Monday, April 25, 2016

Tailoring Smoking Cessation Outreach: Specialty Tools of and an Innovative Study in American Indian/Alaska Native Communities

by Katy Henke

A new study sheds some light on strategies that may help smokers in under-researched communities take steps to quit. Recently, researchers from Washington University in St. Louis led a study that looked at the potential impact that graphic cigarette labels might have in sparking social interaction around smoking cessation in American Indian/Alaska Natives communities. Published in BMJ Open, the study focused on how individuals perceived graphic warning labels on cigarettes and found that participants who saw graphic images were more likely to approach a friend or family member and discuss the idea of quitting smoking. Images that portrayed children or the physical harms of smoking drew the most reaction from participants.
Sample graphic warning labels (Used with author permission) 

This was the first study of its kind to focus on cigarette labels and their potential impact within the American Indian/Alaska Natives communities, where rates of smoking are around double that of the general population. Future research will be able to build on these findings and further explore ways to bolster cessation efforts and help lower rates of smoking in these communities.

Quitting smoking is still the number one way to improve overall health, and, increasingly, efforts that promote prevention and cessation can now be effectively tailored to meet the needs and concerns of specific populations.

A number of tailored cessation programs are offered through the federal government's site, In addition to the site's free telephone counseling at 1-800-QUIT-NOW and text message program, smokefreetxt, it offers a number of specialty websites, including:

smokefreeVET: Focuses on why many veterans begin smoking, how and why to quit smoking, and how to transition back into the civilian lifestyle while quitting. 
smokefreeWomen: Addresses the unique concerns of women who are considering or trying to quit smoking. The smokefreeMOM text messaging specifically helps pregnant women with quitting. 
smokefreeTeen: Provides information to teenagers about the importance of choosing to quit and/or staying smoke free. The site focuses on both the immediate and long term impact of smoking on the health and lifestyle of teens.  
smokefreeEspa├▒ol: Provides culturally appropriate tips and advice in Spanish on how to prepare for and begin quitting smoking. also has a strong presence on social media that continually offers advice and education information about the benefits of quitting.

Other health resources with information on smoking and its impact on health and wellness: 
8 Ways to Prevent Cancer and Stay Healthy: This website highlights ways to lower your risk of certain cancers, including advice for quitting smoking.

Your Disease Risk: An interactive online tool designed to estimate your risk of important chronic diseases, which also offers personalized information about reducing your risk.

Thursday, April 14, 2016

Keeping "Your Disease Risk" Up to Date: Cancer Science Review and Plans for a Responsive Design

Since January of 2000, our website, Your Disease Risk, has reached millions of visitors with
personalized risk estimates and prevention messages for the most important preventable chronic diseases, including cancer, heart disease, osteoporosis, and others.

Based on feedback from both health professionals and the public, much of the appeal of the the Your Disease Risk site is its unique approach that  successfully meshes up-to-date science with engaging messages and an easy-to-navigate interface.

To maintain this important balance, the site has been through a number of programming updates and science reviews since its launch -- the most recent of which looked at the Heart Disease, Stroke, and Diabetes tools and saw the launch of a new chronic bronchitis and emphysema tool.

Starting in 2015, we began the large task of reviewing and updating the science that drives the 12 different cancer tools on the site.   With a science panel consisting of leaders in cancer and nutritional epidemiology, a consensus-based approach will be adopted to identify any necessary changes to the risk factors used in each cancer risk estimate -- as well as to the prevention messages that go along with them.

Among others, a sample of risk factor and messaging issues that will be reviewed in detail in this science update include:
Breast cancer risk
  • Weight/adiposity in youth/young adulthood
  • Mammographic density
  • Alcohol use in youth/young adulthood 
Cervical cancer risk 
    • HPV vaccination
     Colon cancer risk 
      • Processed meat 
      Ovarian cancer risk 
        • Talc use
        Prostate cancer risk 
        • New focus on advanced prostate cancer

        In concert with this science review are plans to optimize the site for mobile viewing by updating the appearance and overall design of Your Disease Risk so that it works seamlessly across all platforms - notebooks, tablets, and smartphones.

