According to Gordon Wishart, professor of cancer surgery and consultant breast and endocrine surgeon ‘we are living in an epidemic of cancer’. Currently in the UK, around 325,000 people are diagnosed with cancer every year, and 160,000 people die of it.
Project these figures across lifetimes, and the risk factors for individuals certainly meet the criteria for calling this an epidemic. In the UK one in three people now get cancer of one type in their lifetime, and cancer charity Macmillan estimates this figure will rise to almost one in two by the year 2020. This presents a huge challenge for UK employers. Of the 325,000 diagnosed each year, over 100,000 are of working age, and estimates suggest that, in total, over 750,000 people of working age are now living with a cancer diagnosis.
The bottom line for employers is that cancer will cause significant downtime among their employees or the partners of their employees, and will therefore impact upon their business. If the cancer is only picked up at a later stage, it will require more treatment, more time off work, more time recovering from ongoing treatment and result in a reduction in productivity from that employee. Late detection is also far less likely to produce a positive outcome for those diagnosed. Putting this in more graphic terms for employers, Professor Wishart has stated that businesses that fail to act in the light of this information will suffer as surely as if they had ignored a looming recession.
Around 10,000 cancers in the UK are thought to be directly work related. Some risk factors are well-known, such as exposure to sunlight, radiation, asbestos or smoke. Some factors are relatively little-known. Night shift work is now understood to increase cancer risk, as is working as part of a flight crew. There are even more subtle ways in which work puts us at risk, however. Take breast cancer as an example – Professor Wishart’s own area of expertise. Like other types of cancer, it is increasing, with around 50,000 new cases in the UK per annum (2010). That means a lifetime risk of one in eight, which is predicted to rise to one in seven by 2024.
Why this increase? There are known lifestyle factors, which include obesity and alcohol intake, both of which seem to be on the rise. But changes in working patterns are also to blame. A third of women in the UK work shifts that include an element of night work, and we now know that over a prolonged period this increases breast cancer risk by 50 percent (in men, shift work carries a similar increased risk of prostate cancer). Other factors known to increase risk of breast cancer include having no children or having them late in life (i.e. after 25) and not breast feeding. With pressure on women to have both a career and a family, many put off having children, or decide not to have them at all because of a desire or need to work – thus putting themselves at increased breast cancer risk.
Even those working 9-5 in comfortable offices are not necessarily immune from increased risk at work. Stress is a known contributor, and studies in the US show that sitting for long periods increases risk of colon, endometrial, and lung cancer – so much so that it has prompted some to claim “sitting is the new smoking”. There are positive signs. While the incidence of breast cancer has increased, the mortality rate has been steadily falling since the 1980s. 2011 figures show the number of deaths to be 11,762, with a fall of 45 percent for women aged 50-64 since 1989. The key reasons for this are higher awareness and improved methods of detection, which catch the cancer early. With other cancers, however – especially those for which there are no national screening programmes – the survival rate remains poor.
Professor Wishart believes that the successes with breast cancer show us the way forward, and that with the right methods of detection, improved survival rates can be achieved across all six of the most commons cancers – breast, bowel, lung, skin, prostate and cervical cancer.One means of delivering this is to offer educational and screening programmes in workplaces – a service currently offered by HealthScreen UK (for whom Gordon Wishart is medical director) and others like them.That this can save lives is not in doubt – in recent screening programmes for Hewlett Packard, HealthScreen UK picked up 65 cancers at early stages that may have otherwise gone undetected. Employers have a duty of care, of course, and the Department of Health has called for the support of employers in the early detection of all cancers in its national plan entitled “Improving Outcomes”. What makes this ultimately so compelling for employers, however, is the fact that it can also help protect their business – and may even save them money.