All Key Message Fact Sheets - WCD2017 - English

WE CAN

#WeCanICan #WorldCancerDay

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INSPIRE ACTION, TAKE ACTION ca

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WE CAN INSPIRE ACTION, TAKE ACTION The first step in driving progress around cancer is to push for actions that we know will improve survival rates and give cancer patients a better quality of life.

The World Cancer Declaration represents a consensus between public health and cancer experts that sets out 9 targets for an effective response to cancer and other non-communicable diseases (NCDs) – mainly cardiovascular diseases, chronic respiratory diseases and diabetes1. It is a tool that can be used by cancer control organisations, groups of advocates, employers, the media and others to urge governments to implement policies and programmes that the cancer community knows will be successful if they are adequately resourced.

With the world’s governments committed to ‘reduce by one third premature mortality from NCDs through prevention and treatment, and promote mental health and wellbeing’ as part of the Sustainable Development Goal (SDGs), using the World Cancer Declaration to frame and strengthen advocacy efforts is imperative2. By working together around common targets and each using our spheres of influence, we can unite in driving governments to take decisive action around cancer, commit adequate resources and embed cancer and other NCDs within broader development planning and financing processes.

We can all call on governments to step up their response to cancer by pushing for actions that we know will reduce premature deaths, and improve quality of life and increase cancer survival rates.

This factsheet is aimed at Healthcare professionals

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Workplaces

Policy makers

Schools

Cities

Sport & leisure groups

World Cancer Declaration. http://www.uicc.org/world-cancer-declaration Transforming our World: The 2030 agenda for sustainable development. https://sustainabledevelopment.un.org/post2015

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#WeCanICan #WorldCancerDay

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PREVENT CANCER ca

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WE CAN PREVENT CANCER Changes in the way we live means that more and more people around the world are exposed to cancer risk factors like smoking, poor diet, and sedentary lifestyles. Educating and informing individuals and communities about the links between lifestyle and cancer risk is the first step in effective cancer prevention.

Smoking is still the biggest cancer risk factor. Tobacco use accounts for five million deaths every year, or 22% of all cancer deaths1,2. Reducing the rates of tobacco use will significantly decrease the global burden of a large number of cancers, including of the lung, oral cavity, larynx, pharynx, oesophageal, pancreas, bladder, kidney, cervix and stomach, and acute myeloid leukaemia.

Consuming alcohol is linked to an increased risk of six cancers. There is now strong evidence that consuming alcoholic drinks increases the risk of seven cancers: mouth, pharynx, larynx, oesophageal, liver, breast3, and pancreas4.

The rising levels of obesity are of concern in many countries around the world.

Overweight and obesity are strongly linked with an increased risk of bowel, breast, uterine, ovarian, pancreatic, oesophagus, kidney, and gallbladder cancers later in life5. Yet, about a third of common cancers can be prevented through a healthy diet, maintaining a healthy weight and being physically active6. Specifically, the World Cancer Research Fund International estimates that for the 13 most common cancers, about 31% of cases in the United States are preventable through a healthy diet, being physically active and maintaining a healthy weight. The estimates for other countries are 32% for the UK, 25% for Brazil and 24% for China7.

Equipping individuals and communities with the latest knowledge of the links between lifestyle and cancer can empower people to adopt healthy choices.

Individuals and communities need to be informed that more than a third of cancers are preventable through adopting healthy behaviours.

This factsheet is aimed at Healthcare professionals

Workplaces

Policy makers

1. WHO. (2012). Global Report: Mortality attributable to tobacco 2012. Geneva: World Health Organization.

2. Tobacco Atlas 2015 3. WHO. (2011). Global status report on alcohol and health.

Geneva: World Health Organization 4. World Cancer Research Fund / American Institute for Cancer Research. Continuous Update Project (2012) Pancreatic Cancer. http://www.wcrf.org/sites/default/files/ Pancreatic-Cancer-2012-Report.pdf 5. World Cancer Research Fund / American Institute for Cancer Research. Continuous Update Project Report. http://www.dietandcancerreport.org/cup/index.php.

Schools

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6. World Cancer Research Fund International. Link between lifestyle and cancer risk. http://www.wcrf.org/int/linkbetween-lifestyle-cancer-risk 7. World Cancer Research Fund International. http://www. wcrf.org/int/cancer-facts-figures/preventability-estimates/ cancer-preventability-estimates-diet-nutrition and http:// www.wcrf.org/int/policy/nourishing-framework?utm_ source=update&utm_medium=email&utm_ campaign=NOURISHINGJuly

WE CAN

#WeCanICan #WorldCancerDay

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CREATE HEALTHY SCHOOLS ca

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WE CAN CREATE HEALTHY SCHOOLS Every school can foster a culture of healthy choices and habits by providing nutritious food and drink choices, as well as time for recreation and sport, and putting practical education about food and physical activity on the school curriculum.1 Providing healthy choices in school canteens and cafeterias to ensure children have access to lower energy density meals and snacks, and to water as an alternative to sugar-sweetened beverages, can have a considerable influence on the development of positive attitudes towards food and promote healthy behaviours.1 In some countries, there are also opportunities for schools to participate in programmes on food growing, harvesting, cooking and eating.

