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Write two evidence-based recommendations on how to improve the uptake or efficiency of that policy/ strategy/ program/ initiative in the country of your choice.

Primary Prevention

Strategies for Primary, secondary, and tertiary prevention of Cancer Disease at Individual, Community, and National/Global Level

1. Primary Prevention

Strategies/policies/programs at:

I. Individual Level

· Nutritional foods and balanced dieting

· Change in lifestyles with no or reduced access to alcohol consumption or tobacco use

· Safety behaviors while working in the chemical industries or hazardous places

· Keep away from  radioactive products or materials, like solar radiation, mobile radiation, X-rays, and other radiations

· Showing great awareness to the risk exposure from  the cancer disease by knowing its symptoms and keeping away from the factors causing for this

· Limit the incidences of cancer disease by controlling the risk factors and specific causes (Andriole, and et al., 2012)

II. Community Level

· Community strategy for reducing exposure to  tobacco smokingand excessive alcohol consumption

· Spreading Awareness through the educational programs regarding the no alcohol or tobacco use

· Encouraging community participation in comprehensive cancer control programs by reducing excessive alcohol use

· Works with the health professionals, foundations, and charitable trust for developing policies and program for the prevention of cancer

· Coalitions with the international foundations, social groups, and charity trusts

III. National/Global Level

ü International coalitions or partners with global cancer research and therapy centers

ü Intervening through vaccination for developing immunization against the critical diseases, like cancer

ü Legislation or enforcement of strict laws against  excessive alcohol usage or tobacco smoking

ü Legislations for the environmental pollution control and waste disposables, and banning  radioactive or organic substances

ü Safety employment legislation in the hazardous or chemical industries

2. Secondary Prevention

Strategies/Programs/policies at:

a) Individual Level

· Screening to diagnose the diseases in the earlier stages

· Measures, like mammography (for breast cancer), CT scan (for tumors) or regular blood tests in the case of prediction of the signs and symptoms

· Regular physical activities, exercising, and yoga

· Regular health check-ups for the heavy drinkers (every 3 months)

· Not eat the junk foods, infectious foods, or food products that cause the cancer

b) Community Level

· Well-organized cancer care system and community hospitals for the control of cancer diseases

· Inviting the panelists, like

 surgical oncologists, cancer epidemiologists, health economics, and environmental science to continuously developing cancer prevention policies

· Continuously encourage the community well-being and environmental protection through the setting of the cleanliness measures, reducing pollutants and radioactive chemicals from the community areas

· Continuously make people aware for the healthy foods with plenty of fruits and vegetables and low sugar, meat, and fewer processed foods (Botwin, Griffin, 2007)

c) National/Global Level

· Comprehensive cancer care system through the improvement of the healthcare system, like the provision of resources, planned diagnosis, treatment facilities, research and rehabilitation centers

· Intervention into the healthcare system and clinics for examining their cancer treatment, curing system, and patients’ care through the regulatory inspection (Chen, Grube, Gruenewald, 2010).

· Provision of resources for diagnosis of cancer, like cytology, pathology, endoscopy imagining, pathology, and biopsy (checking cancer cells)

· Facilitating the researchers or health practitioners to undertake research related to the cancer epidemiology, early diagnosis, prevention, treatment, palliative care, rehabilitation, and survivorship

3. Tertiary Prevention

Strategies/Policies/Programs at:

i. Individual Level

· Regular doctor consultant

· Managing post diagnosis to stop the disease progression

· Surgery for the removal of the infected part involving the cancer cells (like the removal of cancerous breasts)

· The treatments, like chemotherapy, radiotherapy, rehabilitation, and clinical observation

· Keep away from the toxic elements, chemical substances, and harmful products

ii. Community Level

· Continued and sustained efforts for the tobacco and alcoholism control

· Work with media to highlight the excessive drink or heavy drinkers

· Enforcing the strict rules against the pollutants, radiations, alcoholism or smoking activities for the community welfare and environmental protection

· Continuously investing into the educational, research, and social awareness programs for creating the high level of awareness by informing the community individuals (Bray, Ren, Masuyer, Ferlay, 2008)

