33% to 50% of all cancers are attributable to preventable lifestyle causes, such as smoking and tobacco use, poor diet, alcohol consumption, and obesity (1-3). Genetics play a tiny role, causing only 5-10% of all cancers. The remainder of cancer cases can be attributed to environmental factors such as radiation, infections, and occupational exposures such as asbestos.
Given this information, we should understand that cancer is preventable and it’s not necessarily fate or the luck or draw when it comes to getting cancer.
Public attitudes towards cancer are poor: two-thirds of the American public believe that everything causes cancer and almost one-third believe that there’s not much you can do to lower your chances of getting cancer (4).
Luckily, the latest edition of the European Code against Cancer has just been released. It is a project coordinated by the International Agency for Research on Cancer and consists of 12 simple evidence-based recommendations for individuals to reduce their risk of cancer.
The 12 recommendations for cancer prevention are as follows:
1. Do not smoke. Do not use any form of tobacco.
2. Make your home smoke-free. Support smoke-free policies in your workplace.
3. Take action to be a healthy body weight.
4. Be physically active in everyday life. Limit the time you spend sitting.
5. Have a healthy diet:
- Eat plenty of whole grains, pulses, vegetables, and fruits
- Limit high-calorie foods (foods high in sugar or fat) and avoid sugary drinks
- Avoid processed meat; limit red meat and foods high in salt
6. If you drink alcohol of any type, limit your intake. Not drinking alcohol is better for cancer prevention.
7. Avoid too much sun, especially for children. Use sun protection. Do not use sunbeds.
8. In the workplace, protect yourself against cancer-causing substances by following health and safety instructions.
9. Find out if you are exposed to radiation from naturally high radon levels in your home. Take action to reduce radon levels.
10. For women:
- Breastfeeding reduces the mother’s cancer risk. If you can, breastfeed your baby.
- Hormone replacement therapy (HRT) increases the risk of certain cancers. Limit use of HRT.
11. Ensure your children take part in vaccination programmes for:
- Hepatitis B (for newborns)
- Human papillomavirus (HPV) (for girls)
12. Take part in organised cancer screening programmes for:
- Bowel cancer (men and women)
- Breast cancer (women)
- Cervical cancer (women)
Every single item on this list is important. If you identify something on this list that you could improve, do it. If you’re unsure or have questions, talk to your GP.
Although the list is stated in incredibly simple terms, in reality it’s not that simple to change many of these behaviours. Some things on this list, like smoking, are habit-based and incredibly difficult to change. Pressures of daily life get in the way and we often have to prioritise the here and now, rather than take time out for something that won’t affect us for probably many years. For example, going for cancer screening can be stress inducing and time-consuming, but it could save your life. There are other structural barriers too, such as the increasing cost of a healthy diet.
Although we know that many cancers are preventable, this knowledge does not mean that if you do get cancer, you are to blame. In reality, the true causes of any individual’s cancer are often impossible to disentangle and victim blame is never helpful. In any case, knowledge is power and making an informed decision about your own lifestyle is the best way to approach it. Know that many cancers are preventable, and also what you can realistically do to reduce your own personal risk.
- Parkin DM, Boyd L, Walker LC. 16. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010. Br J Cancer 2011;205:S77-81.
- Anand P, Kunnumakara AB, Sundaram C, Harikumar KB, Tharakan ST, Lai OS, et al. Cancer is preventable disease that requires major lifestyle changes. Pharm Res 2008;25(9):2097-116.
- World Health Organization. Global cancer rates could increase by 50% to 15 million by 2020. http://www.who.int/mediacentre/news/releases/2003/pr27/en/ (accessed 18 October 2014).
- Kobayashi LC, Smith SG. Cancer fatalism, health literacy, and information seeking: a national survey of American adults. In prep.
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