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Epidemiologic aspects of cancer prevention in Germany
1German Cancer Research Center, Division of Clinical Epidemiology, Heidelberg. n.becker@dkfz-heidelberg.de
Abstract:
In Germany, as in other highly industrialized countries, cancer is the second most common cause of death. With approximately 210,000 individuals dying each year from malignant tumours, roughly one in four deaths in Germany can currently be attributed to cancer. Only in the past few years has there been a slow decline in the age-standardized mortality rates for cancer, even among men. This follows a long period of some decades, during which the mortality steadily increased and then persisted at a high level. The reversal, however, does not mean that the situation is no longer a cause for concern. In fact, for the most common cause of death, namely the cardiovascular diseases, a much greater decrease in mortality has been observed for many years now. If this trend continues, cancer could become the largest killer in another 15 to 20 years. On the other hand, we have been aware since the end of the 1960s that the majority of cancers are caused by environmental influences and are thus, in principle, avoidable. In the present contribution we present: (a) the fundamental arguments to support the thesis that a large proportion of cancers, and of cancer deaths, could be avoided; and (b) an estimate for Germany of both the theoretical potential of primary cancer prevention and also the practically attainable potential. The estimates are based on very conservative assumptions. They yield, for the theoretical potential, values in the range 43-65% and for the reduction actually obtainable in the medium term due to primary prevention, values of 18-31%.
Insights
Cancer is a leading cause of death in Germany, but many cases are preventable. This study estimates that primary cancer prevention could theoretically avoid 43-65% of cancers and practically reduce them by 18-31%.
Area of Science:
- Oncology
- Public Health
- Preventive Medicine
Background:
- Cancer is the second leading cause of death in Germany, accounting for about one in four deaths annually.
- While age-standardized cancer mortality rates have recently shown a slight decline, they follow decades of increase and remain a significant public health concern.
- Cardiovascular diseases, the leading cause of death, have seen a more substantial mortality decrease, suggesting cancer could become the primary cause of death if current trends persist.
Purpose of the Study:
- To present arguments supporting the thesis that a significant proportion of cancers and cancer deaths are avoidable.
- To estimate the theoretical potential for primary cancer prevention in Germany.
- To estimate the practically attainable potential for cancer reduction through primary prevention in the medium term.
Main Methods:
- The study analyzes existing knowledge on the causes of cancer, particularly environmental influences.
- It employs conservative assumptions to calculate prevention potentials.
- Estimates are derived for both the maximum theoretical and the realistically achievable reduction in cancer incidence and mortality.
Main Results:
- The theoretical potential for primary cancer prevention in Germany is estimated to be in the range of 43-65%.
- The practically attainable reduction in cancer cases and deaths through primary prevention in the medium term is estimated at 18-31%.
- These estimates are based on conservative assumptions, suggesting the actual potential may be even higher.
Conclusions:
- A substantial proportion of cancer cases and deaths in Germany are attributable to environmental factors and are therefore preventable.
- Primary cancer prevention offers a significant opportunity to reduce the burden of cancer.
- Implementing effective primary prevention strategies is crucial for public health in Germany.