Cancer Continuum

Each country has opportunities to prevent and control cancer through resource-stratified evidence-based interventions across the entire cancer care continuum, from risk factor prevention, early detection and timely diagnosis, to quality treatment, survivorship, palliative care, and end-of-life care (Figure 32.1).

A comprehensive tobacco-control program – including interventions that increase tobacco prices by raising excise taxes, ban tobacco advertising, and support tobacco cessation – can effectively reduce smoking prevalence, thereby reducing the risk of lung (Figure 32.2) and 16 additional cancers and other smoking-related diseases. In addition to saving lives from smoking-related diseases, higher tobacco taxes also generate revenue for health care programs. However, many countries have only partly implemented comprehensive tobacco-control policies (see Tobacco Control).

Systematic and policy actions such as health education, nutrition policies, active transport initiatives, and community health programs can foster healthy lifestyles and improve cancer prevention (see Health Promotion). Environmental policies can lower daily exposure to carcinogens, reducing cancer risk (see Environmental Pollutants and Occupational Exposures). Sun protection measures help prevent skin cancer (see Ultraviolet Radiation). Vaccination against hepatitis B virus and human papillomavirus (HPV) can prevent several cancers, including liver, cervical, oral, and anogenital cancers (see Vaccination).

Early diagnosis and screening enable early detection of cancers, ensuring timely and effective treatment and improved survival (see Early Detection). Screening for cervical and colorectal cancers can also identify precancerous lesions, which can be removed before they become cancerous. Cervical cancer screening combined with a high uptake of HPV vaccination can accelerate the reduction in cervical cancers, helping to achieve the World Health Organization’s (WHO) goal of eliminating cervical cancer (Figure 32.3).

Recent advances in cancer treatment, including immunotherapy and targeted drug therapies, have markedly improved cancer survival and lowered cancer mortality (Figure 32.4). While these drugs may not be available broadly in many lower- and middle-income countries (LMICs) because of their high cost, many of WHO’s essential drugs are becoming increasingly accessible in LMICs, leading to improvements in outcomes (see Management and Treatment).

Effective pain management and palliative care services are essential for enhancing quality of life and providing comprehensive care for cancer patients (Figure 32.5) (see Pain Control).