World Day

From 'no' to smoking to nutrition to caregivers: the fight against cancer is teamwork but starts with us

105,000 diagnoses are caused by cigarette habit and overall more than 40% of deaths are caused by bad lifestyles, but alongside primary prevention that starts with the individual, concrete measures are needed to support innovation, operators and families

by Barbara Gobbi

4 February 2026

7' min read

Translated by AI

Versione italiana

7' min read

Translated by AI

Versione italiana

Just look at the data on smoking: 105 thousand are the related diagnoses in Italia, equal to one third of the total (27%) of the 390 thousand cancer cases estimated in 2025 in our country. We are told this by Aiom, the Association of Medical Oncologists, which with its Foundation and the Airc and Veronesi Foundations is engaged in collecting signatures for the popular initiative law aimed at increasing the cost of all smoking and nicotine products by 5 euros. A proposal that is proceeding apace with the 18,000 signatures already collected in just over ten days thanks to the campaign - joined by 30 scientific societies and over 15 associations - on the platform of the Ministry of Justice. "We are satisfied but a further effort is needed to reach the 50,000 signatures needed," warns Aiom president Massimo Di Maio on the occasion of World Cancer Day on 4 February, under the motto "Unite by Unique" chosen for the three-year period 2025-2027.

Risk factors

Di Maio recalls how smoking is the main cancer risk factor, but that the others must also be affected in order to reverse the trend of unhealthy lifestyles. This is a responsibility that starts with each one of us and must be supported by a collective effort and teamwork in cases where the disease does manifest itself. But if the WHO certifies that 4 out of 10 cancers could be avoided by changing habits and fighting infections and environmental pollution, then that is where we must start. Not only by 'no' to smoking, but also to alcohol, which, as Silvio Garattini reminds us, is carcinogenic and in fact correlates with seven types of carcinoma, and to weight control, since excess weight is correlated with as many as twelve types of tumour. The data tell us that today we are a long way from this awareness and that there is great room for improvement, if 24% of adults smoke, 33% are overweight, 58% consume alcohol and 27% are sedentary.

More resources for innovation

"Prevention is the tool to reduce the number of cancer cases and to sustain the increase in outlays for innovative treatments," Di Maio continues. "In 2024, public expenditure on drugs was 5.4 billion, an increase of 13.8 per cent on 2023 and equal to 20 per cent of total public pharmaceutical spending. Innovation is not just a cost but saves lives, and that is why it is strategic to free up resources where we can intervene'.

The lowest common denominator,' she explains, 'is precisely the personalisation of treatment towards the patient, both from the point of view of the organisational structure, and of the therapeutic targets that allow more extensive profiling - today there are new resistance mechanisms for some pathologies, and at the moment the most important paradigm is that of lung cancer - and of the drugs, and this is the case with drug-conjugated antibodies. The latter combine the old technology of chemotherapy with the new one of monoclonal antibodies, which have become an established reality in breast cancer but are simultaneously being tested and approved for those in other sites of the body. As a matter of fact,' Berardi continues, 'this is a transversal therapy for the different types of tumours for which the same drug is being tested, with particular reference to lung and stomach tumours. We are also looking for new targets for molecular genetic profiling even in more sophisticated structures,' Berardi goes on to report. 'It is now possible to proceed with more extensive profiling of several dozen or hundreds of genes, and this represents the prelude to the possibility of developing newer and more targeted therapies than the existing ones.

Decline in mortality

The improvement, although the data are still sub-target, in the adherence to screening and frontier treatments have meanwhile led to a valuable decrease in mortality: in our country, in 2026 compared to the period 2020-2021, a decrease in oncological mortality rates of 17.3% in men and 8.2% in women is estimated. These figures are better when compared to the European average (-7.8% in men and -5.9% in women in 2026 compared to the period 2020-2022). "In Italia, 63% of women and 54% of men are alive five years after diagnosis and at least one patient in four has returned to having the same life expectancy as the general population and can be considered cured," Massimo Di Maio points out.

