Cancer prevention and control in the Eastern Mediterranean region: the need for a public health approach.

Cancer is increasingly recognized as a major health concern in the Eastern Mediterranean (EM) region. The emergence of cancer and other non-communicable diseases (NCDs) in most EM region countries is related to increases in life expectancy, an increasing proportion of elderly people, and the successful control of most childhood communicable diseases, along with rapid strides in socioeconomic development. In the next 15 years, cancer incidence in the EM is expected to increase by 100% to 180%, according to World Health Organization (WHO) projection modelling, the largest increase foreseen among developing countries. Even though 30% of cancers can be prevented and controlled using available knowledge, death rates will increase by 17% by 2015 because of the challenges and barriers to implementing national strategic action plans. Other problems facing countries in the region are the lack of national cancer surveillance and little harmonization in monitoring and surveillance methodologies. Data on cancer mortality in the 21 countries is limited or lacking, with only 7 countries having national population-based registries. There is no linking of cancer mortality data to NCD prevention and control. A model of integrated care for NCD prevention programs in general and cancer in particular is lacking, and finally, there is inadequate national capacity-building and a lack of program sustainability. The WHO Regional Committee for the EM has adopted a resolution recognizing the considerable magnitude of cancer as a major cause of morbidity, human suffering, and mortality in the region. In the last 15 years, the WHO Cancer Control Programme has fostered the development of national cancer control programs as a primary intervention strategy for a comprehensive and cost-effective approach at the country level.