For example, kitchen garden projects in the United Kingdom and Australia support primary schools to bring pleasurable food education and cooking skills to life, and aim to change the way children think about food through fun and hands-on learning.2,3 In some cases, policy changes can support improvements in access to healthier foods and nutrition education in schools. For example, the Healthy, Hunger-Free Kids Act 2010 that allows the U.S. Department of Agriculture (USDA) to make real reforms to the school lunch and breakfast programmes such as establishing national nutrition standards for all foods sold

on the school campus throughout the school day.4 The establishment of standards for meals provided in schools, or foods and beverages sold in schools, that meet healthy nutrition guidelines, is one of a set of recommendations by the World Health Organization to promote healthy school environments.1 Inclusive, quality physical education should also be part of the school curriculum. Physical education programmes provide instruction and skill-learning opportunities that contribute to the development of physical literacy, which is linked to a greater likelihood of life-long participation, as well as positive attitudes and behaviours.5,6 Regular participation in quality physical education can also improve a child’s attention span, enhance their cognitive control and processing.1 For some schools, appointing a person to oversee investment and policies that support a healthy school environment may have widereaching benefits for improving the physical and mental health of students and staff that extend to the whole community.7 Schools can be champions of healthy behaviours among children, staff, parents, families and the wider community by cultivating an environment that supports good nutrition and physical activity.

This factsheet is aimed at Schools

1. WHO (2016). Report of the commission on ending childhood obesity.

2. Food Revolution Day. School Resources. http://www. foodrevolutionday.com/schools/#DVCHyR8LzJQL3EIf.97 3. Kitchen Garden Foundation. Teaching Resources. http:// www.kitchengardenfoundation.org.au/free-resources/ teaching-resources 4. American Heart Association. Healthy, Hunger-Free Kids Act: A health recipe for school nutrition. https:// www.heart.org/idc/groups/heart-public/@wcm/@adv/ documents/downloadable/ucm_474338.pdf

5. Let’s Move: Active Schools. http://www.letsmoveschools. org/about 6. Australian Sports Commission. Clearinghouse for Sport. https://www.clearinghouseforsport.gov.au/knowledge_ base/organised_sport/value_of_sport/school_sport 7. The Guardian. Want a healthy school? A head of wellbeing could be the answer https://www.theguardian.com/ teacher-network/2015/nov/03/healthy-school-head-ofwellbeing-the-answer

WE CAN

#WeCanICan #WorldCancerDay

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CREATE HEALTHY WORKPLACE ca

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WE CAN CREATE HEALTHY WORKPLACE With the global labour force predicted to rise to 3.5 billion by 2030, there is a tremendous opportunity to harness the workplace as a platform for cancer prevention and early detection1.

Workplaces of all sizes can put in place policies and programmes that motivate employees to adopt healthier behaviours.

Creating 100% smoke-free workplaces and providing information and access to smoking cessation tools is one of the clearest examples of effective workplace policy for cancer prevention – a ban on smoking in all indoor workplaces can reduce the prevalence of smoking by 6%2,3,4. Other measures such as providing access to healthy food options;

promoting active transport to and from work; and increasing movement in the workplace for example, through use of stairs, are all effective ways to support a healthier workforce1,5. Workplace wellness programmes can also promote early detection by using communications channels to share information about the signs and symptoms of some cancers and where appropriate, encourage and support participation in cancer screening programmes for early diagnosis6.

Workplaces should also put in place policies to prevent occupational exposure to cancer-causing agents, such as asbestos and other workplace carcinogens7.

Employers can implement measures in the workplace that will motivate and sustain healthy habits throughout a person’s everyday life.

This factsheet is aimed at Workplaces

1. UICC, Bupa. (2014). Cancer – It’s everyone’s business. http://www.iccp-portal.org/cancer-its-everyones-business 2. UICC, Bupa (2015). Less Smoking, Better Business. http:// www.iccp-portal.org/less-smoking-better-business 3. Global Smokefree Partnership. Smokefree-in-a-box. www. globalsmokefreepartnership.org 4. Eriksen M, Mackay J, Schluger N, et al. The Tobacco Atlas, 5th Edition, (2015). American Cancer Society, Atlanta.

5. NCD Alliance (2016). Realising the potential of workplaces to prevent and control NCDs. https://ncdalliance.org/sites/ default/files/NCDs_%26_WorkplaceWellness_web.pdf 6. UICC, Bupa (2015). Tackling breast cancer in the workplace. http://www.iccp-portal.org/tackling-breastcancer-workplace 7. International Labour Office. Safety in the Use of Asbestos. http://www.ilo.org/wcmsp5/groups/public/@ed_protect/@ protrav/@safework/documents/normativeinstrument/ wcms_107843.pdf

WE CAN

#WeCanICan #WorldCancerDay

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CREATE HEALTHY CITIES
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WE CAN CREATE HEALTHY CITIES With 66% of the world’s population projected to live in urban areas by 2050, the quality of the urban environment will play an increasingly important role in public health.1 In many cities across the world, mayors and urban policy makers are collaborating more than ever before on innovative solutions for creating and sustaining healthy cities. They are sharing ideas; forming alliances; and challenging their national governments to adopt policies to promote and protect the health and wellbeing of their citizens.1-3 One of the clearest examples of the use of effective public policy for cancer and non-communicable diseases (NCDs) prevention is the creation of smokefree environments to prevent cancer and other NCDs. Even in the absence

of comprehensive national policies, cities in many countries are taking the lead in strengthening implementation of comprehensive smoke-free regulations that cover all indoor workplaces, public places and public transport.4,5 Cities can also support people to be physically active by making cycling and walking accessible and safe modes of transport for everyone, and providing universal access to safe, inclusive and accessible, green and public spaces.1,6 Creating public spaces and improving infrastructures in cities to encourage active play and travel can have wideranging benefits for communities, increasing the integration of physical activity into people’s everyday life as well as reducing deaths and injuries from road traffic accidents and improving air quality.

Cities can take the lead in creating a quality urban environment that promotes and protects the health and wellbeing of its citizens.

This factsheet is aimed at Cities

Policy makers

1. World Health Organization (2016). Global report on urban health: equitable, healthier cities for sustainable development.

