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Guidelines For Cancer Prevention
One out of every four people (23%) will die from
cancer. The lifetime probability of getting cancer is 43% for men and
38% for women. Cancer, as a leading cause of death, is second only to
heart disease. Yet many people fear cancer the most because they feel
there is little they can do to prevent it.
A new report from the National Cancer Policy Board
of the National Institute of Medicine, however, reveals just the
opposite. They state, "Prevention interventions are available today
that can sharply reduce the future burden of cancer." Their estimate
is that 100,000 cases of cancer can be prevented each year if people
will follow two basic prevention strategies.
Healthier lifestyles and preventive exams offer
great promise as effective means of reducing the incidence of cancer.
Here are six key strategies for cancer prevention recommended in the
Institute of Medicine report1.
Prevention Strategies
1. Avoid tobacco use. Smoking is responsible
for 30% of all cancer-related deaths. Smoking more than doubles the
risk for cancer of the lung, mouth and throat, bladder, kidney,
pancreas, and liver. Stopping smoking has major and immediate health
benefits. For example, persons who stop smoking before the age of 50
have, on the average, half the risk of dying in the next 15 years than
those who continue to smoke. Half of all Americans who have ever
smoked have now quit! If you would like to quit, ask your doctor for
help. Aids are available to help make the quitting process
easier and more successful.
2. Eat healthfully. Poor nutrition is
estimated to be responsible for about 33% of all cancer related
deaths. The strongest evidence of a relationship between diet and
cancer is the benefit of eating more fruits and vegetables. The new
DASH diet, designed to help lower high blood pressure and prevent
heart disease, is also a good diet for cancer prevention. It
recommends as many as 8-10 servings of fruits and vegetables each day.
These foods are high in dietary fiber. New large studies from Europe
show that persons eating a high fiber diet reduced their risk of colon
cancer by over 40%.
Fruits and vegetables are low in calories and
contain a cocktail of anti-cancer substances including both
known nutrients and non-nutritive substance linked to lower rates of
cancer. Together, these substances inhibit the formation of
carcinogens, help the body produce anticarcinogens, reduce cancer cell
proliferation, and act as antioxidants. All these functions reduce
cancer risk including cancers of the mouth, stomach, esophagus,
pancreas, bladder, lung, colon, prostate, breast, endometrium, liver,
and kidney.
Other dietary recommendations include eating less
red meat and foods high in saturated fat, eating more whole grains,
and eating foods high in carotinoids, folate, vitamin D, vitamin E, and
selenium. Eating a wide variety of fresh fruits, vegetables, whole
grains, legumes, and nuts is the best way to get these key nutrients.
3. Be physically active. Physical activity
has many benefits including lower risk for heart disease, stroke,
diabetes, high blood pressure, depression, and osteoporosis, as well
as lower risk for cancer. Overall, physical inactivity is linked to 1
out of every 4 deaths (23%) from major chronic disease including 5%
of deaths from cancer. Specifically, a sedentary lifestyle increases
the risk for colon cancer, breast cancer, and endometrial cancer.
Maintaining an active lifestyle throughout life
appears to impart the greatest cancer protection. Activity guidelines
recommend getting at least 30 minutes of moderate activity, such as
brisk walking, most days of the week, and daily when possible. An hour of
activity daily has even more benefits. Other examples of aerobic
activity include active gardening, aerobics to music, active dance,
golf (walking and pulling clubs), biking, swimming, skiing, tennis, and
other active sports.
When first starting, keep your activity moderate and
slowly progress in time and intensity to reach your goal of 30-60
minutes daily. Get your doctor's guidance if you are getting older or
have existing health problems.
4. Maintain a healthy weight. As weight
increases, so does the risk for many cancers including cancer of the
stomach, prostate, breast, uterus, cervix, ovary, esophagus, colon and
rectum, liver, gallbladder, pancreas, kidney, non-Hodgkin's lymphoma,
and multiple myeloma. In the large American Cancer Society Cancer
Prevention II Study including 900,000 people, researchers estimate
that overweight was responsible for 14% of all cancers in men and 20%
in women2. For persons in the
highest category of obesity (BMI 40+) the risk for any cancer
increased by 53% in men and 62% in women compared to persons of normal
weight.
