Written by Subbra Palaniappan, 3rd Year Med Student
Cancer is one of the most common diseases of the 21st century. Along with other non-communicable diseases, it is estimated by the WHO to kill around 38 million people per year with detrimental economic and social costs (1). In 2012, 14.1 million cases of cancer were diagnosed worldwide with 8.2 million deaths (2). This led to an approximate loss of 169.3 million years of healthy life cumulatively (2). More than 4 in 10 of these cancers occurred in countries classified as having a low or medium human development index level, where a healthy labour force is necessary for the economic growth and development of the country (2).
In the UK in 2011, 331 487 cases of cancer were diagnosed with close to 162 000 deaths in the following year (3). The most common cancers were breast, lung, prostate and bowel which accounted for 46% of all cancer deaths (3). However, in the UK over the past 40 years, cancer survival rates have doubled to the point that almost half of all male and female cancer patients are predicted to survive more than 10 years beyond their initial diagnosis (3). The most recent evidence and data suggests that 1 in 2 people born after 1960 will be affected by cancer sometime in their lifetime (4) but that an estimated 42% of cancers are preventable (3). According to the World Cancer Research Fund (WCRF), if patients in the UK enacted healthy life style changes such as eating an improved diet, doing more physical activity and managing their weight it would prevent 47% of bowel cancers and 38% of breast cancers, to give but a few examples (5).
Doctors have an important role to play, not only in primary prevention of cancer, but also in secondary prevention and helping to support their patients through ways to prevent cancer as well as cancer diagnosis and treatment. This inevitably involves answering questions about the cancer itself, what changes can be undertaken such as lifestyle that could help in preventing and overcoming cancer and what can be done to prevent recurrence. In recent years, evidence has accumulated on ways to reduce the risk of cancer occurrence and recurrence (6) (7). However, to enable doctors to support and promote lifestyle change, education and training in these arenas are required in medical school. Currently in the UK, at undergraduate level, both teaching and the curriculum in medical education are centred on identifying and managing illness and disease. The proportion of undergraduate teaching that deals with preventing disease has been minimised over time (8).
There is an urgent need to increase understanding of disease prevention for the betterment of future medical practice. We need to create a new generation of doctors who are fully informed on the evidence for disease prevention and the actions needed to reduce risk, who can become advocates and role models for lifestyle change. The constraints on the capacity of the medical curriculum are as such that other avenues, apart from formal teaching, need to be looked at as a way of delivering learning opportunities to medical students on cancer prevention (including social media). With nearly 3 in 5 people in the UK and 1 in 4 people worldwide engaged in social media, this medium provides an opportunity to improve engagement, motivation and behavioural skills to communicate and influence lifestyle behaviours (9) (10).