2. Cities Changing Diabetes. http://citieschangingdiabetes. com 3. Bloomberg Philanthropies Mayors Challenge. http:// mayorschallenge.bloomberg.org 4. NCD Alliance (2016). Realising the potential of workplaces to prevent and control NCDs. https://ncdalliance.org/sites/ default/files/NCDs_%26_WorkplaceWellness_web.pdf

5. China Tobacco Control Partnership. Smoke-free business for a healthier tomorrow, 2015. Emory Global Health Institute, Atlanta.

6. Daniel K (2016). Public spaces: A key tool to achieve the Sustainable Development Goals. http://healthbridge.ca/ images/uploads/library/Final_Electronic.pdf

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#WeCanICan #WorldCancerDay

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SUPPORT OTHERS TO RETURN TO WORK ca

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WE CAN SUPPORT OTHERS TO RETURN TO WORK Employers can create a workplace culture where employees with a cancer diagnosis are encouraged to know that when they return to work they will be supported to adapt to the challenges they face from their illness1-3.

Employers can take several actions to help people living with cancer transition back to the workplace successfully.

Supporting a flexible return to work, such as making changes in hours or responsibilities, can be an important factor in getting people back to work successfully. Keeping the lines of communication open can also be critical. Talking with an employee about job modifications, legal rights and responsibilities, and support programmes available in the workplace will empower them to take control of their health and

wellbeing and help ease their transition back to work. Additionally, employers should be aware of their obligations to prevent discrimination at work and enforce workplace policies that ensure employees coping with cancer and their caregivers are not disadvantaged in recruitment, at work and when returning to work.

Caregivers also need flexibility at work. Employers can be supportive by extending flexible workplace policies to caregivers, and providing access to resources such as workplace counselling.

For co-workers, being sensitive to the needs and feelings of the person affected by cancer at work and keeping in touch during time away from the workplace can be very helpful.

By providing the right support, employers and co-workers can foster a successful transition back to work for cancer patients.

This factsheet is aimed at Workplaces

1. UICC, Bupa (2015). Working with cancer: Supporting employees living with cancer to return to work. http:// www.iccp-portal.org/resources/uicc-bupa-–-workingcancer-supporting-employees-living-cancer-return-work 2. NCD Alliance (2016). Realising the potential of workplaces to prevent and control NCDs. https://ncdalliance.org/sites/ default/files/NCDs_%26_WorkplaceWellness_web.pdf

3. Macmillan Cancer Support. Managing Cancer in the Workplace. http://www.macmillan.org.uk/ Cancerinformation/Livingwithandaftercancer/ Workandcancer/Supportformanagers/Employersguide/ Managingoverview.aspx.

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#WeCanICan #WorldCancerDay

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CHALLENGE PERCEPTIONS ca

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WE CAN CHALLENGE PERCEPTIONS In many cultures and societies today, cancer remains a taboo subject. People living with cancer are often subject to stigma and discrimination that may stop them admitting they have cancer and from seeking care and support. Even within communities where cancer is discussed openly, people affected by cancer can sometimes be discriminated against and feel isolated from friends and peers1.

Specific efforts are required to improve knowledge of cancer, counter misinformation and reduce stigma among all communities2,3.

Supporting awareness campaigns such as World Cancer Day can be a powerful platform to challenge negative beliefs, attitudes and behaviours that perpetuate myths about cancer4. Workplaces, community groups, healthcare providers and schools can all take actions to improve communication about cancer, shifting perceptions and strengthening support for people affected by cancer. In schools, for example, theatre can provide a platform for children, parents, and teachers to work together to improve communication and remove stigma around the disease. Such education programmes have been shown to be successful in supporting the inclusion of children with cancer into everyday life at school5.

Governments can also play a critical role in providing accurate information to communities around effective cancer interventions. For instance, extensive social mobilisation has been identified as critical to the implementation of human papillomavirus (HPV) vaccination programmes in lowand middle- income countries as part of comprehensive cervical cancer prevention strategies. Providing appropriate and adequate information to communities, especially to avoid rumours and myths is a key factor to achieving high vaccine coverage6.

The media also have a particular role to play around public education campaigns by disseminating information and raising population-level awareness of cancer control to change attitudes and dispel common myths.

Governments, communities, schools, employers and media can challenge perceptions about cancer and dispel damaging myths and misconceptions so that all people are empowered to access accurate cancer information and quality cancer prevention and care.

This factsheet is aimed at Healthcare professionals

Workplaces

Schools

1. LIVESTRONG. (2011). Cancer Stigma and Silence Around the World: A LIVESTRONG Report . Austin: LIVESTRONG. 2. http://www.livestrong.org/What-We-Do/Our-Actions/ Programs-Partnerships/Anti-Stigma-Campaign 3. Cancer Research UK http://scienceblog.cancerresearchuk. org/2014/03/24/dont-believe-the-hype-10-persistentcancer-myths-debunked/

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Sport & leisure groups

4. American Cancer Society http://www.cancer.org/aboutus/ howwehelpyou/rumors-myths-and-truths 5. dos Santos Gomez LA (2007). Removing the stigma of cancer at school. Lancet Oncol. 8:682-4.

6. Watson-Jones D, Mugo N, Lees S, Mathai M, Vusha S, Ndirangu G, et al. (2015) Access and Attitudes to HPV Vaccination amongst Hard-To-Reach Populations in Kenya.

PLoS ONE 10: e0123701. doi:10.1371/journal.pone.0123701

WE CAN

#WeCanICan #WorldCancerDay

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IMPROVE ACCESS TO CANCER CARE ca

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WE CAN IMPROVE ACCESS TO CANCER CARE Closing the gap in access to affordable, quality cancer care is an imperative for maximising outcomes and quality of life for all people living with cancer, including children and adolescents.