        The science review is expected to be completed by summer 2016, with updates to the site launched later in the year or early 2017.

        Tuesday, March 29, 2016

        Potential of Prevention: Only 3 Percent of Us Meet 4 Key Health Behaviors

        by Katy Henke

        When it comes to leading a healthy lifestyle, let's just say that Americans have a lot of room for improvement. That's according to a recent study published in Mayo Clinic Proceedings that found that only 2.7 percent of U.S. adults practice four key behaviors that can improve health and lower the risk of important chronic diseases.

        The study analyzed data from more than 4,700 people who volunteered for the U.S. National Health and Nutrition Survey. Researchers were specifically interested in learning how many Americans follow four key guidelines for living healthy: not smoking, eating a healthy diet, exercising a moderate amount, and keeping body fat in a healthy range.

        Around 34 percent did one of these healthy behaviors. Around 37 percent did two. Just under 3 percent did all four. And 11 percent did none at all.

        What these results show is that the great majority of Americans can make changes in their lifestyles that can have an important impact on their risk of the most common diseases in the US, including heart disease, stroke, type 2 diabetes, and cancer. At least half of these diseases can be prevented by things we can all do.

        So what can we do to create a healthy lifestyle? It’s pretty straightforward.
        1. If you smoke, try quitting immediately. Quitting can be the best thing you do for your overall health. Contact 1-800-QUIT-NOW or today for ways to quit and support along the way.
        2. Exercise regularly. It’s recommended that adults exercise at a moderate level for 150 hours each week. Think of that as 30 minutes each day for 5 days a week. Walk with your family after dinner, play games with your children or dance at home. Any amount is better than none.
        3. Eat a healthy diet. Focus on fruits, vegetables, and whole grains. Remember to cut back on red meats and unhealthy saturated and trans fats. Consider a multivitamin with folate for a little boost to your diet.
        4. Maintain a healthy weight. Focus on exercising daily and eating a healthy diet. It's also important to watch portions, eat slowly, and be especially mindful of how much you eat. Calories really matter. 
        In addition to these four strategies, check out Your Disease Risk, an online prevention tool that estimates your risk of important chronic diseases and offers personalized tips for lowering risk.

        Change can be hard. And living a healthy lifestyle isn't always easy -- Just ask the 97 percent of folks who missed perfect marks in this latest study. But decades of research show that it’s worth the effort, greatly lowering the risk of many diseases and improving overall health.

        Get started today, and you'll be well on your way to a healthier you.

        Monday, February 29, 2016

        Benefits TODAY from the HPV Vaccine (Infographic)

        While the ultimate goal of the HPV vaccine is to prevent cancer, that benefit can feel very far off in the future, especially since vaccination ideally takes place in eleven and twelve-year-old girls and boys.  But studies looking at the five to six years after the vaccine was approved and became widely available show that it has real - and it seems impressively big - benefits over the short term.  For more details on the HPV vaccine and recommended vaccination schedule, visit the CDC's HPV page.

        Tuesday, February 23, 2016

        With Breast Cancer in the News - A Brief Primer on Screening and Prevention

        by Katy Henke

        Breast cancer is back in the headlines this week with the announcement by U.S. Senator Claire McCaskill (Missouri) that she has been diagnosed with the disease following a routine mammogram.

        Because such news coverage can raise questions about current breast cancer screening guidelines and the steps women can take to prevent the disease, we offer this quick primer.  


        Breast cancer screening with mammography remains the single best way to protect yourself from the disease. Mammograms do not help prevent cancer, but they can help find cancer early, when it’s most treatable.

        For most women, regular mammograms can begin at age 40, but specific recommendations vary by age:

        If you are age 40 - 44:
        You can choose to begin yearly mammograms. It is important to talk to a doctor about the risk and benefits of mammograms at these ages. 

        If you are age 45 - 54:
        Mammograms are recommended every year. 

