(I)
Longevity is one of the greatest risk factors for cancer development. Ranking life expectancy per capita and cancer incidence in every country in the world shows that the two numbers are very correlated. Those who live longer tend to have higher rates of cancer.
Australians live a long life and have the highest cancer rates; at the other extreme, Chad, Africa, has a life expectancy of less than 54 years and essentially the lowest cancer rates.
China, in the middle of the pack in both rankings.
But there are some countries that are odd in that they don’t have a long life expectancy, but have a particularly high incidence of cancer. Those are the countries in the red box in the chart below.
It is clear that there are other significant cancer-causing factors in these countries outside of longevity, including genes, environment, and lifestyle.
Studying the causes of their high incidence of the disease is very relevant to help us prevent cancer ourselves.
The most typical example is Hungary: with a life expectancy of 75.9, it ranks 55th in the world and has the 4th highest incidence of cancer!
In contrast, China’s life expectancy of 76.1 is a little higher than Hungary’s, but the cancer incidence rate is only 52nd.
There are 301 cancer patients per 100,000 people in China, compared to 727 in Hungary! More than twice as many as in China!
Look at a country with a life expectancy similar to Hungary’s, and you’ll see that its cancer rate is really “outstanding”.
(ii)
Why is there so much cancer in Hungary?
One of the many reasons: Very much lung cancer!
In terms of total numbers, China ranks first in lung cancer. But as a percentage of the population, Hungary has the highest incidence of lung cancer in the world.
Another thing about Hungary is that there is a very, very high number of lung cancers in both men and women!
Hungary has the highest incidence of lung cancer among men in the world, with 77 out of 100,000.
Hungarian women have the highest incidence of lung cancer in the world, with 41 in 100,000.
The most dramatic is the graph below of the incidence of lung cancer in women. You can see a particularly “black” country in the middle of Europe, and it’s Hungary!
So why is there so much lung cancer in Hungary?
Two important reasons, one is more smoking and the other is the poor environment.
There is a lot of smoking in Hungary, both men and women! 47% of men in Hungary and 21% of women smoke, both among the highest in the world.
In contrast, only 2% of Chinese women smoke, a good habit to keep up.
Smoking is not the only reason for the high incidence of lung cancer. Another big lung cancer risk in Hungary is pollution in the work environment, especially asbestos pollution.
Hungary does not protect its workers enough, including construction workers, car mechanics, and many other occupations that are easily exposed to materials containing carcinogens such as asbestos. This has brought about not only a lot of lung cancer, but also mesothelioma. This type of cancer is called “asbestos cancer” because many of them are caused by inhaling asbestos, which causes cancerous changes in cells in the body.
It is estimated that 20% of Hungarian workers have been exposed to toxic chemicals for a long time.
(iii)
Hungary is just one representative. If you look closely at the other countries in the red circle, you’ll see that they are all Eastern European countries!
Russia, Belarus, Ukraine, Lithuania, Latvia, Bulgaria, Moldova ……
Looking around, a whole bunch of Eastern European countries have low life expectancy and a lot of cancer.
Their life expectancy per capita rankings are in the middle and lower parts of the world, none of them as good as China. Russia, for example, has a life expectancy of 70, which is about the same as Iraq.
So, what’s wrong with Eastern Europe? What makes so much cancer?
One of the main reasons, is bad lifestyle habits, especially a lot of smoking and a lot of alcohol.
It was mentioned earlier that Hungarians smoke particularly heavily, and in fact these Eastern European countries are similar. Not surprisingly, all Eastern European countries have a high incidence of lung cancer, especially in men.
Lung cancer incidence and mortality rates have continued to rise in several Eastern European countries over the past few decades due to poor tobacco control.
Smoking brings not only lung cancer, but also more than 10 other cancers, especially bladder cancer, head and neck cancer, and more. The CDC estimates that about 40% of all cancers in the United States are linked to smoking. Any cell that can be reached by the carcinogens in tobacco is dangerous.
Almost all cancers that are strongly associated with smoking are highly prevalent in Eastern European countries.
Smoking and alcohol are not separate. Eastern European countries are also some of the heaviest drinkers in the world.
I’m sure everyone knows how much Russians drink, but it’s actually only 4th in per capita alcohol consumption, and the 3 ahead of it are all its Eastern European neighbors.
The 6 countries in the world that drink the most alcohol, and they’re all from Eastern Europe!
I’ve written many times that any alcohol is a class 1 carcinogen, so it’s important to stop drinking when it’s appropriate.
Eastern European countries have the highest rate of cancer deaths from drinking! In these countries, at least 1 in 10 men who die of cancer die from drinking.
Facts speak louder than words!
If you want to live a long life and not get cancer prematurely, you better be determined to quit smoking and drink less.
(iv)
In addition to the “small environment” of personal habits, the “big environment” of society also has a huge impact on the occurrence of cancer.
The larger environment includes not only direct factors such as air pollution, but also the economic, cultural, and human environment.
The most typical examples are the neighboring countries of Austria and Hungary.
Historically, the similarities are so strong that even more than 100 years ago, these two countries were a family, both belonging to the Austro-Hungarian Empire, before disintegrating and going their separate ways after World War I in 1918.
But now, Austrians live quite a bit longer than Hungarians and have much lower cancer rates.
The difference is even more striking when you look at the time-varying curve of cancer mortality.
The cancer incidence and mortality rates in these two countries were close until 1970, but then took diametrically opposite paths.
The mortality rate in Austria is getting lower and lower, while the exact opposite is true in Hungary, which is getting higher and higher.
Why is this happening?
The difference in economic level is an important reason.
Beginning in 1955, Austria and Hungary embarked on very different political systems and development paths. Today, Austria is a highly developed country with a GDP per capita of over $50,000, while Hungary’s GDP per capita is only a quarter of Austria’s.
The different economic levels and pressures of life have not only made Hungary a more polluted working environment and worse healthcare, but also brought about worse habits, including smoking, drinking, and unhealthy eating.
These all increase the incidence and mortality of cancer, as well as lowering life expectancy.
Hungary is just a microcosm of the problems faced throughout Eastern Europe, where dramatic political and economic changes in several countries after 1950 were accompanied by a steep decline in overall health: more cardiovascular disease, more cancer, and lower life expectancy.
So, to fight cancer, not only does each person need to work for themselves, but we need to work together as a whole to develop our country.
There may be other factors behind the high incidence of cancer in Eastern European countries that are worth digging deeper into. Whatever it is, it will be a great guide for the future of cancer prevention in China.
Recent studies have found that close to half of all cancers in China are caused by avoidable factors.
I hope the country will continue to develop and provide a good environment for every citizen, but I also hope that we will all have the necessary knowledge to prevent cancer, try to avoid the risks, and not waste the opportunity for longevity that modern medicine has given us.