Access to effective, quality cancer care should be embedded within a country’s National Cancer Control Plan (NCCP). NCCPs should cover access to each of the critical components of a multidisciplinary approach encompassing supportive and palliative care, high-quality cancer medicines and effective cancer treatment modalities1,2.

This includes radiotherapy, which is recognised as an essential tool in the cure and palliation of cancer and is indicated in more than half of new cancer patients3. Additionally, resource-sensitive clinical guidelines can be used to assist with the planning and delivery of early detection and treatment4,5. Addressing barriers to equitable access to quality cancer services should include the

alleviation of cultural and structural issues e.g. transportation, as well as policies and programmes to improve the availability of a skilled cancer workforce.

Of equal importance is to address affordability of care to protect individuals and families from financial hardship as a consequence of out-of-pocket expenses.

The provision of universal health coverage (UHC) and other social protection measures can play an important role in closing the unacceptable gaps in access to cancer services that occur in most lowresource settings.

We can advocate for improved access to cancer treatment and services across the care continuum. All people have the right to benefit from these interventions on equal terms, regardless of geography and without suffering economic hardship as a consequence.

This factsheet is aimed at Healthcare professionals

Policy makers

Cities

1. International Cancer Control Partnership. Cancer Plans. http://www.iccp-portal.org/cancer-plans 2. Hogerzeil HV, Liberman J, Wirtz VJ, et al. (2013). Promotion of access to essential medicines for non-communicable diseases: practical implications of the UN political declaration. Lancet , 381, 680-9.

3. Delaney G, Jacob S, Featherstone C, Barton M. (2005).

The role of radiotherapy in cancer treatment: estimating optimal utilization from a review of evidence-based clinical guidelines. Cancer 104, 1129-37.

4. WHO. (2013). WHO guidelines for screening and treatment of precancerous lesions for cervical cancer prevention.

Geneva: World Health Organization.

5. Yip CH, Smith RA, Anderson BO, et al. (2008). Guideline Implementation for Breast Healthcare in Low- and MiddleIncome Countries Early Detection Resource Allocation.

Cancer 113, 2244-56

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#WeCanICan #WorldCancerDay

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SHAPE POLICY CHANGE ca

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WE CAN SHAPE POLICY CHANGE The law and regulatory measures can be used effectively to reduce exposure to cancer risks including to tobacco, alcohol and unhealthy foods, as well as environmental exposures.

Tobacco taxation has been identified as the single most important policy intervention that governments can take to reduce major risk factors for NCDs1. It costs little to implement and increases government revenues. The World Health Organization (WHO) calculates that if all countries increased taxes on cigarette packs by 50%, there would be 49 million fewer smokers (38 million fewer adult smokers and 11 million fewer young future smokers) and this would avert 11 million deaths from smoking2.

Additionally, policy interventions around product labelling, procurement and regulation of advertising, promotion and sponsorship can reduce exposure to unhealthy foods and drinks3,4.

Effective policy at the national level can also improve access to essential cancer medicines including pain relief medicines, and deliver quality cancer care. Following a targeted advocacy campaign, in 2014 at the World Health Assembly, governments adopted a resolution which provided clear recommendations to improve access to palliative care5. These include ensuring

palliative care is embedded in all national health policies and budgets, and in the curricula for health professionals. Vitally, it also highlights the need for countries to ensure that there is an adequate supply of all essential palliative care medicines for adults and children.

In another concerted advocacy effort, UICC led a close collaboration with WHO and a dedicated task team to ensure the best representation of cancer drugs in the WHO Model List of Essential Medicines (EML).

As a result of these efforts, in May 2015, the latest edition of the WHO EML was published and includes 16 new cancer treatments - a milestone in patients’ access to cancer medicines6,7.

Patients, families, healthcare providers and civil society now need to continue to advocate to governments for the implementation of policies and programmes at the national level that translate these commitments into action for patients and their families.

Effective advocacy for policy change at all levels - local, national, and global - can reduce exposure to cancer risk factors and improve access and availability of essential cancer medicines and quality cancer care.

This factsheet is aimed at Healthcare professionals

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Policy makers

Cities

Jamison DT, Summers LH, Alleyne G, et al. (2013). Global health 2035: a world converging within a generation.

Lancet, Published Online December 3, 2013 http://dx.doi. org/10.1016/.

2. WHO (2014). Raising tax on tobacco: What you need to know. Geneva: World Health Organization.

3. WHO. (2010). Set of recommendations on the marketing of foods and non-alcoholic beverages to children.

Geneva: World Health Organization.

4. WCRF International. (2014). WCRF International Food Policy Framework for Healthy Diets: NOURISHING. http://www.wcrf.org/policy_public_affairs/nourishing_ framework/index.php.

5. WHO (2014). Strengthening of palliative care as a component of integrated treatment throughout the life course. A67/31 4 April 2014.

6. 19th WHO Model List of Essential Medicines (April 2015). www.who.int/medicines/publications/essentialmedicines/ EML2015_8-May-15.pdf 7. 20th WHO Expert Committee report on the Selection and Use of Essential Medicines (2015) www.who.int/ medicines/publications/essentialmedicines/ExecutiveSummary_EML-2015_7-May-15.pdf

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#WeCanICan #WorldCancerDay

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BUILD A QUALITY WORKFORCE ca

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WE CAN BUILD A QUALITY WORKFORCE Inadequate education of healthcare providers is one of the most pervasive and urgent obstacles to address in delivering quality cancer care1.

