World Cancer Day is an initiative of the Union for International Cancer Control (UICC) and came to life on February 4, 2000 at the “World Summit Against Cancer for the New Millennium” in Paris. The core belief of the organizers of World Cancer Day is that access to life-saving cancer diagnosis, treatment and care should be equitable for all – no matter where you live, what your income, your ethnicity or gender. They think that governments must be accountable and national leadership on policies, legislations, investment and innovation is key to accelerated progress.

We spoke to Dr Cary Adams, CEO of UICC.

Note: The statements and opinions contained in the video and podcast episode are solely those of the speaker.

Video Interview

Podcast Interview

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Transcript

Welcome Dr Adams and thank you for agreeing to this interview. Will you please introduce yourself?

Thank you very much for giving me the opportunity to talk to you. I’m Cary Adams, I’m the CEO of the Union for International Cancer Control, and we’re the organization behind World Cancer Day every year, which takes place on February 4th. We’re a small team, but we’re fortunate enough to be part of a membership organization which has 1,200 cancer organizations around the world in 173 countries. And what we’re able to do is to galvanize that community to make World Cancer Day on February 4th a great celebration of progress in the way in which we are addressing cancer in the world. And it’s something that, personally, I look forward to every year because I see the cancer community do the most amazing things on that particular day.

Your campaign theme for this year and the following two years is “Close the Care Gap”, concentrating on the power of knowledge. Based on this scheme, what do you hope to achieve by 2024?

We have a three-year theme for our World Cancer Days, and we’ve just completed the last one, which was very successful. And the theme of that one was called “I am and I Will”, and over a three-year period, we’re trying to give people encouragement to take some responsibilities about their life and their families and colleagues and friends, and to make a difference. So, what will you do to make a difference individually? And that worked really well. We had fantastic coverage through social media. The press picked it up around the world, and I think we engendered a spirit of ambition that we can do something about cancer.

The new thing, which has been discussed across our community with an advisor group and the board of the Union for International Cancer Control, is probably a punchier theme than we’ve had before. It’s on the subject matter of inequities; the inequities which drive different outcomes with regard to cancer survival and treatment and care, and “Close the Care Gap” is all about inequities. Now, inequities have become a major concern for all of us as we’ve actually gone through the COVID pandemic, where we’ve seen that different communities have received vaccinations, different communities have had different reactions to COVID. Often, some underlying risk factors like obesity or smoking has caused a more serious reaction to COVID.

And all of these risk factors and inequities which exist in the world, access to health systems, access to financial coverage for being treated for any disease or illness around the world, are the very same ones which cause there to be different survival rates of cancer around the world. Availability and knowledge, the understanding of your body and when you should go and see a doctor. All of these inequities make a big difference to cancer survival in all countries. It’s not just the low- and middle-income countries, but also high-income countries as well.

So, UICC at the very heart of its purpose statement talks about addressing inequities, and that’s manifesting itself in the way that we framed the World Council Leaders Summit last year, which is about inequities in technology, the way we’re constructing the World Cancer Congress in October this year in Geneva, which will have an equity theme running through it, the way that we’re addressing cervical cancer around the world to make sure that no woman should die from cervical cancer because they haven’t had vaccination when they were a girl. They haven’t had access to screening. The availability of medicines around the world, making sure that every country has the basic medicines available, as described by WHO, which is the essential medicines on their list for cancer.

So, it’s right at the heart of everything we do, but we’ve decided for the next three years we will raise the temperature on inequities around the world, which are causing people to die unnecessarily through cancer and to close the care gap, because that’s the main theme that we will use is the way we will publicize the day both this year, next year and the year after. With a view that this year is more about information sharing, so that people become more aware of the issues of inequities and how it impacts cancer, both the chance of someone getting it and the chance of someone surviving it, and hopefully over the next two years we will progress the campaign, link it with other work that we’re doing, we’ll be able to get by the third year people to actually say: I want to make a difference here. I want to talk to my governments. I want them to ensure that our National Cancer Control Plan is open to all parties in society, that no minority is going to be missed out. That this is clear in how it helps the aged as it helps the young. It is clear how it helps the people who are rich and those who are poor, the ones in the cities and the ones in the rural environments.

We are hopeful, by the end of the campaign we’re going to have people not only recognizing that there are major challenges we have to face to ensure that everyone has a fair chance to get the treatment and care they want, but that also we have responses from those in power to make sure that those issues are addressed. So, it’s a fairly large campaign that we have to run over the next three years, but we’re very comfortable given the feedback we’ve had so far that this is a subject matter which resonates not only with the cancer community, but with the media and with governments and with our colleagues at the World Health Organization, for example. So, it’s the start of an exciting three-year campaign.

