World Cancer Day: President of the European Society for Paediatric Oncology says more needs to be done to tackle children’s unhealthy life-styles

The world faces an "explosion” in obesity-related cancers in adults if individuals and governments do not take action now to tackle children’s unhealthy lifestyles, warns a leading childhood cancer specialist.

In an interview for ECCO – the European CanCer Organisation, to mark World Cancer Day today, Professor Kathy Pritchard-Jones, President of the European Society for Paediatric Oncology (SIOPE), said: “While it should be stressed that improving lifestyle choices in childhood almost certainly does not reduce your risk of childhood cancer, which is, in any case, remote, childhood is the time when the habits of a lifetime are established. So if you want healthy adults you have to start by making healthy children.

“The chronic risk factors for cancer in adults, such as smoking, obesity and diet, are habits that are established in childhood. If we don’t do something about tackling how much exercise our young people take and how concerned they are about what they eat and their weight, we are going to have another explosion of cancers, to which unhealthy lifestyles will be a significant, contributory factor. We have just started to make an impact on the rates of cancers caused by smoking, at least in the Western world, but now we are going to start seeing a rise in the rates of obesity-related cancers.”

Prof Pritchard-Jones, who is Professor of Childhood Cancer Biology & Consultant Paediatric Oncologist at The Institute of Cancer Research and the Royal Marsden Hospital, made her remarks as the International Union Against Cancer (UICC) launched World Cancer Day with a specific focus on encouraging children to have an energy-balanced lifestyle, based on a healthy diet and physical activity.

The prevalence of overweight and obesity is rising dramatically among adults and children around the world. According to the World Health Organization, one billion adults are overweight, and at least 300 million of these are clinically obese. The International Obesity Taskforce estimates that one out of every ten school-age children is overweight. Of those, around 30-45 million are classified as obese –accounting for 2-3% of the world's children aged 5-17.

Dietary factors, physical inactivity, overweight and obesity are estimated to account for approximately 30% of cancers in Western countries, making diet and physical activity second only to tobacco as a preventable cause of cancer. This proportion is thought to be about 20% in developing countries and is projected to grow.

Prof Pritchard-Jones echoed the UICC’s call on families, health professionals, teachers and policy makers to do more to promote health and prevent cancer by encouraging children to lead healthy, energy-balanced lifestyles, which will help to reduce their risk of cancer in later life.

“I think World Cancer Day should make governments and the world’s policy makers take a look at what is happening in their own populations and at trends, and this may stimulate them into action,” she said.

Focusing on the “World” in “World Cancer Day”, she said: “One of the main challenges is to help the 80% of children with cancer in the world who live in countries with limited resources. For children with cancer in the Western world, the good news is that survival levels are continuing to improve and now three quarters can expect to be cured. However, this is usually not the case for countries with limited resources.”

One effective way of improving survival rates for childhood cancer around the globe is for partnerships to be established with Western centres or networks, she said.

“There are some good studies of twinning programmes that show that with relatively simple supportive measures in terms of some targeted infrastructure in the local hospitals and linking them with experts in Western medical centres you can make quite dramatic improvements in treatment outcomes over a matter of five years in some under-resourced countries.

“Several European childhood cancer groups and treatment centres reach out beyond the borders of Europe and help countries adapt protocols to their local situation. This has led to marked improvements in outcome in some centres, from Eastern Europe and Moscow to as far afield as Indonesia and Malawi. Members of the International Society of Paediatric Oncology (SIOP) organise clinical trials for very rare cancers that recruit from around the world and share good practice. The very active twinning programme between St Jude Children’s Research Hospital in Memphis and medical centres in Central America has really improved outcomes even for a very complex cancer like osteosarcoma, which needs very good pathology, surgery and intensive chemotherapy.”

She said that such partnerships not only improve childhood cancer treatment, but also have a positive impact on the general medical treatment of children seen in the same hospital or clinic.

“If you implement the infrastructure to treat children with cancer, even with a relatively simple protocol, just focusing on a few cancers that you’ve got a chance of curing, such as Wilms’ tumour and Burkitt’s lymphoma, what you find is that there’s a knock-on effect in that it improves the general paediatric medical infrastructure,” she said.

“Also the message gets out to the community that some of these horrible lumps that occur in their children are curable. They start bringing the children to the medical centre earlier because they realise something can be done, whereas perhaps in the past, certainly in Africa, they would have used traditional medicine first. If they see that Western medicine has something to offer, they might seek it earlier and then of course the cancers start to be diagnosed earlier and you have a better chance of curing them.

“World Cancer Day should be a forum to promote these inter-country partnerships and to encourage us all to reach out beyond borders,” concluded Prof Pritchard-Jones.

Professor Alexander M.M. Eggermont, president of ECCO, commented: “The World Cancer Day focus on over-weight and obesity is a very important and timely initiative. The obesity epidemic has a devastating impact on the rise in the incidence of cardiovascular disease in terms of hypertension, myocardial infarctions and strokes, in the rise in diabetes with all its complications, such as in the kidneys and eyes, and in the rise in arthrosis. All these are very costly chronic diseases. However, the rise in obesity-related cancers is also very important and generally not so well known.

“Prevention programmes that will reduce the incidence of cancers are of prime importance and these ‘World Cancer Cays’ focus rightly on prevention. If, on top of this, we can make kids realise that smoking is not sexy and will probably kill them, this programme will have a bigger impact than many a treatment programme. Thus, making people aware of the dangers of smoking, as well as the dangers of unhealthy eating, should be part of all public awareness programmes and national cancer plans.”