Cancer continues to be one of the leading causes of death. No part of the world has been spared the impact of this public health issue.

In the Caribbean, cancer is the second-leading cause of death, accounting for a fifth of all deaths. In 2020 over 100,000 new cancer cases and over 65,000 cancer deaths in the Caribbean were estimated. Female breast cancer accounted for the most cancer cases in the Caribbean (15 per cent), while lung cancer caused the most cancer deaths (12 per cent). Prostate, colorectal, and stomach cancers are also common.

According to Dr Joy St John, executive director at the Caribbean Public Health Agency (CARPHA), "Up to 50 per cent of cancer cases are preventable and 27 per cent of cancers relate to alcohol and tobacco use. People can reduce their risk of getting certain types of cancer by adopting healthy lifestyles and practising suitable health-seeking behaviours."

Adopting healthier behaviour can help to reduce the risk of cancer, such as consuming less alcohol, avoiding tobacco products and exposure to second-hand smoke; increasing physical activity; and eating foods low in salt, sugar, and harmful fats.

Worldwide, cancer is the second-leading cause of death and accounts for one-sixth of all deaths. In 2020 there were 19.3 million new cancer cases, with breast, lung, prostate, skin, and colon cancers being the most common, and there were 10 million cancer deaths in that same year.

CARPHA is engaged in initiatives to address the risk factors associated with increased cancer risks, including poor nutrition and the consumption of harmful substances, such as alcohol and tobacco. CARPHA also supports regional efforts to reduce the threats posed to Caribbean people by unhealthy diets, obesogenic food environments, and the harmful use of alcohol.

The International Agency for Research on Cancer (IARC) Caribbean Cancer Registry Hub ("Caribbean Hub"), based at CARPHA headquarters in Trinidad, provides technical support to increase the quality and population coverage of national cancer registries in the Caribbean through guidance, training, networking, and advocacy for the critical role of such registries in cancer surveillance and cancer control. Cancer registration activities in several Caribbean countries are also being strengthened. Better quality cancer data provides more reliable evidence to support decision-making for cancer prevention and control at the national and regional levels.

As the three-year 2022-2024 World Cancer Day theme 'Close the Care Gap' continues, we focus on "uniting our voices and taking action" in 2023. This campaign seeks to close the equity gaps in cancer outcomes among people with different social determinants of health, such as race/ethnicity, income level, gender, and geographical location through a united approach.

To help address these issues, a whole-of-society approach is needed to close the gap in inequities. This means collectively taking action and committing to health equality so that everyone has the same opportunity to prevent cancer, find it early, and get proper treatment. Primary health care delivered in communities needs to be strengthened; social and economic factors that negatively affect people's health need to be addressed through policy and programmes; and investments in health-care systems and national programmes are needed.

It is important to support and advocate for the collection and dissemination of high-quality data on cancer incidence, mortality, and treatment to ensure evidence-based decision-making for improvements to national cancer control programmes. Additionally, investments in strategies can help improve cancer outcomes, such as universal health coverage, primary health care, early detection, timely referral mechanisms, effective treatment, and palliative care.

Cancer is a critical public health concern. When we unite, when we collaborate, change is within reach. When we act, there is progress, impact, and equity. Let us close the gap.

www.carpha.org