World Cancer Congress, Dec. 3-6
The biannual meeting of the Union for International Cancer Control, the World Cancer Congress, was held from Dec. 3 to 6 in Melbourne, Australia, and attracted participants from around the world, including cancer control experts, practitioners, and advocates. The conference featured presentations focusing on the latest information in cancer control as well as effective interventions for cancer prevention, diagnosis and care, and supportive and palliative care.
During the meeting, Nathalie Broutet, M.D., Ph.D., of the World Health Organization (WHO) in Zurich, discussed the new WHO guidance on the prevention and control of cervical cancer. The WHO guidelines aim to aid practitioners in understanding the available options to prevent and control cervical cancer.
"Options for the prevention and control of cervical cancer are targeted for specific age groups. Vaccination is commonly recommended in young adolescent girls who are not yet sexually active. The reason to vaccinate young adolescent girls is that human papillomavirus (HPV) infections have been linked to cervical cancer and vaccination prevents the acquisition of HPV infection," Broutet said. "For women of 30 years of age and over, there are three types of screening available: VIA (visual inspection with acetic acid), HPV testing, and Papanicolaou smear testing. This is the first time that WHO is recommending HPV testing in this population as a strategy to prevent and control cervical cancer."
The new WHO guidelines highlight the need to change communication strategies about cervical cancer prevention.
"When the only strategy to prevent cervical cancer was screening and treatment, the message focused on woman 30 years of age and older. However, with HPV vaccination available, communication strategies have to change to include a broader population," Broutet said.
The WHO guidelines are a global standard. They outline what types of preventive strategies are available and cost-effective, but do not tell providers in particular countries which strategies to use.
In addition, during the meeting, Mary Gospodarowicz, M.D., of the UICC in Geneva, discussed new guidelines regarding prostate specific antigen (PSA) testing.
"The objectives of the new Australian draft prostate cancer clinical guidelines, released for public consultation at the 2014 World Cancer Congress, were to provide clear recommendations to maximize the benefits and reduce the harms associated with the PSA test for prostate cancer," Gospodarowicz said. "Approaches to prostate cancer testing differ across the world. Decision-making is complicated by the need to balance effective cancer detection and care with concerns about over-diagnosis and prostate cancer treatment adverse side effects, including urinary incontinence, loss of sexual potency in men treated by radiotherapy, and bowel problems."
According to Gospodarowicz, wide-spread population-based PSA testing is not recommended in Australia. However, the guidelines outline specific male patient populations where testing would be appropriate.
"These new draft clinical guidelines are significant as they provide a careful examination of existing evidence through widespread consultation to empower consumers (men). They are expected to inform international opinion and practice regarding PSA testing; however, individual countries must make an informed decision on PSA testing based on their own populations," Gospodarowicz said.
Another initiative launched at the meeting by the American Cancer Society (ACS) aims to reduce the global cancer burden. John Seffrin, Ph.D., of the ACS, discussed the importance of The Cancer Atlas, a new tool released in a joint effort with the International Agency for Research on Cancer and the UICC.
"Today we know more about cancer -- how to control it -- than ever before. But making sense of the mountains of available data can be a challenge for anyone. The Cancer Atlas solves this problem, consolidating research from 184 countries and the best sources available into a comprehensive guide to the global cancer landscape, a one-stop shop for all the best cancer information," Seffrin said. "And we know information is power. In the hands of policymakers, advocates, researchers, and academics, The Cancer Atlas provides a way to fully assess differences in cancer risk, burden, and prevention. The data featured in the book and on the website also point to strategies that governments can use to reduce their cancer burden. But most importantly, it provides the power to help discover ways to further this fight worldwide."
In one study, Inger Gram, M.D., Ph.D., of the UiT Artic University of Norway in Tromsø, and colleagues found that women who started to smoke before the birth of their first child had an increased risk of breast cancer.
"Since women today commonly start to smoke at an earlier age and have children later in life, there is a longer period of smoking before child birth, which appears to be associated with an increased risk of breast cancer," Gram said. "To prevent breast cancer, based on our results, we promote that primary prevention for breast cancer should begin among teenagers. This research provides yet another reason to encourage young girls to not start smoking and/or quit smoking immediately and not wait until they think about getting pregnant."
In a meta-analysis of randomized-controlled trials, Jose Meneses-Echavez, P.T., M.P.H., of the Universidad Santo Tomás in Bogotá, Colombia, and colleagues evaluated the effects of exercise training on the blood parameters of inflammatory biomarkers in breast cancer patients.
"The key results were that exercise can have positive psychological and biological effects on the mechanisms related to tumor progression. This is a very safe and effective treatment option that differs from traditional approaches such as chemotherapy and radiation, as these treatments exert cytotoxic effects on the immune system and exercise is not associated with these types of side effects," Meneses-Echavez said. "Based on this evidence, exercise should be strongly recommended for cancer patients, not only in the prevention of cancer, but for the treatment as well. It is both a very effective and safe treatment option."