Prevention is better than cure—an age-old saying, but one that is highly relevant in these times of increasing incidence of diseases and skyrocketing health care costs. It is estimated that at least half of all cancers are related to unhealthy habits or environments and are therefore preventable by environmental modification.
Primordial prevention, a concept introduced in 1978, deals with control of underlying conditions that may lead to exposure to causative factors. As disease patterns—even in developing countries—shift from communicable diseases to chronic diseases, creating healthy environments with the goal of preventing the emergence of risk factors known to cause cancer is assuming great importance.
The focus needs to shift from disease control to health preservation and promoting wellness. The approach has to be multipronged and implemented at the level of individuals and the population. Governments must recognize the importance of creating an environment that promotes healthy food choices, encourages physical activity, and enforces tobacco control. Governments must also accept responsibilty and undertake strong measures to reduce air, water, and food pollution, which is emerging as a growing threat to the health of populations, especially in developing countries.
Health education can lead to the adoption of healthy behaviours and simultaneously reduce the emergence of risk factors. Legislative policies have the greatest impact when they optimize the environments where people live, work, learn, and go for recreation—communities, workplaces, schools, etc.
There is growing evidence to suggest that environments can strongly influence the physical and mental health of individuals. A simple measure like building roads with sidewalks or cycling lanes that make walking and cycling safe and enjoyable can go a long way in encouraging physical activity. Nutritious food, smoke-free environments, and opportunities for exercise and healthy recreation should be made the norm in all schools and workplaces. Legislative measures like the sugar tax in Mexico can also be effective strategies towards promoting healthy food choices. Governments and industries need to work together to control environmental pollution and find and implement ways to safely dispose of hazardous chemicals and wastes.
Primordial prevention should be recognized as a priority at the policy and programme level, with the necessary investment of resources, since this is likely to be the most successful and cost-effective approach in the long run. This in turn necessitates mutilevel collaborative parterships involving all stakeholders including governments, scientific organizations, health care institutes, and the private industries.
Dr. Malik is Associate Professor, Department of Radiation Oncology at Nizam’s Institute of Medical Sciences in Hyderabad, India.
Read more posts in ASCO Connection’s blog series on World Cancer Day:
- World Cancer Day: “We Can” and We Will Make a Difference
- The Janitor Is a Member of the Multidisciplinary Team
- Challenging the Myths About Cancer, Causes, and Care
- Medical Students as Agents of Change
- Hello from Lagos, Nigeria
- Preventing Cancer: Genes Do Not Dictate Our Fate
- Work Together for Increased Impact
- We Can Mobilise Our Networks: Approval or Coverage for Oral Cancer Medications in Brazil