Monday, February 13, 2017

Cancer Missed Factors: Many People Unaware of Key Behaviors That Can Lower Cancer Risk

A new report from the American Institute for Cancer Research (AICR) shows that a large percentage of the United States population remains confused about which lifestyle factors increase the risk of cancer and which do not.

While a large majority of the public knows that smoking and sun exposure increase cancer risk, only 50 percent or fewer know that key risk factors like overweight, physical inactivity, alcohol, and processed meat increase risk.  In addition, many lifestyle factors with unproven or tenuous links to cancer were identified by high percentages as proven cancer risk factors. Between 52 - 60 percent of people incorrectly stated that genetically modified foods (GMOs), artificial sweeteners, hormones in beef, and food additives impact a person's chances of developing cancer. Good evidence does not support these links.

Based on a phone survey of a nationally representative sample of around 1,000 people, the AICR report is the eighth in a series, with the first published in 2001.

Perhaps the most surprising finding in the report is the continued low-level understanding that overweight and obesity increase cancer risk.  While there has been overall improvement since 2001, when just 35 percent of respondents identified the link between weight and cancer, the percentage has bounced around the 50 percent mark since 2009, seemingly stalled. Overweight causes over 130,000 cancers a year and increases the risk of over ten different cancers.

Studies show that half of all cancers could be prevented through healthy behaviors. And the list of key steps that lower cancer risk is generally straightforward and relatively short.  We highlight them in our Eight Ways to Prevent Cancer series (see figure), and AICR, the National Cancer Institute, and other such organizations have similar publications.

As the new report suggests, to help people realize these benefits, we need to continue to get the word out on these important prevention messages.  But our efforts must reach beyond the public and also include institutions throughout society - state/local governments, schools, healthcare systems, insurers, and workplaces.  For knowledge to transform into sustained action, reinforcement is key.  Our friends, our workplaces, our healthcare providers, and our community each play a key role in helping us meet our health goals.

From knowledge, to action, to impact.  Together, we can make this happen.



Tuesday, February 7, 2017

Large Study Finds Inequality Increases Risk of Premature Death on Par with Unhealthy Behaviors


Suggests focus on inequality should be similar to that on lifestyle risk factors

by Hank Dart

A large, new study has found that income inequality contributes to premature death on a level similar to important lifestyle factors like smoking, physical inactivity, and diabetes.

The study, appearing in The Lancet, combined findings from 48 cohort studies in high-income countries and included over 1.7 million men and women.  Its goal was to assess the impact of socioeconomic status (SES) alongside key lifestyle factors included in the World Health Organization's (WHO) 25 x 25 initiative.

The WHO created the 25 x 25 initiative in 2011, with the goal of reducing premature deaths from non-communicable diseases, like heart disease and cancer, by 25 percent by 2025.  The initiative targets seven major risk lifestyle factors: smoking, diabetes, physical inactivity, excessive drinking, high blood pressure, overweight, and salt intake.

The study included each of these lifestyles factors, except salt intake, which was not measured in enough of the combined studies to be included in the analyses.  Income and socioeconomic status (SES) were estimated through a person's occupation, a measure available across the 48 studies.  The three main occupation levels were:  high (e.g., managers, higher professionals), intermediate (e.g., farmers, lower supervisors), and low (e.g., sales workers, semi-skilled/unskilled workers).

The researchers found that low socioeconomic status (SES) increased the risk of premature death from all causes by 26 percent compared to high SES.  This was greater than the impact of overweight and close to the impact of physical inactivity (28 percent increase), high alcohol intake (36 percent increase), and high blood pressure (31 percent increase).  Diabetes increased the risk of premature mortality 73 percent, and smoking more than doubled risk.  The findings controlled for the potential interrelation of SES with the lifestyle risk factors.

When looking at the potential impact population wide, the rankings of the risk factors included in the study shifted a bit, with inequality coming just after smoking and physical inactivity in importance.  The researchers calculated the percent of premature deaths that could be avoided if everyone in the population had a low-risk level of each factor - for example, if inequality were eliminated and everyone had a high-earning occupation, if everyone exercised, and if everyone avoided smoking.

Doing this, they found that low SES accounted for 15 percent of premature deaths in women and 19 percent in men.  This falls not too far behind smoking (21 percent in women, 29 percent in men) and physical inactivity (23 percent in women, 26 percent in men) and in front of the other lifestyle factors included in the study (see figure).



