Can you meaningfully reduce your cancer risk?

A while back, I read a highly-reviewed, but really disappointing book to Evan– Dead End in Norvelt (a story without any conflict really isn’t much of a story).  The one redeeming feature of the book is that there was a lot about obituaries in there and Evan and I started occasionally reading obituaries and discovering the extraordinary lives of seemingly ordinary people.

So, yesterday Evan was just sitting around at the kitchen table and started reading the obituaries and discovered that the long-time art teacher at his (and previously older brothers’) elementary school had recently died from ovarian cancer.  My kids loved her art classes and I had many a pleasant conversation with her at back-to-school nights and such over the years, but little did I realize that Mrs. Howard had played basketball for UNC or been a Miss Lincoln County.  Alas, she was done in my ovarian cancer at the age of 64.

Evan said he thought that people didn’t die from cancer any more.  If only.  It certainly got me thinking about not wanting to die from cancer.

So, by way of that lengthy introduction, that brings me to this recent post from Aaron Carroll in the Upshot on the preventability (and lack thereof) of various forms of cancer.  Here’s the thing– turns out there’s a lot you can to do to lower your risk of cancer.  For now, cancer is still very much a crapshoot with a lot of luck involved, but that doesn’t mean you can’t lower the odds of that bad luck hitting you.  To wit:

What we really care about is how much we can reduce our own risk of cancer by changing our behavior.

A more recent study published in Nature argues that there is a lot we can do. Many studies have shown that environmental risk factors and exposures contribute greatly to many cancers. Diet is related to colorectal cancer. Alcohol and tobacco are related to esophageal cancer. HPV is related to cervical cancer, and hepatitis C is related to liver cancer.

And you’d have to be living under a rock not to know that smoking causes lung cancer and that too much sun can lead to skin cancer.

Using sophisticated modeling techniques, the researchers argued that less than 30 percent of the lifetime risk of getting many common cancers was because of intrinsic risk factors, or the “bad luck.” The rest were things you can change…

Most recently, in JAMA Oncology, researchers sought to quantify how a healthful lifestyle might actually alter the risk of cancer. They identified four domains that are often noted to be related to disease prevention: smoking, drinking, obesity and exercise.

They defined people who engaged in healthy levels of all of these activities as a “low-risk” group. Then they compared their risk of getting cancer with people who weren’t in this group…

About 82 percent of women and 78 percent of men who got lung cancer might have prevented it through healthy behaviors. About 29 percent of women and 20 percent of men might have prevented colon and rectal cancer. About 30 percent of both might have prevented pancreatic cancer. Breast cancer was much less preventable: 4 percent.

Over all, though, about 25 percent of cancer in women and 33 percent in men was potentially preventable. Close to half of all cancer deaths might be prevented as well. [emphasis mine]

So, no, you can’t eliminate your cancer risk, but you can make a very meaningful change.  And it’s not even really all that hard.  To be low risk really isn’t all that onerous:

I was especially worried because, in this study, “low-risk” status required all four healthy lifestyles. Failing in any one domain put you in the high-risk category, and that seemed like a lot to ask of people.

On further reading, though, I discovered that the requirements weren’t overly burdensome. Not smoking was defined as never having smoked or having quit at least five years ago. That’s clearly good for health. Moderate alcohol consumption was defined as no more than one drink a day on average for women, and no more than two for men. That’s pretty much what I argued for in my column on alcohol, and in no way requires abstinence.

Adequate weight was defined as a BMI of at least 18.5 and no more than 27.5. The cutoff for “overweight” is 25, meaning that you don’t have to be thin; you just have to be less than obese (BMI 30). Finally, exercise was defined as 150 minutes a week of moderate-intensity activity or 75 minutes of vigorous-intensity activity. That’s the benchmark I talked about in detail two weeks ago.

I was surprised to realize that I’m already “low risk.” I bet many of you are “low risk,” too.

Hooray– I’m low risk.  I suspect that the exercise is the hang up for many.  More incentive than ever to get moving.  And, of course, these are just factors the researchers were able to study.  There’s surely additional features of healthy living (I’ve got to think there’s something to fruits, vegetables, nuts, whole grains, etc., beyond body weight) that reduce cancer risk.  Anyway, even though we cannot eliminate our cancer risk, it certainly is good to know that we can make real progress through healthy lifestyles.


About Steve Greene
Professor of Political Science at NC State

2 Responses to Can you meaningfully reduce your cancer risk?

  1. ohwilleke says:

    Weight and exercise are in no sense easy for many of us. They are life long struggles where you are the underdog every single day.

    • Steve Greene says:

      I’ll give you weight– especially as the modern American environment is structured. But a decent brisk walk everyday should certainly be doable for most.

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