Many cancers are preventable. Strategies to reduce cancer incidence include both screening and prevention. In a study of global cancer burden in 2019, 51 percent of worldwide cancer deaths in males and 36 percent of those in females were deemed attributable to behavioral, environmental and occupational, or metabolic risk factors.
Smoking was the leading cause for all adults, while other important factors included alcohol use, high body-mass index, and unsafe sexual practices. Counseling and other strategies to decrease these modifiable risk factors are an important part of preventive health.
Basic lifestyle changes can have a tremendous impact on the rates of cancer. General lifestyle recommendations include avoiding tobacco, being physically active, maintaining a healthy weight, eating a healthy diet, limiting or eliminating alcohol, protecting against sexually transmitted infections, avoiding sun exposure, and obtaining appropriate cancer screening.
Tobacco use is the most preventable cause of cancer. Significant health benefits accompany quitting, even for longtime tobacco users. The health benefits of quitting can be seen at all ages and can be measured almost immediately after cessation.
Decreased physical activity appears to increase the risk for cancer. Physical activity is associated with a decreased risk for many different types of cancers, but the most compelling data are in the reduction in colon and breast cancer risk.
Obesity has been found to increase the risk of many types of cancers, and weight loss decreases risk.
Alcohol intake, even in light to moderate quantities, increases the risk for colon, breast, esophageal, and oropharyngeal cancer.
Potentially modifiable or avoidable environmental contributors to cancer incidence include exposure to excessive solar radiation or to artificial ultraviolet radiation, air pollution, radon gas in enclosed environments, and arsenic in drinking water.
Skin cancer is directly related to natural and artificial ultraviolet exposure. A history of blistering sunburns and indoor tanning, especially in youth and young adults, is of particular risk for melanoma; cumulative sun exposure has more impact on non-melanoma cancers.
The association of dietary fat, fruits, and vegetables with cancer risk is largely unconfirmed. Red meat and processed meat consumption may promote colorectal cancer and a high intake of tomatoes probably decreases prostate cancer risk.
High calcium intake (>2000 mg/day) increases risk for prostate cancer but is associated with a reduced risk of colorectal cancer. Folate in diet has been associated with a decreased risk of colon cancer, especially in women who drink alcohol; data on folic acid or multivitamin supplementation are inconsistent.
Chemoprevention may be helpful in high-risk patients, but risks and benefits should be weighed carefully. Aspirin and nonsteroidal antiinflammatory drugs (NSAIDs) offer protection against adenomatous polyps and colorectal cancer, and long-term use in low doses likely decreases cancer-related mortality risk from other solid tumors.
Human papillomavirus (HPV), hepatitis C virus (HCV), human T-lymphotropic virus type 1 (HTLV-1), HIV, hepatitis B virus (HBV), Epstein-Barr virus (EBV), and Helicobacter pylori have been linked to human cancers. Exposure prevention, pre-exposure prophylaxis (PrEP), screening, vaccination, and early treatment can help prevent infection-associated cancers.
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