The demand for a care network

But it is precisely these data, which translate into a long survival, that call for a comprehensive and widespread caring apparatus. People living after a diagnosis are estimated (2024) at 3,661,499: about 6.2 per cent of the population, equal to one Italian in 16, configuring an epidemiology that awaits appropriate and widespread responses. The reality for these cases is also described by the data: "In 10 years, in Italia, 1,091 public beds in medical oncology have been cut: in 2013 there were 5,234, reduced to 4,143 in 2023," the Aiom president goes on to explain. 30% of centres still lack oncology home care and more than half of the facilities (52%) lack clinical research coordinators, who are essential figures for conducting trials. Important aspects of care, such as clinical psychology and clinical nutrition, also remain suboptimal in many settings. In addition to more modern beds and hospitals, more doctors and nurses are needed. The shortage of specialists is also affecting oncology, albeit to a lesser extent than in other specialities. Moreover, the Regional Oncology Networks, which are currently only active in about half of the regions, must be set up throughout the territory. Only in this way can multidisciplinary collaboration be guaranteed throughout the treatment pathway'.

"Digital passport" and "navigator"

From Women for Oncology comes the dual proposal of a 'digital care passport' and 'oncology navigators': 'The document, which can be shared between hospital, territory and family, could contain the treatment plan, management of side effects, rapid team contacts, and individual preferences,' says Berardi. 'The aim is to guarantee continuity of care and make every stage of the pathway truly person-centred, avoiding fragmentation and disorientation. Alongside this,' he continues, 'we can think of a structured figure of a pathway navigator, a professional dedicated to supporting patients and their families in the most complex moments. The navigator supports the organisation of visits, facilitates the understanding of clinical information, and orients towards the available territorial and social services. A presence that can reduce anxiety, delays and organisational difficulties, making care more accessible and understandable'.

Malnutrition risk for 60%

The Favo, the Italian Federation of Voluntary Associations in Oncology, is emphasising aspects of cancer disease such as malnutrition. An issue to which the budget law for 2026 devotes resources and attention. "In Italia, about 60 per cent of cancer patients are at risk of malnutrition already at the time of diagnosis. Cachexia and sarcopenia affect up to 80% of patients at an advanced stage, resulting in a 250% increase in mortality, a tripling of complications, and a significant extension of the length of hospital stays (+30%),' warns Francesco De Lorenzo, president of Favo. For this reason, Favo already promoted in 2016, together with Aiom and Sinpe, the Charter of the rights of the oncological patient to appropriate and timely nutritional support, one of the pillars of the Ministry of Health's Guidelines on nutritional pathways in oncological patients, approved at the State-Regions Conference in 2017. "However," De Lorenzo further states, "years later, only a few regions have fully implemented them. More recently, with the approval of the motion by the Chamber of Deputies, which commits the Government to make nutritional support an integral part of oncological pathways, and the amendment to the Budget Law 2026, which introduces the obligation to record the results of nutritional screening in the medical record, thus making nutritional care measurable, traceable and therefore enforceable, represent a turning point to overcome inequalities and to facilitate the inclusion of Food for Special Medical Purposes (Afms), true therapeutic presidia, in the Lea".

Supporting caregivers

Not only the patients but also the caregivers: 'For the first time, we can think of an oncological pathway that formally includes the caregiver from the very beginning of the care process,' Berardi proposes. 'In addition to the clinical assessment of the patient, the model includes a moment dedicated to the caregiver, with information on available services, psychological support, and guidance on social rights and protections. Acknowledging the caregiver as an integral part of the care system means protecting his or her wellbeing and improving, at the same time, the patient's clinical outcomes and quality of life'.

Cues contained in the Caregiver Bill launched by the government in recent weeks but which still represents a timid first step, even on the crumbs front in terms of financial support for those who devote their lives to their loved ones with the disease. "Recognising and protecting caregivers, of whom there are as many as 7 million in Italy, is not only an act of social justice," says Paolo Tralongo, president of Cipomo, the College of Oncology Head Teachers, "but also means improving the quality of oncological care. A supported, informed, and protected caregiver is better able to support the patient, encourage adherence to treatment, and reduce the risk of isolation and frailty. For this reason, the Caregiver Bill represents an important step, which must be strengthened and made more and more adherent to the reality of families and oncological pathways'.

And from Parliament on the Caregiver Bill comes a promise: 'There is a joint commitment by the entire 'Together for a Commitment Against Cancer' Intergroup, which, I stress, has no political colour, to give it that fast track and number in Parliament and move it forward as quickly as possible'. These were the words of Chamber of Deputies Vice-President Giorgio Mulè, speaking at the #UnitedByUnique conference organised in Rome for World Cancer Day by the group 'Health: an asset to defend, a right to promote'.