Investment in continuing professional development (CPD) to equip healthcare workers with the appropriate tools and knowledge to deliver best practice services across the cancer care continuum is vital. This includes building expertise and capacity amongst health professionals to recognise the early signs and symptoms of some cancers, as well as appropriate early detection measures; ensuring the safe and proper

administration of chemotherapy and other cancer treatment modalities including radiotherapy and surgery; and delivering palliative care and pain and distress management.

Whilst education can include both conventional teaching methods as well as e-learning platforms and multimedia tools, where possible it should also build on existing materials, training networks and infrastructure2,3,4.

The cancer workforce can be equipped with the skills, knowledge and competencies required to meet the needs of individuals and communities across the cancer continuum.

This factsheet is aimed at Workplaces

1. Global Health Workforce Alliance. (2013). A universal truth: no health without a workforce. Geneva: World Health Organization.

2. C-Change. (2012). A National Strategy to Strengthen the Cancer Workforce: Position Statement and Call to Action. http://c-changetogether.org/Websites/cchange/images/ Workforce/WORKFORKCE_POSITION_STATEMENT-_ with_endorsements-_February_28_2013.pdf

3. iheed Institute. (2012). Preparing the next generation of community health workers: The power of technology for training. iheed Institute, the Barr Foundation, the mHealth Alliance, and the MDG Health Alliance. Cork, Ireland: Dalberg Global Development Advisors.

4. The Recife Political Declaration on Human Resources for Health (HRH). http://www.who.int/workforcealliance/ forum/2013/recife_declaration_13nov.pdf

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#WeCanICan #WorldCancerDay

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MAKE THE CASE FOR INVESTING IN CANCER CONTROL ca

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WE CAN INSPIRE ACTION, TAKE ACTION The economic case is a vital piece of the puzzle to change mind-sets around the value of investing in cancer prevention, early detection and control.1

revenues – evidence suggests that if countries increased tobacco tax by 50% per pack, governments around the world would earn an extra USD 101 billion in revenue.5

There is already a compelling financial/ economic argument for investing in the prevention of cancer. A case in point is tobacco control. While the annual economic costs of tobacco-related cancers exceed USD 200 billion, for the average low- and middle-income country, the amount necessary to deliver the four “best buy” tobacco control measures is approximately USD 0.11 per capita.2,3 These four measures include: tobacco tax increases, smoke-free policies, graphic package warnings, and advertising bans.

The cancer community is now drawing on its networks of experts to build the global evidence base on the economic costs and the return on investment (ROI) in taking on other proven strategies for cancer prevention, early detection and health systems strengthening. This includes the case for investment in radiotherapy, which is indicated to be a critical tool in the cure and palliation of more than half of cancer cases6.

The Global Task Force on Radiotherapy for Cancer Control (GTFRCC) has provided compelling evidence to show that scalingup investment in radiotherapy could enable treatment of large numbers of cancer cases to save lives, and at the same time deliver substantial economic benefits.7

Of these four measures, increasing excise taxes on tobacco products is widely accepted as one of the most effective and affordable tobacco control interventions4.

The World Health Organization (WHO) estimates that raising tobacco taxes costs as little as USD 0.005 per person per year and can save millions of lives.4 Additionally, it has been shown that raising tobacco taxes does not lead to a fall in government

Building the economic case for investment in cancer can change mind-sets and allow governments to justify placing cancer control at the heart of their national health plans.

This factsheet is aimed at Healthcare professionals

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Workplaces

Policy makers

UICC. The Economics of cancer prevention & control: Data digest (2014). http://www.iccp-portal.org/ economics-cancer-prevention-control-data-digest 2. World Health Organization. Scaling up action against noncommunicable diseases: how much will it cost?

Geneva: WHO Press; 2011 3. Tobacco Atlas. Investing in tobacco control. http://www. tobaccoatlas.org/topic/investing-in-tobacco-control/ 4. Chaloupka F, Yurekli A, Fong G. Tobacco Taxes as a Tobacco Control Strategy. Tobacco Control. 2013.

Cities

5. World Health Organization. (2014). Raising tax on tobacco - What you need to know, Geneva: WHO Press.

6. Delaney G, Jacob S, Featherstone C, Barton M. (2005).

The role of radiotherapy in cancer treatment: estimating optimal utilization from a review of evidence-based clinical guidelines. Cancer 104, 1129-37.

7. The Lancet Oncology Commission. (2015). Expanding global access to radiotherapy. Lancet Oncology 16, 1143-86

WE CAN

#WeCanICan #WorldCancerDay

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JOIN FORCES TO MAKE A DIFFERENCE ca

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WE CAN JOIN FORCES TO MAKE A DIFFERENCE Joining forces to create innovative and multisectoral partnerships is a key step in mobilising civil society, strengthening advocacy efforts and making governments accountable.

By uniting around common goals and aspirations, the global cancer community can leverage the complementary skills, knowledge and spheres of influence of each partner to increase investment in cancer prevention measures, to address inequities in access to quality affordable cancer treatment and care, and reduce premature deaths from the disease.1,2 The Union for International Cancer Control (UICC), as a founding member of the NCD Alliance, recognises the power of working together as a network united in the goal of creating sustained global action on non-communicable diseases (NCDs). Through the NCD Alliance,

local, national and regional networks of cancer experts and advocates have come together to drive remarkable progress in elevating cancer and other NCDs on the global health and development agenda and to stimulate collaborative advocacy, action and accountability at the national level.3 Other global networks, such as the global coalition Cervical Cancer Action, are accelerating progress by uniting global health leaders and grass-roots organisations from diverse backgrounds to call on governments to invest in cervical cancer prevention.4 Through political mobilisation, coalitions of partners can expand global support to end cancer, engaging champions to support a comprehensive approach to cancer prevention and control.