How do member organizations use this day?

The member organizations, and we’ve got over 1,200 in 173 countries, they have choices. I mean, we provide them with a lot of basic information from Geneva, fact sheets and ways in which they can publicize the issue of inequity in their country. But it’s really down to each organization within their country to build the day and the theme into work which is important to them. By way of example, the challenges of inequity in the USA will be very different from the challenges of inequity, for example, in India or the challenges of inequity in an African country. So, each organization has to understand where the challenges are in their country and then use the day to raise the profile of that, whatever it may be, to ensure that something can be done over time.

For example, a breast cancer organization, which focuses specifically on breast cancer, will use the day and the theme to talk about, for example, in Washington, which I know, I’ve been to it a fair number of times, the cancer survival rate of breast cancer in the wealthier areas of Washington is far higher than in the poorer areas of Washington. Okay. So, this isn’t about between high-income countries and low-income countries. It can even be within a city that we can challenge the issues and the problems that exist, which means that women in poorer areas of cities all around the world tend to be fought and have screening, and they present later. And for those of us who are aware of the challenges of a late presentation on any cancer, the late presentation of stage three of a breast cancer is far more difficult to treat, and less successful being treated, than one which is identified at stage one and two. So, this is an example where a cancer organization in UICC specifying in this particular cancer may reuse the day to raise a challenge that they see on their particular area of interest.

But it’s not just on the cancers. If I take, for example, organizations in UICC are passionate about the risk factors, like tobacco control. In some countries, you have tobacco use at 25, 30, 35%. In other countries, it’s down at 10%. Now, that’s not an inequity issue, but it is unfair on a general population if the tobacco industry is allowed to promote its products to the young and those who, you know, don’t know better in their country because it leads to people picking and taking up smoking at an earlier stage, becoming addicted. And, of course, their chances of having cancer in their lifetime is increased significantly. So, even on the risk factor side, you know, getting the information out there and making sure that governments understand where they are creating inequities in their country by not applying simple policies like increasing the taxation on packets of tobacco, that is a problem that needs to be resolved around the world.

So, I think our community love using World Cancer Day to talk about the global challenges that we have, but making it very real to the issues they face in their country and all very real on the subject in cancer control, which is very peculiar to their own organization. It’s a great day for bringing us all together because the outcome from all of that hopefully is less cancer patients and more successful treatment.

On your website, you mention the seven barriers that stand in the way of cancer care. What are they and why are they so important in the fight to rid the world of cancer?

Well, it’s important to describe what inequity is and where it emerges in society for people to understand it. So, as I said earlier, we are trying to get information out to our members because a lot of people think inequity is purely about high-income countries and lower-/middle-income countries. That’s what they think what inequity is. And the truth is it exists everywhere in society. I would recommend that anyone who’s interested in the subject matter should go to World Cancer Day website, and they can read about all of the areas of inequity, but they exist between gender. In countries. Women’s access to health. Full stop. Women’s ability to go into a health system. And a culture where it’s not deemed appropriate for a woman, potentially with breast cancer, to go to a hospital to actually reveal her body. This is inequity, so it’s not fair on the women. Children, gender; for young girls to have vaccinations for HPV to prevent cervical cancer in the longer term. OK. That has to be allowed around the world.

And then you’ve got issues about minority populations in a country where they don’t have access to the medical system or they don’t have access to the means to actually pay for their treatment. Refugees in countries and whether or not they have access to the health system where they have arrived, having left from their country. And then there’s a difference in the educated groups and those who don’t have access to education, and then knowledge and understanding of the health choices they take on every single day, which can affect their health in the future. And their ability to even pay for good quality food and their reversion to poor quality food because they don’t have the money or they don’t understand the long-term implications of doing that.

And, of course, there are also the differences I mentioned earlier between rural and urban. You know, the rural have often a long way to go to get access to treatment and care. Or they may not even have access to screening or primary health care, which allows them to identify their cancer earlier. Often in rural, it means leaving your work, leaving your family and going for treatment into an urban center, because cancer treatment centers tend to be in urban centers. And, of course, uncompounded on all the other challenges of the LBQT community, there is the challenge that there is on access to health and access to cancer advice and guidance.

So, all of those inequities which exist in society affect cancer outcomes, the ability to detect cancer early and the ability to get access to treatment and care. So, just to say, I would recommend anyone going to the World Cancer Day website, if they’re interested in the types of inequities that exist in society, which lead to inequities in access to treatment and care for cancer.

Dr Adams, thank you very much for your time and your insight.