Cancer ranks as the world's second leading cause of death, with approximately 13 million new cases diagnosed annually, resulting in 7.6 million deaths. The burden of cancer, particularly in low- and middle-income countries (LMICs), is escalating as lifestyles evolve and life expectancy increases. Remarkably, over half of global cancer cases and 63% of cancer deaths now occur in LMICs, with projections indicating a rising trend.

A significant portion of cancer cases worldwide can be attributed to environmental factors, including workplace exposures. While accurately quantifying this contribution is challenging due to data gaps and the complexity of exposure effects, estimates suggest that 7% to 19% of global cancers may be linked to environmental toxins. Notable carcinogens such as asbestos, silica, arsenic, and radon have been identified as major contributors, with their effects being profoundly felt across LMICs due to unregulated and intense exposures.

Despite the grim statistics, many cancers resulting from occupational and environmental exposures are preventable. Primary prevention strategies, which focus on eliminating the root causes of exposure, have proven to be the most effective approach. Examples of successful intervention include significant reductions in lung cancer and mesothelioma rates following asbestos bans, decreased bladder cancer incidences after removing aniline dyes, and the eradication of hepatic angiosarcoma in chemical workers through safer technology implementations.

However, efforts to mitigate environmental cancer risks have not been as robust or coordinated as those targeting tobacco-induced cancers. Recognizing this shortfall, the World Health Organization (WHO) convened an international conference in Asturias, Spain, in March 2011, aimed at bolstering global policies on environmental cancer prevention. The outcome, known as the "Asturias Declaration," underscores the necessity of integrating primary prevention of environmental and occupational cancers into worldwide cancer control initiatives.

Key recommendations from the declaration include:

  • Development of a global framework by the WHO to address environmental and occupational carcinogens, focusing on substances classified by the International Agency for Research on Cancer (IARC) as confirmed or likely carcinogens.
  • Creation of measurable indicators for carcinogen exposure and cancer burden to enhance global cancer surveillance.
  • Implementation and enforcement of protective legislation and regulations by all countries, prioritizing the safety of vulnerable populations.
  • Launch of localized education campaigns to raise awareness about environmental cancer risks and prevention methods.
  • Mandatory compliance by corporations with all preventive regulations and adherence to consistent safety standards globally.

Conference participants concurred that preventing environmental cancer necessitates international cooperation and public health collaborations across various sectors. Moreover, independent research into the environmental and occupational causes of cancer is crucial for effective prevention.

These strategic recommendations align with broader cancer control measures and contribute to the prevention of wider noncommunicable diseases, supporting the United Nations' global health agenda. Importantly, these actions aim to avert future health crises akin to the global asbestos epidemic, which continues to claim over 100,000 lives annually.

Adapted from Environmental Health Perspectives (EHP), authored by Philip J. Landrigan, Carolina Espina, Maria Neira.


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