Cancer Prevention Unit and WHO Collaborating Centre for Tobacco Control

Nearly 40 percent of all new cancer cases are caused by preventable cancer risk factors such as smoking, unhealthy diet, obesity, physical inactivity, alcohol consumption, and infections, such as with the human papillomavirus (HPV). All these cancers are potentially preventable, as most of these risk factors could be prevented through lifestyle changes. The most important risk factor for cancer is smoking – nearly 20 percent of all new cancer cases are a result of smoking. There is thus great potential for prevention, particularly regarding smoking, but also regarding the other lifestyle-related cancer risk factors.
The Cancer Prevention Unit of the German Cancer Research Center (DKFZ), founded in 1997, has the mandate to make a noticeable contribution to the reduction of preventable cancer risk factors. For a long time, the focus of work was essentially on reducing tobacco use because of its particularly high prevention potential. The aim is to help reduce the individual and societal harm caused by smoking. For some years now, the reduction of other cancer risk factors has also increasingly been part of the Cancer Prevention Unit's remit. For example, a significant goal of the Cancer Prevention Unit is to promote HPV vaccination to achieve the WHO goal of having 90 percent of 15-year-old girls vaccinated against HPV by 2030 through increased vaccination coverage, thereby ultimately eliminating HPV-related cancers. Alongside this, the Cancer Prevention Unit aims to raise awareness of the health hazards of alcohol consumption – particularly its carcinogenic effects – and ultimately contribute to a reduction in alcohol consumption. In addition, the Cancer Prevention Unit is active in the areas of obesity prevention and the promotion of physical activity.
In 2002, the Cancer Prevention Unit received recognition from the World Health Organization (WHO) as a WHO Collaborating Centre for Tobacco Control. This has a mandate to provide information on the health hazards of tobacco use and to support health policies to reduce tobacco use. Since the last redesignation in 2021, the WHO Collaborating Centre's mandate also includes providing information on the risks of alcohol use, particularly in relation to smoking, and supporting health policies to reduce alcohol use. The WHO Collaborating Centre for Tobacco Control is financially supported by the German Federal Ministry of Health.

To evaluate and assess the effectiveness of tobacco control measures, the Cancer Prevention Unit/WHO Collaborating Centre is involved in national and international research projects. The Cancer Prevention Unit/WHO Collaborating Centre documents developments in Germany that are relevant for health policy decisions with its own surveys.
Important completed or ongoing research projects are in particular:

• PIECES (2023 to 2027): This EU-funded project will develop and test a framework through which evidence-based cancer prevention programs can be selected, adapted to different settings, and implemented. Improved population implementation of prevention programs will promote healthy lifestyles and reduce cancer risk factors such as smoking, alcohol consumption, lack of physical activity, HVP infections, sun exposure, and diet.
• Media Monitoring (2022 to 2023): The project "Media Monitoring: Advertising for Tobacco, Related Products and Alcohol in Social Media," funded by the German Federal Ministry of Health, aims to show for the first time for Germany to what extent and with which messages and target groups advertising for e-cigarettes, tobacco heaters and alcohol is available in social media and in the German language. A complementary part of the project, funded by the Baden-Württemberg Cancer Association, will determine to what extent and in what form HPV vaccination is addressed in social media.
• "Approaches to increase HPV vaccination coverage in Germany – barriers and opportunities: A qualitative study" (2019 to 2023): Identifying opportunities and barriers related to the use and implementation of different approaches to increase HPV vaccination coverage in Germany will serve as a basis for improving interventions.
• "Future Cancer Burden – Predictors and Prevention Potential" (2016 to 2018): This project, funded by German Cancer Aid, predicted the future cancer burden, quantified the proportions of preventable cancer cases for major cancer risk factors, and used simulation models to assess the potential effectiveness of intervention strategies in terms of their impact on the future cancer burden.
• European Regulatory Science on Tobacco (EUREST-PLUS) (2016 to 2018): Participation in a multicentre, EU-funded project to evaluate the European Tobacco Products Directive 2014/40/EU.
• International Tobacco Control Policy Evaluation Project (ITC) (2007 to 2011): Participation in an international consortium of longitudinal studies evaluating tobacco control policies. A standardized questionnaire allows international comparisons and inferences on the impact and effectiveness of tobacco control policies.
• Public Information Tobacco Control (PITOC) (2009 to 2012): Participation in a multicentre, EU-funded project to provide information on the multiple effects of tobacco additives.
• Monitoring of tobacco smoke exposure and evaluation of non-smoker protection laws in Germany: Particle measurements were used to document tobacco smoke exposure in the catering industry and to evaluate the implementation of non-smoker protection laws.

The Cancer Prevention Unit/WHO Collaborating Centre for Tobacco Control cooperates with various national and international alliances of professional societies from the fields of medicine and public health to jointly achieve effective measures for the prevention of cancer. Particularly noteworthy as partner organizations are: The "Aktionsbündnis Nichtrauchen", the "Deutsche Allianz Nichtübertragbare Krankheiten", Smokefree Partnership, and the European Network for Smoking and Tobacco Prevention. In the area of HPV prevention, the Cancer Prevention Unit networks relevant actors in the field of HPV prevention to pool competencies, resources, and forces for the implementation of effective HPV prevention measures. Cooperation exists with the Robert Koch Institute, the "Nationale Lenkungsgruppe Impfen", the "Stiftung Deutsche Krebsgesellschaft", and the "Preventa-Stiftung".

The Heidelberg WHO Collaborating Centre for Tobacco Control is located in the German Cancer Research Center and is closely linked to the Cancer Prevention Unit. Funding is provided by the German Cancer Research Center, the Federal Ministry of Health based on a resolution of the German Bundestag, third-party funds, donations and through training events.
Financial contributions by the tobacco industry and e-cigarette manufacturers are rejected because the goals of these industries – to sell products that are harmful to health or at least questionable to the largest possible (and young) clientele – are not compatible with the goal of the DKFZ to provide the population with the greatest possible health protection. For this reason, an Ethical Code for the Rejection of Tobacco Industry Funds is in place for all departments at the German Cancer Research Center.
The Cancer Prevention Unit was financially supported by the Klaus Tschira Stiftung gGmbH from 2009 to 2016.