Uniting around common goals will drive action on all fronts - in prevention, early detection, treatment and care - catalysing progress towards achieving the World Cancer Declaration targets.

This factsheet is aimed at Healthcare professionals

Workplaces

Policy makers

1. UICC Advocacy Toolkit 2014. http://www.uicc.org/ advocacy/advocacy-resources 2. World Cancer Declaration. http://www.uicc.org/worldcancer-declaration

Schools

Cities

Sport & leisure groups

3. NCD Alliance. http://www.ncdalliance.org/ 4. Cervical Cancer Action. http://www.cervicalcanceraction. org/home/home.php

I CAN

#WeCanICan #WorldCancerDay

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MAKE HEALTHY LIFESTYLE CHOICES ca

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I CAN MAKE HEALTHY LIFESTYLE CHOICES Everyone can take steps to reduce their risk of cancer by choosing healthy options including quitting smoking, keeping physically active and choosing healthy food and drinks.

Tobacco use is the single largest preventable cause of cancer globally.

Quitting smoking will have a major positive impact on an individual’s health and that of their families and friends. The good news is that quitting at any age is beneficial, increasing life expectancy and improving quality of life1.

Individuals can also reduce their risk of many common cancers by maintaining a healthy weight, and making physical activity part of their everyday lives2,3.

Being overweight or obese increases the risk of ten cancers - bowel, breast, uterine, ovarian, pancreatic, oesophagus, kidney, liver, advanced prostate and gallbladder cancers4,5. Specific changes to a person’s diet can also make a

difference – for example, individuals can limit their intake of red meat and avoid processed meat.3 Alcohol is also strongly linked with an increased risk of several cancers.

Reducing alcohol consumption decreases the risk of cancers of the mouth, pharynx, larynx, oesophagus, bowel, liver and breast6. Overall, more than a third of common cancers could be prevented by a healthy diet, being physically active and maintaining a healthy body weight.

Reducing exposure to ultraviolet (UV) radiation from the sun and other sources, such as solariums, is also important to reduce the risk of many skin cancers7.

Everyone can make healthy lifestyle choices to reduce their risk of cancer.

This factsheet is aimed at Individuals

Patients & Carers

1. Jha P, Peto R. (2014). Global Effects of Smoking, of Quitting, and of Taxing Tobacco. N Engl J Med. 370:60-8.

2. World Cancer Research Fund International. Our cancer prevention recommendations. http://www.wcrf.org/int/ research-we-fund/our-cancer-prevention-recommendations 3. World Cancer Research Fund International. Link between lifestyle and cancer risk. http://www.wcrf.org/int/linkbetween-lifestyle-cancer-risk 4. World Cancer Research Fund International/American Institute for Cancer Research. Continuous Update Project. http://www.wcrf.org/int/cancer-facts-figures/link-betweenlifestyle-cancer-risk/cancers-linked-greater-body-fatness

5. World Cancer Research Fund International/American Institute for Cancer Research. Continuous Update Project Reports. http://www.wcrf.org/int/research-we-fund/ continuous-update-project-findings-reports 6. WHO. (2011). Global status report on alcohol and health.

Geneva: World Health Organization.

7. SunSmart. UV and sun protection. http://www.sunsmart. com.au/uv-sun-protection

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UNDERSTAND THAT EARLY DETECTION SAVES LIVES ca

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I CAN UNDERSTAND THAT EARLY DETECTION SAVES LIVES Diagnosing cancer isn’t always easy – not all cancers show early signs and symptoms and other warning signs appear quite late when the cancer is advanced.

However, for a number of cancers, increasing awareness of signs and symptoms and the importance of timely treatment has been shown to improve survival from cancer. This is because finding cancer early almost always makes it easier to treat or even cure. In fact, recent figures from the United Kingdom for example, have found that for eight common cancers - bladder, bowel, breast, cervical, womb, malignant melanoma, ovarian and testicular cancers - survival is three times higher when cancer is diagnosed early1.

Public awareness campaigns and workplace health and wellbeing initiatives are important communication platforms to raise awareness of the signs and symptoms of cancer and encourage people to seek help promptly. With the right information, individuals can be encouraged to know what’s normal for their body and to recognise any unusual or persistent changes2. For example, a person can

become familiar with the look of their skin so they can be aware of any changes that might suggest a skin cancer, such as recognising a spot that is growing and changing in shape or size3.

For some cancers, there is robust evidence to support cancer screening. This means testing apparently healthy people for signs that could mean a cancer is developing.4 For example, in many countries, national bowel cancer screening programs are available that use the Faecal Occult Blood Test, also called FOBT, the most effective population screening tool for detecting early signs of bowel cancer. This test looks for hidden traces of blood in a bowel motion (faeces) in people without symptoms. It can help detect bowel cancer in its early stages when treatment is more likely to be successful and the chances of survival are much better.5 Individuals can talk to their local health professional to learn about what screening programs are available for them.

Diagnosing cancer at its stages and seeking timely care can save lives.

This factsheet is aimed at Individuals

Healthcare professionals

1. Cancer Research UK. Survival three times higher when cancer is diagnosed early: po.st/PilTnn 2. Cancer Research UK. Key signs and symptoms of cancer. http://www.cancerresearchuk.org/about-cancer/cancersymptoms#accordion_symptoms13 3. Cancer Council Australia. Skin Cancer Identification poster. http://www.cancer.org.au/content/pdf/Factsheets/MS%20 214%20CCA%20MELANOMA%20POSTER%20V4%20. pdf#_ga=1.144286962.678793188.1438205862

4. Cancer Research UK. Understanding cancer screening. http://www.cancerresearchuk.org/about-cancer/screening/ understanding-cancer-screening 5. Cancer Council Australia. Bowel Cancer. http://www. bowelcancer.org.au/index.php

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TAKE CONTROL OF MY CANCER JOURNEY ca

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I CAN TAKE CONTROL OF MY CANCER JOURNEY Many cancer patients and their families describe feeling a loss of control of their lives after a cancer diagnosis. Empowering patients to do whatever they need to regain a sense of control and preserve their dignity throughout their cancer journey can help them manage the changes cancer brings to their lives.