· Long-term commitment to healthy lifestyles   

· Free-of-cost cancer treatment to the poor people, or  individuals living in the aboriginal and indigenous communities

iii. National/Global Level

· Advancing the medical science for developing the effective therapy and drugs for preventing the growth of the cancer

· Expanding the radiotherapy facilities with quality assurance and adequate medical physics throughout the country

· Availability of the critical cancer surgical specialty services

· Availability of the curative and adjuvant drugs and chemotherapy at all cancer clinical systems through developing National Chemotherapy protocols

· Preventing the overuse of  chemotherapy in the palliative care setting (Campbell, Hahn, Elder, et al. 2009)

Information and Evidence about Evaluation of the Policy- ‘Reducing Excessive Alcohol Use’

According to Guyatt, et al. (2008), Reducing excessive alcohol use is chosen as an ultimate strategy for reducing/ minimizing the chances for the occurrence or developing symptoms of cancer among the individuals living in the local communities in Australia. Cancer is a complex chronic disease that is mostly caused due to excessive alcohol use by the individuals living in the local Australian communities because Alcohol (found in liquor, beers, wine) is a carcinogen that can contribute to the development of cancer for the females breasts as well as mouth, larynx, liver, colon, lungs, rectum, pharynx, esophagus, and in other parts of the humans (both males and females)(Guyatt, Oxman, Vist, Kunz, Falck-Ytter, Alonso-Coello, et al. 2008).

The excessive alcohol consumptionincludes heavy drinking (8 drinks or more by females per week and 15 or more drinks by men a week), binge drinking (exceeding blood alcohol concentration level to 0.08% or more), and more alcohol use by the individuals under the minimum legal age of 21 years. Binge drinking is the pattern of alcohol use in which the men consume alcohol drinks five times and women five times on a single occasion, only within two hours. In Australia, almost 185.8 liters of alcohol consumption in the form of wine, spirits, ciders, bears, and RTDs in 2016-17 was accounted at 9.4 liters of pure alcohol consumption per person that cause for the several deaths from the cancer (cervical mouth, liver, kidney breasts, and cancers of other parts in the human bodies).

From the views of Mirghani, Jung, and Fakhry (2017), the highest prevalence of dependence on alcoholic consumption occurs mostly in adolescents and youths (between the ages of 18 and 25 years). From the WHO report, 2017, it is identified that 13-15% are binge drinkers, 5% are heavy drinkers including 18% or more had 5 or more drinks at a single occasion. The strategic initiatives, policy development, and awareness programs in the community settingwill be effective in reducing the higher amount of the alcohol use by the adults (both men and women) and youths (under age 21)across different regions or areas in Australia that will prevent more chances of cancer because 30-50% cancer are preventable by limiting the amount of alcohol use(Mirghani, Jung, Fakhry, 2017).

Two Evidence-Based Recommendations

Community Level

Increasing Cancer Awareness through the social media campaigns and educational programs of the Alcohol Prevention Awareness– According to Field, et. Al (2012), the educational awareness by the communities through the health awareness social programs, camps, and events for the alcohol prevention that may keep them fit, strong, and healthy for the long-term. The local communities can invite different stakeholders, like the public and private hospitals, clinics, healthcare professionals, oncologists, social reformers, charitable trusts, or cancer foundations in the camps, events, and social awareness programs to work interactively for spreading awareness among the community individuals for no alcoholism or limited alcohol consumption for directing toward good control on the critical illness of cancer diseases(Field, Smith, Aberle, Oudkerk, Baldwin, Yankelevitz, et al. 2012). The local communities in different Australian states and regions can engage in the Alcohol Prevention program by organizing the publicity programs, media campaigns or social media posts (videos, images, slides, text messages), and conferencing for informing the local residents and foreigners the bad or harmful effects of the alcohol consumption on their health and can take the serious forms, like cancer further in their lives. The community through the setting of physicians or oncologists can aware the public about reducing the alcohol consumption for living long life with better health by reducing the risk exposure to cancer. 

