MICHEL MARTIN, HOST:
A recent global survey predicts cancer cases and cancer deaths will continue to rise through at least 2050, especially in low- and middle-income countries. Lebanon has particular reason to be alarmed. As reporter Ari Daniel reports, the country is experiencing the fastest increase in cancer incidence and mortality anywhere in the world.
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ARI DANIEL, BYLINE: I'm in the middle of Beirut, and there are cars and trucks and motorcycles everywhere.
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DANIEL: Beirut has terrible air quality. The capital of Lebanon is often submerged under a blanket of exhaust, and vehicles belch pollution across the country.
ALI MOKDAD: If you look at a car passing by, you see smoke coming out of it. That's illegal in Lebanon, but nobody enforce it.
DANIEL: Ali Mokdad grew up here but moved abroad almost 40 years ago. He's the chief strategy officer of population health at the University of Washington and a co-author of a new global cancer survey published in The Lancet. For him, like many in Lebanon, the disease is personal.
MOKDAD: I'm losing cousins. I'm scared I'm losing them at a very young age. It's not only deaths. They have so many health problems.
DANIEL: There are various reasons why cancer is surging in Lebanon. Air pollution's a big one from vehicles, but also from diesel-fueled generators due to unreliable state electricity. In addition...
MOKDAD: We overuse chemicals for our agriculture. And in many places, sewage are dump in the river. And people say, oh, I don't drink it, but they wash their tabbouleh and their fattoush with it. They're consuming this.
DANIEL: But by far, the biggest risk factor is smoking.
MOKDAD: Everybody smokes. Kids smoke in front of their parents. Yesterday, I went to some of my friends for dinner. You come home, you stink of tobacco.
DANIEL: It's gotten to the point where Mokdad keeps a set of clothes in Lebanon he only wears when visiting here. There are no public health campaigns warning against the dangers of smoking or secondhand smoke. So lung cancer has jumped, as has prostate, colon and breast cancers.
MOKDAD: These are easy to detect.
DANIEL: You mean by screening?
MOKDAD: Of course, screening is available, but there is no awareness. Health education is a problem. If you caught it earlier, he or she didn't have to die.
DANIEL: Mokdad's report on cancer got the attention of the Lebanese parliament. In particular, they were struck by the finding that the frequency of new cancer cases in Lebanon leaped by 162% and the death rate due to cancer by 80% - both since 1990. These are the largest jumps anywhere in the world, and that's why Mokdad is here on this day. Lawmakers wanted to hear more about his findings.
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DANIEL: After the national anthem and opening remarks...
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UNIDENTIFIED PERSON: (Speaking Arabic).
DANIEL: ...Mokdad walked through the results of the study...
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MOKDAD: (Speaking Arabic).
DANIEL: ...And suggested Lebanon could improve its health screening, ban smoking in public spaces and launch a set of aggressive anti-tobacco ads.
(CROSSTALK)
DANIEL: After the meeting broke, I approached Inaya Ezzeddine. She's a member of parliament and a physician who says any kind of government response will take time.
INAYA EZZEDDINE: It's a journey. It's not something that we can implement overnight because it has to do with a lot of sectors. We have to work hard towards this political will.
DANIEL: After the meeting disperses, Ali Mokdad and I talk outside. He says the government needs to act now.
MOKDAD: Cancer is killing. Here is the sad part - many people in the parliament said I'm not surprised with this funding. And my question - what are you doing about it? Why have you been waiting so long to take action?
DANIEL: As I'm about to leave, I spot a mother and son seated outside. They're taking a break from work. The mother, Najah Mourda (ph), who's 57, tells me she's recently lost several loved ones to cancer.
NAJAH MOURDA: My mom and my friend, my sister - it's very dangerous, and I afraid of it.
DANIEL: You want the government to do something?
MOURDA: Yes, of course.
DANIEL: I look down at Mourda's hand. She's holding a cigarette. She knows it's bad for her.
But it's hard to stop.
MOURDA: Yes. I try. Really, I try.
DANIEL: Mourda's son looks at me. People are dying because of cancer, he says. We're losing people we love.
For NPR News, I'm Ari Daniel, Beirut, Lebanon.
(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.
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