Cancer prevention, screening and early detection

Primary prevention

• Tobacco control (about 22% of cancer deaths; lung, oesophagus, larynx, mouth, bladder, pancreas, stomach, cervix); avoid second-hand smoke.

• Healthy diet and physical activity to prevent obesity (oesophagus, colorectal, breast, endometrium, kidney).

• Stop or moderate alcohol (mouth, pharynx, larynx, oesophagus, liver, colorectal, breast).

• Reduce environmental carcinogens: aflatoxins, asbestos, indoor smoke, UV light (especially people with albinism).

• Prevent and treat infections: hepatitis B/C (liver), HPV (cervix, anus), H. pylori (stomach), HIV (lymphoma, Kaposi sarcoma), schistosomiasis (bladder).

Vaccination

• Hepatitis B vaccine: 3 doses – 0, 1 and 6 months (general population and high-risk groups such as health workers).

• HPV vaccine: girls aged 9–14 years, 2 doses 6 months apart.

Screening and early detection

• Cervical cancer: the organised national screening programme.

• Breast: teach breast self-examination from 25 years (day 10 of the cycle; monthly after menopause), clinical breast examination, mammography from 40 years (ultrasound in younger women), MRI for BRCA carriers.

• Colorectal: from 45 years – annual digital rectal examination, faecal occult blood and colonoscopy.

• Prostate: no routine screening; if done, PSA from 50 years with life expectancy over 10 years (45 years in high-risk men).

• Skin: self-checks and prompt treatment of early lesions; sun protection for people with albinism.

• Teach the public and health workers the warning signs of cancer for early diagnosis.