Nutrition, Physical Activity and the Cancer Reform Strategy. Professor Sir Mike Richards September 2010

Transcription

1 Nutrition, Physical Activity and the Cancer Reform Strategy Professor Sir Mike Richards September 2010

2 Overview of presentation Cancer in England The political context How many cancers are preventable? How can we best prevent cancer?

3 Cancer in England (1) High incidence Around 250,000 new cases per annum 1 in 3 people will get cancer Incidence is rising, largely due to an ageing population (but note specific increases such as melanoma and oesophageal cancer) High mortality Around 130,000 deaths p.a. Over 1 in 4 of all deaths (around 29%) Actual number of deaths p.a. fairly stable Age standardised death rates are falling (by around 2% p.a. in people under 75 years).

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6 Cancer in England (2) Major improvements in cancer services over past 15 years Shorter waits Specialist teams Better screening (breast, cervix and bowel) Better treatment Better experience of care for patients Survival rates Are improving year on year Are almost certainly still below those achieved in other developed countries Poor survival is largely due to late diagnosis in England/UK

7 The political context: cancer Cancer has had a high political profile for over a decade. Downing Street Summit on Cancer, May 1999 cancer was declared a top priority NHS Cancer Plan 2000 Targets and new investment Cancer Reform Strategy 2007 New emphasis on early diagnosis, survivorship care and inequalities Coalition Government (2010): continuing commitment on cancer demonstrated through announcement of Review of the Cancer Reform Strategy (to be completed by Winter 2010) and determination to improve survival rates

8 The political context: The wider picture The Coalition Government (May 2010) Equity and Excellence: Liberating the NHS (July 2010) Information and choice Outcomes not process targets NHS Commissioning Board and GP consortia Ring fenced public heath budget White paper on public health (Autumn 2010) Cold financial climate

9 How many cancers are preventable? Most Potentially preventable causes of cancer include: Tobacco Obesity, diet, alcohol and physical inactivity Excessive exposure to ultraviolet light Infections: HPV, Hepatitis B, Helicobacter etc. Occupational cancers (e.g. asbestos; shift working)

10 Tobacco and cancer Tobacco remains the single largest preventable cause of cancer deaths in this country accounting for around 1/3 of all cancer deaths The evidence linking smoking and cancer is now over 50 years old We know what works: e.g. taxation; action on smuggling; bans on advertising; campaigns highlighting risks of smoking; stop smoking services; smoke free public places etc. Although we have made good progress, around 1 in 5 of adults are still smokers We need to learn lessons from tobacco in relation to other preventable causes of cancer

11 Lifestyle and cancer (1) Diet, obesity, alcohol and physical inactivity Probably account for around one third of all cancers Obesity The evidence base linking obesity and cancer is now very strong (e.g. oesophageal, pancreatic, postmenopausal breast, colorectal, endometrial, kidney cancer WCRF 2007) But: obesity levels are rising and prevalence is highest in social class v.

12 Rising prevalence of obesity in adults (BMI >30)

13 The Eatwell plate shows the balance and variety of different foods that make a healthy, balanced diet. It is made up of five different food groups.

14 Fruit and vegetables WCRF (2007): The evidence shows fruits and vegetables may protect against a range of cancers Eat at least five portions/servings of a variety of nonstarchy vegetables and of fruits each day

15 Recommendation: Eat at least 5 portions of a variety of fruit and vegetables a day Fruit & vegetables intake (NDNS, 2003): Average consumption of fruit and vegetables for adults aged years was 2.7 portions per day for men and 2.9 portions for women. 17% percent of adults ate less than one portion of fruit and vegetables a day 13% of men and 15% of women met the five-a-day target. Mean consumption was lowest in the y age group at 1.3 portions per day for men and 1.8 portions for women.

16 Physical Activity Increased physical activity is associated with reduced risk of several cancers Best evidence is for breast and colon cancer Growing evidence for endometrial and lung cancer minutes per day of moderate to vigorous physical activity is recommended. This is also protective against heart disease, diabetes and stroke Physical activity following a diagnosis of breast cancer reduces the risk of recurrence and improves quality of life

17 How can we best prevent cancer? Raise public awareness (e.g. of benefits of healthy lifestyles) Behaviour change interventions e.g. Change4Life (social marketing) Let s Get Moving (LGM) integrate with health checks Boris Bikes Legislation e.g. Sunbeds Point of sale tobacco displays Food labelling? Specific anti-cancer preventative measures e.g. HPV vaccination (and screening) Flexible sigmoidoscopy screening?

18 Where next? You have opportunities to influence future policy on cancer prevention Cancer Reform Strategy Review Forthcoming White Paper on Public Health

19 Summary Many cancers are preventable We need to learn from the experience on tobacco and move faster on diet, obesity and physical inactivity Please contribute to policy development in this area