People-centred care requires that all patients have the education and support they need to make decisions and participate in their own care across the entire cancer journey.1 Health professionals can support this approach by providing clear explanations of the available treatment options, including the risks, benefits, and uncertainty associated with the options to ensure patients and their families are active participants in decisions about their care, and their treatment plan respects their individual needs and preferences.1-4

Cancer patients receiving palliative or supportive care may have particular needs in finding relief from symptoms, pain, and distress.5 Having access to people-centred, dignity-conserving care where patients take part in decisions, and all their care needs are addressed - physical, emotional, spiritual, and social - is essential to delivering effective palliative or supportive care.6,7 Addressing issues of body image can also be an important way of regaining control and preserving a degree of normality.

Accessing dedicated support services to help manage the physical changes that can occur during and after cancer treatment, such as hair loss or speech impairment, can improve confidence and the way patients look and feel about themselves.7,8 Even if others can’t see these changes, for example urinary incontinence, seeking professional help can rebuild self-esteem.

People living with cancer can take control of their cancer journey by being empowered to be active participants in decisions about their care, having their choices respected and their needs met.

This factsheet is aimed at Patients & Carers

Healthcare professionals

1. WHO (2016). Framework on integrated, people-centred health services. A69/39 15 April 2016.

2. Kehl KL, Landrum MB, Arora NK, et al. (2015).

Association of actual and preferred decision roles with patient-reported quality of care: shared decision making in cancer care. JAMA Oncol. 1:50-8.

3. Politi MC, Studts JL, Hayslip JW. (2012). Shared Decision Making in Oncology Practice: What Do Oncologists Need to Know? Oncologist. 17:91-100 4. MacMillan Cancer Support. Making treatment decisions. http://www.macmillan.org.uk/information-and-support/ treating/treatment-decisions

5. American Cancer Society. A Guide to Palliative or Supportive Care. What is palliative care? http://www. cancer.org/treatment/treatmentsandsideeffects/ palliativecare/supportive-care 6. WHO (2014). Strengthening of palliative care as a component of integrated treatment throughout the life course. A67/31 4 April 2014.

7. Managing body image difficulties of adult cancer patients: Lessons from available research. Cancer. 120:633–41.

8. Macmillan Cancer Support. Changes in body image. http:// www.macmillan.org.uk/information-and-support/coping/ changes-to-appearance-and-body-image

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LOVE, AND BE LOVED ca

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I CAN LOVE, AND BE LOVED Cancer affects everyone in a patient’s life in different ways. Partners, families and friends can take steps to work together through the challenges of cancer and its treatment so that no one faces the disease alone.

There is no ‘right way’ for a cancer patient and their partner to cope with cancer, but there are actions that couples can take to support each other through this challenging time.1 For example, keeping the lines of communication open and taking time to talk about feelings and difficult topics such as the fear of recurrence or financial concerns can be helpful in dealing with the emotional impact.2 For many, one of the longest lasting and most devastating consequences of a cancer diagnosis is the impact on sexual health and wellbeing.3 Both men and women can experience changes to sexual function and sexuality after cancer treatment.4

Changes may be associated with side effects of cancer treatment – sometimes these are short-term such as fatigue or pain, or for others there may be long-term effects, such as erectile dysfunction due to some treatments for prostate cancer.

Seeking information and assistance from health professionals and cancer support services can help cancer patients to adjust to changes in sexual function and assist couples to renegotiate sex and intimacy.5 Friends and families can also play a major role in providing emotional, social and practical support. Spending time with a person, being willing to talk about their experiences and offering assistance, even with small tasks, can all be enormously helpful.6 For some people, support may be needed over many years after the initial diagnosis as they continue to live with the physical and emotional impact of cancer even when treatment is finished.

For a person living with cancer, strong emotional support and loving relationships with partners, friends and families can make a big difference in their life.

This factsheet is aimed at Patients & Carers

1. Macmillan Cancer Support. Relationships – You and your Partner. http://www.macmillan.org.uk/informationandsupport/coping/relationships/you-and-your-partner 2. Livestrong. Communicating with your partner. http:// www.livestrong.org/we-can-help/preparing-yourself/ communicating-with-your-partner/ 3. Ussher JM, Perz J & Gilbert, E. (2012). Changes to sexual well-being and intimacy after breast cancer. Cancer nursing, 35, 456-65.

4. Girgis A, Lambert S, Johnson C, et al. (2013). Physical, Psychosocial, Relationship, and Economic Burden of Caring for People With Cancer: A Review. J Oncol Practice, 9, 197-202 5. Perz J, Ussher JM, Gilbert et al (2014). Feeling well and talking about sex. BMC Cancer 14:228.

6. American Cancer Society. How to be a friend to someone with cancer. http://www.cancer.org/treatment/ understandingyourdiagnosis/talkingaboutcancer/how-tobe-a-friend-to-someone-with-cancer

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ASK FOR SUPPORT ca

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I CAN ASK FOR SUPPORT Maintaining social support networks and talking about cancer can be important strategies for coping with the social and emotional impact of cancer, both in the short and long term.

This is true for both the person living with cancer and their carer(s). Support can come from many sources – partners, friends, family, colleagues, healthcare professionals and counsellors – with some people choosing to join self-help or support groups. Support groups can provide a caring and supportive environment for people living with cancer to express their feelings and reduce anxiety and fear1.