Community legal system against the excessive alcohol consumption- Accoding to Ferlay, et Al. (2013), the communities in Australia should be empowered by the Australian National and Federal Government to enforce the law against the individuals found accused of excessive alcoholism. The communities across the Australian locations should be strengthened to take the legal action by penalizing the accused person in the form of the fine (imprisonment or financial charge). Firstly, the communities can instruct the individuals for not involving themselves in the heavy drinks at public places by managing/placing for the alcohol restriction chart with signals, pamphlets, hoardings, and other prints in the community areas so that the individuals think once before carrying-out the alcoholism activities(Ferlay, Soerjomataram, Ervik, Dikshit, Eser, Matherset al. 2013). The community should also be empowered to ban the excessive alcohol consumption by using the power itself and can file the police report or court case if the regularly excessive alcoholism and violence activities found.

Globally there are several preventive measures that could be introduced to prevent the excessive alcohol consumptionbecause these are related to reducing the likely impact of the excessive alcohol use on the human bodies for the prevention of Cancer disease.

National/Global Level

Age-restriction-there should be a legal policy or law for the age restriction for the alcohol or liquor usethat might be effective to reduce the excessive alcohol consumption. The minimum age of 21 could be legally effective in reducingexcessive alcohol use among the children so that they could find themselves away from the chronic disease of Cancer. The living individuals in the rural and urban areas in the Australian country should be legally permitted for producing, selling, or consumption of the alcoholic drinks after attaining the minimum age of 21 years. This could be implemented by holding the strict legal compliance for the age restriction through the legal intervention on the age factor the alcohol consumption(Botvin, Griffin, 2007). The person found convicted of law for involving in the alcohol or drugs production, selling or consumption should be legally punished by the court of law.

Timing restrictions-According to Pirschel (2017), the alcohol or liquor selling stores, bars, pubs, or hotels should be closed before the local 9:00 pm. in all areas throughout Australia so that the alcoholism consumption could be reduced to the great extent for controlling/ minimizing the occurrences of cancer symptoms among the local individuals. This could be implemented by ensuring the legal rules for the timing of alcohol selling and consumption. There should be a legal system of the prohibition on the timing for the opening of stores, pubs, hotels, and bars so that the person found for any action against this, should be legally penalized or punishment in the form of imprisonment (Pirschel, 2017).

Higher Taxes- the National Government and Federal Government in Australia should impose the higher amount of taxes (35% or more) on the liquor or alcohol products so that alcohol products may be more expensive, out of the reach of the average person. This could be implemented by raising the tax rates on alcoholic drugs or liquors by the Federal Government in the annual budget so that the higher amount of taxes could keep away the alcohol products in the regular consumption of the average people that in turn will reduce the chances of the alcoholic impacts in the form of cancer to some extent.   

Media Campaigns- The advertisements (images, videos, text messages, or slides) should be posted regularly on the social media networking sites (like Twitter, Facebook, YouTube Videos, Whats-App, Google Plus) showing the harmful impacts of the alcohol use for creating awareness among the people for the prevention of the alcohol consumption in their daily lives.

Secondary Prevention

Alcohol-free Zones- From the research of IARC (2002), the supermarkets, retailing markets, and local communities should be held alcohol restricted areas in Australia by banning the liquor or alcohol drug stores, pubs, hotels, or bars in such areasthat could be effective to prevent more usage/ consumption of the alcohol to the great extent (IARC, 2002). The alcohol consumption should also be banned in the communities, societies, public placesor social/ publicity eventsso that a great control could be achieved on the alcohol use for minimizing the future likely impacts of alcoholism (like cancer disease).  