A positive strategy for preventing cancer is to
maintain a healthy weight by developing good eating habits and an
active lifestyle. Look for ways to choose lower calorie foods. Limit
snacking, especially on typical snack foods including soda pop and
other sugary drinks. Limit frequent eating out, especially at
fast food restaurants. Watch portion sizes and second helpings. Learn
to enjoy lower calorie foods.
If you need help in losing weight, talk to your doctor or
nutritionist or join a credible weight loss program such as those
offered by your local hospital or Weight Watchers(TM) . Being in a group
support environment and having professional guidance is very helpful.
The Cancer Prevention 2 Study estimates that 90,000 deaths due to
cancer could be prevented each year in America if people would avoid
being overweight!
5. Limit alcohol if used at all. Alcohol has
long been listed as one of the top preventable contributors to death
in the United States; causing about 100,000 deaths yearly. Some
studies show that moderate use of alcohol may reduce the risk of heart
disease, but in relation to cancer, alcohol is now classified as a
Group A carcinogen by the International Agency for Research on Cancer.
For cancers of the mouth, pharynx, larynx,
esophagus, colon, and breast, there is a dose-response relationship.
Even at low intakes, their is an increased risk for cancer and the
risk increases as the amount of alcohol consumed increases. For liver
cancer, the most important factor is heavy and persistent use of
alcohol.
Avoiding alcohol is the safest course for preventing
cancer. If you choose to drink, limit your intake and don't drink
every day.
6. Cancer Checkups3.
Next to preventing cancer, the next best strategy is to get
recommended cancer screening tests and exams. If you find cancer early,
before it has spread throughout your body, your chances of a cure are
much greater. Recommended exams include:
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Colorectal cancer screening for everyone 50
or older. Estimates are that up to 90% of all colon cancer deaths
could be prevented if everyone got regular screening. There are
several methods available including an annual test for blood in the
stool, a flexible sigmoidoscopy every 5 years, a colonoscopy every 10
years, or a double contrast barium enema every 5 years. Talk to your
doctor to decide what's best for you.
-
Mammography for women over 40 and clinical
breast exam annually. Women 20-39 are encouraged to get a clinical
beast exam at least once every three years. Ask your doctor how often
is best for you.
-
PAP test screening for cervical cancer for
all women who are sexually active (or at least by 21) every 1-2 years.
After age 30, if three tests have been normal, a screening every 2-3
years is recommended. More frequent screening may be indicated if you are at
increased risk. Ask your doctor how often is best for you.
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Prostate exam and PSA should be offered
annually for all men age 50 or older (age 45 if you are high risk or
an African-American man). Discuss the benefits and limitations of the PSA
blood test with your doctor to see if you should have this test.
-
Regular medical care. Seeing your doctor
regularly is important for many reasons in addition to cancer
prevention. Good medical care including blood tests, skin exams, and
other tests can help identify serious health problems early.
Other Cancer Prevention Strategies. These six
recommended guidelines address the major ways of reducing risk of cancer.
There are other ways to reduce cancer risk as well such as limiting
exposure to known cancer causing chemicals in industrial settings,
limiting excess exposure to the sun by wearing protective clothing,
hats, sun glasses, and using sun block (SPF 15+), practicing safe sex
(avoiding exposure to HIV and HPV virus infections), supporting clean
air and water in your communities, and generally taking good care of
your health.
There is much that can be done to prevent cancer.
The choice is in your hands. By adopting a more healthful lifestyle
and getting regular health care you can greatly reduce your odds of
getting or surviving cancer! It can also help put your mind at ease
knowing you are taking preventive action.
References
1. National Cancer Policy Board, Institute of Medicine, National
Research Council of the National Academies, Fulfilling the Potential
of Cancer Prevention and Early Detection, The National Academies
Press, Washington, DC 2003
2. Calle EE, et al. Overweight, Obesity, and Mortality from Cancer in
a Prospectively Studied Cohort of U.S. Adults, New England Journal of
Medicine 348 (17):1625-38, April 24, 2003
3. American Cancer Society, Cancer Facts and Figures 2003
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