Sometimes the people at work make up another vital network of support. Talking about cancer with colleagues as well as keeping in touch with them during work absences can have a positive impact on recovery2.

Cancer caregiving can also have an enormous influence on both physical and mental health. Carers – most commonly partners, family members or friends receive little preparation, information or support to carry out their vital role3. Many carers put their own needs and feelings aside to focus on the person with cancer, and as a consequence may experience emotional distress and social isolation4.

Recognising the challenges of looking after someone with cancer and seeking support can have wide-ranging benefits for coping and quality of life5.

People living with cancer and their caregivers can ask for support to help them cope with cancer.

This factsheet is aimed at Patients & Carers

1. Ussher J, Butow P, Wain G. et al. (2005). Research into the Relationship Between Type of Organisation and Effectiveness of Support Groups for People with Cancer and their Carers. http://staging.cancercouncil.com.au/ wp-content/uploads/2011/02/Executive-Summary-for-CSGresearch-2005.pdf.

2. Macmillan Cancer Support. Work and Cancer. http://www.macmillan.org.uk/Cancerinformation/ Livingwithandaftercancer/Workandcancer/Workandcancer. aspx

3. Northouse LL, Katapodi M, Song L, et al. (2010).

Interventions with family caregivers of cancer patients: meta-analysis of randomized trials. CA Cancer J Clin, 60, 317-339.

4. NBCF. (2013). So I Bit down on the Leather: Ending the Silence. Sydney: National Breast Cancer Foundation 5. Looking after someone with cancer. http://be.macmillan. org.uk/be/s-330-information-for-carers.aspx

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I CAN MAKE MY VOICE HEARD ca

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I CAN I CAN MAKE MY VOICE HEARD People living with cancer and their families, friends and caregivers can be powerful advocates for others dealing with the disease.

By sharing their own story, cancer survivors can help others by reducing the fear and stigma around the disease that often deter others from seeking care and support.1 For example, the impact assessment of an antistigma campaign in Mexico that centred on giving cancer survivors a platform to tell their own story, showed that 76% of people exposed to the campaign learned something new about cancer and 70% said they now talked more openly about the disease.

Participants also commented that they were more supportive of a person living with cancer because of what they learned.2

Individuals can also be part of the wider conversation on cancer policy through engaging in public campaigns, communicating with decision-makers, and joining with consumer support groups to ensure the patient’s voice is heard. In this way, cancer patients and their families can inspire change by helping define the issues that matter to them and advocate for measures to address these issues.3 The parents, families and caregivers of children and adolescents with cancer have a particular role to play in advocating for their rights to be protected, pushing for equitable and affordable access to quality cancer care and making others aware of the particular challenges faced by children and adolescents with cancer.4

By making their voices heard, individuals can be powerful agents of influence and change for all people affected by cancer.

We encourage you to make your voice heard and share your story at worldcancerday.org/share-your-story

This factsheet is aimed at Patients & Carers

1. L IVESTRONG. (2011). Cancer Stigma and Silence Around the World: A LIVESTRONG Report. Austin: LIVESTRONG. http://www.livestrong.org/What-We-Do/Our-Actions/ Programs-Partnerships/Anti-Stigma-Campaign 2. Results from LIVESTRONG Mexico anti-cancer stigma campaign. http://blog.livestrong.org/2012/08/27/resultsfrom-livestrong-mexico-anti-cancer-stigma-campaign/

3. C ancer Voices Australia. http://www.cancervoicesaustralia. org/ 4. Childhood Cancer International. http://www. childhoodcancerinternational.org/

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RETURN TO WORK ca

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I CAN RETURN TO WORK Many people living with cancer want to return to work. They mention both financial and emotional reasons for going back to work, with a job restoring normality, stability, social contact and income1.

Most often, people living with the disease need their employers to make some allowances to support them to get back to work successfully2,3. Talking about cancer to their employers can help ensure that appropriate adjustments are put in place for the person living with the disease or their caregivers, such as changes in tasks or accommodation of different physical needs, e.g. adjusting for changes in mobility or physical functioning such as difficulty with stairs. A phased-return to work

may also be possible so that a person is supported to ease back into work. Often, the types of changes required vary over time and continuing open and honest conversations with an employer about what is and is not possible in terms of flexible work arrangements and job adjustments is critically important to avoid distress for all.

It is also important for people with cancer who want to return to work to understand their rights. In many countries, employers have a legal obligation to make reasonable adjustments at work for people living with cancer and to ensure they are not at a disadvantage compared to other employees4,5.

With the right support, people living with cancer can return to work successfully.

This factsheet is aimed at Workplaces

1. Macmillan Cancer Support. Work and Cancer. http://www.macmillan.org.uk/Cancerinformation/ Livingwithandaftercancer/Workandcancer/Workandcancer. aspx 2. Cancer Council NSW. Working during cancer treatment and recovery. http://www.cancercouncil.com.au/31271/b1000/ cancer-work-you-47/working-during-cancer-treatment-andr ecovery/#dMHmPfc29xMVaWJ6.99 3. Canadian Partnership Against Cancer. (2012). Return to Work Concerns Faced by People Dealing with Cancer and Caregivers. http://www.cancerview.ca/idc/groups/public/ documents/webcontent/rtw_literature_review.pdf

4. UICC, Bupa (2015). Working with cancer: Supporting employees living with cancer to return to work. http://www. iccp-portal.org/resources/uicc-bupa-–-working-cancersupporting-employees-living-cancer-return-work 5. McCabe Centre for Law & Cancer, Cancer Council Victoria.

(2013). Making the law work better for people affected by cancer. Melbourne: McCabe Centre for Law & Cancer.