understand the significance of World Cancer Day.

• The need for creating awareness regarding cancer was felt especially in the current scenario where because of the CoVid-19 outbreak and subsequent lockdowns, the treatment of cancer patients took a backseat. We have heard various instances in the past year where cancer patients have suffered due to the absence of adequate healthcare facilities. We need to bring this discourse around cancer to the centre and address it in a way that makes a difference.
• Presently we have cancer treatments but the predicament is that it remains curable only in the initial stage. Cancer has claimed so many lives mainly because in most patients, it was not diagnosed in the initial stage. Through World Cancer Day, we need to increase awareness regarding Cancer for early detection and aim to reduce casualties.
• The first step towards creating a cancer-free world is the awareness that a disease like cancer exists and it could happen to anyone and everyone. We all need to talk about it and adopt healthy habits into our lives which could help us tackle this problem at its root. Therefore, the need for World Cancer Day to ensure that people talk enough about cancer and make everyday lifestyle changes to prevent its spread is paramount.
• World Cancer Day is also important to pay our tribute to the healthcare workers who are constantly working towards both preventing and curing this disease. This day, as such can be used to appreciate their contribution in the battle against the same.

World Cancer Day has grown into a positive movement for everyone, everywhere to unite under one voice to face one of our greatest challenges in history. Each year, hundreds of activities and events take place around the world, gathering communities, organisations and individuals in schools, businesses, hospitals, marketplaces, parks, community halls, places of worship – in the streets and online – acting as a powerful reminder that we all have a role to play in reducing the global impact of cancer.

While we live in a time of awe-inspiring advancement in cancer prevention, diagnosis and treatment, many of us who seek cancer care hit barriers at every turn. Income, education, geographical location and discrimination based on ethnicity, gender, sexual orientation, age, disability and lifestyle are just a few of the factors that can negatively affect care.

So, this year’s World Cancer Day theme, ‘Close the Care Gap’, is all about raising awareness of this equality gap that affects almost everyone, in high as well as low- and middle-income countries, and is costing lives. The first year of the ‘Close the Care Gap’ initiative is centred on recognizing and analysing cancer care inequalities throughout the world. It’s all about keeping an open mind, questioning preconceptions, and examining the facts:

• Cancer care inequity costs lives.
• People seeking cancer treatment face obstacles at every turn.
• Discrimination based on race, gender, sexual orientation, age, disability, and lifestyle are just a few of the characteristics that might have a detrimental impact on treatment.
• Everyone is affected by the divide, including you and your loved ones.
• These obstacles are not inflexible. They are modifiable.

This is the year to challenge the existing status quo and work to decrease stigma; to listen to the perspectives of cancer patients and their communities, and to allow those lived experiences to drive our ideas and actions.

That’s how we can start to conceive a new way of doing things and a more equitable future—one in which people live healthier lives and have greater access to health and cancer treatments regardless of where they are born, how old they are, where they work or reside.

Cancer Screening Programs

Certain tests help find specific types of cancer before signs or symptoms appear. This is called screening. The main goals of cancer screening is to:

• Reduce the number of people who die from the disease, or prevent deaths from cancer altogether.
• Reduce the number of people who develop the disease.

A number of organizations provide guidelines on cancer screening tests. Sometimes these guidelines suggest different things. Recommendations vary on:

• Which type of cancer people should be screened for.
• Which tests should be used to screen for a particular type of cancer.
• What age screening should begin and end at.
• How often screening tests should be done and
• What happens if the screening indicates a positive result.

If you have symptoms, don’t wait for a screening invitation – tell your doctor as soon as possible. Talk with your doctor about your personal risk of developing cancer. Together you can decide on an appropriate screening schedule based on your age and personal and family medical history.

Many of the countries in Europe have heavily invested in implementing cancer screening programs over the last few decades. In the United Kingdom, there are 3 national screening programs –

• Bowel cancer screening is offered to people aged 60-74 in England, Wales and Northern Ireland. In Scotland people aged 50-74 are offered bowel cancer screening.
• Breast cancer screening is offered to women, some transgender men and some non-binary people aged 50-70 in the UK.
• Cervical screening is offered to women, some transgender men and some non-binary people aged 25-64 in the UK.

In the United Arab Emirates (UAE), under the BASMAH initiative, Dubai residents will be covered for breast, colon and cervical cancer screening and treatment, irrespective of the cost and duration, in dedicated Centres of Excellence (CoE) allocated by the Dubai Health Authority (DHA). CoE are being built throughout Dubai, with dedicated healthcare practitioners who will oversee patients using the initiative. BASMAH includes a seamless and successful process which is ensured through training the primary healthcare physicians and a third party “TruDoc 24X7” accompanying patients throughout their entire journey. The process includes home visits from doctors for patient onboarding, a medical call centre that is available 24/7 in multiple languages, an interactive mobile application with medication and appointment reminders, wellness tips and push notifications.

The initiative makes UAE authorities the first government entity in the world to provide a complete spectrum of care from screening to treatment for the three types of cancer (breast, colorectal and cervical cancer) under the essential benefit health insurance plan. Before the scheme, cancer coverage was limited to Dh150,000. Now there are no sub-limits and coverage is unlimited. To make the initiative work, all approved health insurance providers in Dubai have asked policyholders to pay an additional amount of Dh19 and Dh18 for cancer and hepatitis C (HCV) treatment respectively. This sum for cancer is pooled into DHA’s trust account and helps cover the additional cost of these three types of cancer treatment.

A plan for the diagnosis and treatment of cancer is a key component of any overall cancer control plan. Its main goal is to cure cancer patients or prolong their life considerably, ensuring a good quality of life. For a diagnosis and treatment program to be effective, it must never be developed in isolation. It needs to be linked to an early detection program so that cases are detected at an early stage when treatment is more effective and there is a greater chance of cure. Furthermore, programs should include an awareness-raising component, to educate patients, families and community members about the cancer risk factors and the need for taking preventive measures to avoid developing cancer.

It is obvious that a diagnosis of any type of cancer causes stress to both the patient and the family caregivers. Coping strategies employed could either be problem-focused or emotion-focused. If you or a loved one has been affected by a diagnosis of cancer, know that options, resources, and support are readily available. Speak to your doctor or call the assistance program for help with the anxiety, stress, and other factors that can affect you or your loved ones.