        If you are age 55 or over:
        Mammograms are recommended every other year. You can choose to continue to have them every year.

        Clinical breast exams and self-exams are not recommended. Be familiar with your breasts and tell a health care provider right away if you notice any changes in how your breasts look or feel.

        Learn more about the new mammography guidelines from the American Cancer Society.


        In addition to getting recommended mammograms, women can also take steps to lower the risk of breast cancer. Some of these steps include being active, staying at a healthy weight, not smoking, and avoiding too much alcohol (see figure). While such healthy behaviors have the biggest impact when started earlier in life, they can have important breast health benefits for women of all ages.

        Information for taking steps to improve breast health and lower cancer risk at nearly any age can be found in the free ebook, Together – Every Woman’s Guide to Preventing Breast Cancer.

        For additional tips on lowering your risk of breast cancer, see the personalized prevention tool Your Disease Risk and the site 8IGHT WAYS to Prevent Breast Cancer

        Monday, February 22, 2016

        Big Drop in Cancer-Causing HPV Following Vaccination, But Rates of Vaccination in US Lag

        by Hank Dart

        Thirteen years ago, in an earlier incarnation of Cancer News in Context, we wrote our very first post about the potential of the HPV vaccine following the release of a promising study in the New England Journal of Medicine. That post - "A Shot in the Arm for Cervical Cancer Prevention" -  concluded:
        "While much work remains before there is any sort of widespread cervical cancer vaccination program in the U.S. or abroad, the results of this initial study spawn a realistic hope that over the next decade or so great strides will be made in preventing cervical cancer the world over."
        Well here we are, that decade or so on from the original post, and the latest news on the HPV vaccine - as reported in today's New York Times - is quite positive, but with a number of important caveats.

        HPV (human papillomavirus) is a common sexually transmitted infection, and certain types of HPV are a primary cause of cervical cancer. It's estimated that nearly all adults - men and women - are infected with HPV at some point in their lives. While the body naturally clears most of these infections, some can persist, increasing the risk of cervical (and a number of other) cancers.

        New national data, as reported in the Times and published in the journal Pediatrics today, show that in the six years after 2006, when the HPV vaccine became available for girls, rates of infection with four main cancer-causing types of HPV(6, 11, 16, and 18) have dropped dramatically - as much as 64 percent in younger females (age 14 - 19), the age group that had been the most widely vaccinated.

        Though only time, and data, will tell for sure, such findings seem likely to translate to significantly lower future rates of cervical cancer in today's groups of vaccinated girls and young women.

        Alongside such positive news, however, is the fact that the HPV vaccine remains frustratingly underused in the United States.  As we wrote about in 2014, vaccination rates for the HPV vaccine are much below those of other childhood vaccines.  The most recent numbers show that only 38 percent of girls in the United States receive the complete 3-shot series of the HPV vaccine.  Boys' numbers are even lower - at 14 percent.  And low as these are, they are modest improvements from pervious years.

        In comparison, in Australia, where the vaccine is offered for free at schools as part of its national immunization program, rates of full 3-dose HPV vaccination in girls is over 70 percent by age 15.

        No such integration into systems has happened in the United States, and HPV vaccination remains in many ways on the fringe.  Though it has huge potential to prevent cervical cancer - as well as to lower the risk of anal, throat, and penis cancers, as well as genital warts - many physicians aren't proactive in suggesting vaccination, many parents don't know to request it,  and both groups may not be perfectly clear on its safety, effectiveness, and ultimate purpose of preventing cancer.

        Clearly, there has been a lot of progress since our post in 2003 but perhaps not surprisingly it has been at a pace slower than hoped.  To be sure, there have been some "great strides" in further developing the vaccine, in documenting its safety and effectiveness, and - in certain countries - developing model vaccination programs.

        But there is still a great deal of work to do before we tap the HPV vaccine's full potential in the United States - as well as worldwide.  This latest study shows the likely benefits of developing a better-integrated HPV vaccination program.  Let's use it to spur on coordinated efforts toward that important end.