This video represents the complex problems or dilemma that the indigenous people in Aboriginal communities in Western Australia’s Kimberley region face and represent the epidemic of the suicide concerns of the indigenous youths (almost 70-80 deaths per 100,000 populations in Kimberley). The economic, political, socio-cultural factors affect the indigenous individuals in the aboriginal communities. The politics (the lack of government support) and bureaucracy affect the socially, physically, economically, and cultural development of these people.The inadequacy of the sufficient means or arrangement for the basic resources, the malnutrition or poor dieting because of the lack of healthy foods, the lack of colonization, the socio-cultural differences, and the lack of the social activities make them psychologically distressed and mentally sicked for enforcing them to the suicide attempts.The indigenous and aboriginal population, especially in the rural and remote communities of Western Australia facing the health-related problems, cultural dilemmas, and social problems because of the lack of adequate infrastructural development facilities, the lack of clean environment, the lack of clean and drinkable water, poor or malnutrition, poverty or funding problems, the lack of awareness of the health awareness, and the lack of the advanced clinical facilities or poor healthcare system in these communities that can lead to the increase of the critical diseases, like cancer (Pirschel, 2017).

The youths are harming themselves by making unnecessary suicides for ending their lives in these communities. The poverty or lack of sufficient funding, poor employment levels, and the lack of financial support are the major causes for facing the problems by the indigenous people in these communities. Along with this, the lack of awareness and acceptance for the chronic illness, injuries or complex health problems is another factor for affecting the indigenous youths. The lack of infrastructural facilities and resources, the lack of healthcare clinics, advance healthcare planning, and health policies are other factors for affecting the indigenous youths in remote communities. The psychological distress, mental health sickness, emotional attachment, and suicidality tendency cause for the increasing the suicide attempts among the indigenous people (Mirghani, Jung, Fakhry C, 2013).

Community Level

List of interventions that can be successfully implemented within the community

The Western Australia government should intervene through the development of the localized strategies for the physically, socially, and cultural development of the indigenous and aboriginal people in Australia. The prevention can be classified into the categories, like preventive intervention and therapeutic intervention. The preventive intervention includes educational awareness for preventing the causes of the disease and reducing the incidents for critical diseases. It also includes nutritional intervention, vaccines, maternal and neonatal interventions, educational and behavioural changes, drugs availability, injury prevention, environmental alternations, and vector control. The therapeutic intervention includes the surgical treatment, treatment for the infectious diseases, early diagnostic to guide therapy, and availability of drugs and therapy for the acute and chronic diseases, injury prevention, and better health planning and management policies (Ott, Ullrich, Mascarenhas, Stevens, 2011).

The indigenous or aboriginal people in the remote communities could be educated for the self-awareness among them regarding the healthy foods, safety behaviours, avoiding from injuries or unnecessary deaths, and living in the clean and safe environment for preventing the health-related concerns. The provisions for the educational programs, training and learning programs, health-awareness camps and school-based education could be successfully implemented for increasing awareness of the indigenous people for their social, cultural, and health development concerns.

Along with this, the availability of the vaccines, drugs, and therapy through the clinics or healthcare setting, advancement of the medical science and healthcare system for curing the chronic diseases (like cancer) or abnormal diseases (since birth) in these communities. The government can invest into the healthcare system infrastructure and development facilities, rehabilitation centres, diagnostic care centres, medical science research, epidemiology, and inventing drugs and vaccines for the preventing the occurrence of the chronic illness or critical diseases.

The indigenous people or aboriginal individuals in the remote or rural communities could be strengthened by providing the adequate support by the federal government in WA for facilitating the funding support for the establishment of schools, clinics, research centres, and diagnosis centres (Paavonen, Naud, Salmeron, Wheeler, Chow, Apter D, et al. 2009). The legal interventions (like enforcement of anti-pollution laws, food labelling law, and legal restrictions on the alcoholand tobacco consumption),health system intervention (developing effective health policies for the well-being and development of the people), and nutritional intervention (encouraging the people for healthy and balancing foods dieting) could also be implemented for promoting health and safety environment within these communities. The psychological intervention could be effective for examining the social determinants of the psychological distress and suicidally behaviours and improved access to the culturally development appropriate services for addressing the underlying mental health conditions.   


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Ott JJ, Ullrich A, Mascarenhas M, Stevens GA. Global cancer incidence and mortality caused by behavior and infection. Journal of Public Health. 2011 Jan; 33: 223-233.

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Pirschel C. Cancer Prevention through Community-Based Programs.2017, Oct [Internet]. Available From: (Accessed: 30 October 2018).

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