In 2007 we published a report on diet and cancer that was the result of a mammoth review of all the scientific evidence on diet, nutrition, physical activity and cancer. We published it in the form of conclusions and recommendations but we didn’t actually say how to do any of it, how to achieve it. There were recommendations, so individuals, were they motivated, could read the report and say: “ah perhaps that’s what I should be doing”. In a different context I’ve been using the phrase that we should look not just at the causes of disease, but at the causes of the causes. The causes of cancer were laid out in the diet, nutrition, physical activity and cancer report. What this report on policy does is to address the causes of the causes – why do people eat, drink, be sedentary or physically active in the way they are? And given that our judgement is that the causes of these patterns are social, economic, cultural, so should the remedies be. So this looks at the policy implications of the scientific findings in the 2007 diet and cancer report.

It’s quite possible to be gloomy about cancer, and a lot of people are very gloomy about cancer because somehow they think: “well there’s nothing you can do about it. It’s a terrible sentence and it just happens, it’s out of the blue, it’s an act of God and it’s awful”. The message coming out of this report is, that’s not the right way to think about it. We know already that a huge proportion of cancers are preventable by eliminating smoking. And the message that’s coming out of this report is many, many more cancers are preventable by healthy patterns of diet, nutrition and physical activity. So it’s a very optimistic report. It’s actually saying there’s much that we can do to prevent cancer, we don’t have to accept it‘s a sentence that will strike at random. There’s much that we can do, so it’s a very optimistic report. But it says that in order to achieve that optimistic aim of making a significant impact on the burden of cancer, it’s going to involve a lot of actors. It’s going to involve all sections of society starting, of course, with individuals, but running right across the whole of society. And we identify nine groups of actors, as I say, starting with individuals, but it runs across the gamut; civil society, schools, workplaces, industry, governments, multinational organisations, the media, and we’re really concerned that everybody has a part to play here.

Let me give you some examples of recommendations in the report but let me emphasise that we did not come up with a priority list. We didn’t say do this before you do that because we emphasise that there has to be action taking place across the different sectors all at the same time. We said there’s much the government can do: labelling, restriction of advertising, taxation, thinking about other financial instruments; subsidies for example, so there’s much that government can do. Schools – a place where children eat and are, or are not, physically active – there’s much that can be done there on the quality of nutrition in schools; the opportunities for physical activity in schools. Workplaces – we say for example, that where only unhealthy food is available in vending machines this is encouraging unhealthy eating where there are opportunities to encourage healthy eating. We talk of course about what individuals and families can do for themselves and for their children, so we run across the whole gamut.

Currently we are facing in the world a huge problem with the burden of cancer. Globally, every year, there is something like eleven million new cases of cancer and more than seven million deaths. By 2020 this is predicted to rise to fifteen million new cases and more than ten million deaths. A big part of that is, of course, the growing obesity epidemic, and it’s urgent, urgent to take action. So we calculated what proportion of cancers potentially could be prevented by diet, nutrition and physical activity and the answer is, of the most common cancers, about a third in the rich countries could be prevented by these recommendations and about a quarter in low and middle income countries. So we did calculations for the United Kingdom, the United States, Brazil and China. About a third of cancers in high-income countries and about a quarter in low and middle-income countries, so these are high stakes, high stakes. Following this is not a footnote and it’s not trivial. It’s actually saying we could make an enormous difference to those millions of new cases and deaths that occur globally every year.

We have this rising tide of obesity, we have this rising tide of non-communicable disease in general, and we have this rising tide of cancer. The costs of inaction are enormous; this enormous increase in cancer cases and cancer deaths that will occur globally over the next decade. We can’t afford to do nothing. Looking on the other side, the benefits are potentially enormous. We’re talking about actually giving people a better quality of life, better health and lower risk of non-communicable disease and cancer. The benefits to individuals and society are potentially very great indeed.