WORLD Cancer Day was marked yesterday with a warning from the WHO that nearly four in 10 cancer cases are preventable. For Pakistan, where health systems are stretched, that figure is not a number to cite; it is a directive to act. Tobacco remains the largest driver of preventable cancers. In Pakistan, cigarette smoking, naswar and increasingly, vaping, continue to draw young people into nicotine dependence. Yet tobacco taxation remains inconsistent, enforcement of smoke-free laws is patchy, and graphic warnings are often diluted by industry pressure. A meaningful increase in excise duties, strict advertising bans and enforcement without exception are essential. Air pollution — now a seasonal emergency in Punjab and beyond — is another carcinogenic threat. Smog is not merely a respiratory irritant; it is a cancer risk. Federal and provincial governments must treat clean air as a public health intervention, not an environmental afterthought, by enforcing emissions standards, regulating brick kilns and transport and accelerating the transition to cleaner energy.

Infections account for a significant share of preventable cancers. Cervical cancer, overwhelmingly caused by HPV, remains a silent killer of Pakistani women. Pakistan’s first nationwide HPV vaccination campaign last year reportedly reached over 9m girls aged nine to 14. This is an important start despite early misinformation. The programme must reach eligible girls as part of routine immunisation. Workplace safety laws, especially regarding asbestos and industrial exposure, require stronger monitoring. At the same time, urban planning must promote physical activity and healthier diets to combat obesity-linked cancers. Cancer care cannot remain concentrated in tertiary hospitals in major cities. A system that waits for advanced disease is neither efficient nor equitable. Prevention, early detection and integration within primary care are not only more cost-effective, they are more humane. If four in 10 cancers can be prevented, the real test will lie not in expanding treatment alone, but in reducing the number who need it.

Published in Dawn, February 5th, 2026

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