Too often, factors like inequality and socioeconomic status are left out of prevention planning - viewed as health factors that cannot be modified.  This study, however, adds to the evidence that inequality has an independent and important impact on health and that reducing inequality should be a key goal of efforts to improve individuals', and the nation's, health -- right alongside efforts focused on limiting smoking, increasing physical activity, and controlling weight.  


Monday, February 6, 2017

Benefits of the HPV Vaccine for Girls and Boys

Only two doses now needed for most youth, instead of three

By Katy Henke

HPV, or human papillomavirus, is an increasingly popular health topic these days. Not only are there news stories about HPV and the HPV vaccine just about every week, but there's a push across nearly all levels of healthcare -- from federal agencies to local healthcare providers -- to encourage parents to vaccinate their children against the cancer-causing virus. And for good reason. The Centers for Disease Control and Prevention (CDC) estimates that almost all adults in the United States will have an HPV infection at some point in their lives. 

Most of these infections will clear on their own, but some can persist. And the CDC reports that over 90% of cervical cancer and anal cancer cases are caused by HPV, as are 60% of penile cancers and 70% of head and neck cancers.  It is a much broader list than many people may understand (see table).


But it's not all doom and gloom.  In fact, the fight against HPV-related cancers is one of the bright spots in cancer prevention, with huge potential for benefit. Since 2011, both girls and boys have been able to receive the HPV vaccine, which protects against HPV and reduces the risk of developing future cancers. What used to be a three-dose vaccine is now an easier two-dose vaccine. 

Boys and girls ages 11-12 should receive the two doses six months apart to be most effective. HPV is a sexually transmitted disease, and often times doesn’t have any symptoms, so it’s important to take preventative measures before your child becomes sexual active.  

Older teenagers and young adults (up to 26 years of age) can also benefit from the HPV vaccine. Specific recommendations can vary based on age, gender, and other factors. So, it's important to see a healthcare provider for details.

The HPV vaccine is a safe and great way to prevent cancer later in life. And most insurance plans cover it. For more information, visit the CDC’s HPV website.

HPV vaccination is a simple step to help protect our future generations.


Monday, January 9, 2017

The Importance of Taking an Honest Look at Your Child's Weight

It's not news that parents can sometimes have blinders on when it comes to their kids. It's only natural that we look for all the positives in our children and downplay any possible negatives.

And this is just what seems to be happening with parents and the loaded issue of their child's weight.  Parents of overweight kids can have real trouble understanding that their child is actually overweight.  One 2013 review of studies found that over 60 percent of parents of overweight kids didn't know that their child was overweight.  And for young kids (ages 2 - 6 years), this number rose to over 85 percent.

While a child's weight has no bearing on his or her character or worth, it can have important lifelong implications for health.  Overweight children are at much greater risk of becoming overweight adults, which can then put them at increased risk for a host of weight-related issues ranging from diabetes and cancer to stigmatization and lower lifetime earnings.

With 17 percent of US youth ages 2 - 19 obese and nearly 6 percent extremely obese, it's important that parents, health professionals, and health systems try to be honest about childhood weight so that children have the chance to build healthy behaviors that will benefit them throughout life.

For parents, a good place to start is the CDC’s BMI Calculator for Child and Teen.  This tool uses a special calculation of weight, height, gender, and age to estimate whether a child is underweight, normal weight, overweight, or obese.  Because children are still growing and developing, these labels are not always perfectly accurate, so it’s important to bring up any concerns about your child’s weight directly with a healthcare provider.

Additional tips:
  • Keep track of your child’s weight, but don't obsess about it, and bring up any concerns with a health care provider.
  • Help your children focus on healthy food choices and healthy activities rather than on weight and body image.
  • Give your children the chance to be physically active every day.
  • Limit sweets and processed foods, which are often high in calories as well as carbohydrates that can stimulate hunger.
  • Limit TV, tablet, computer, and other screen time to under two hours a day. The less, the better.
  • Help your children get enough sleep by setting a bed time and sticking to it every day. Keeping electronics out of the bedroom also helps.
It's a simple step really -- taking an honest look at our child's weight.  But it can be a key step for helping a child move toward lifelong good health.

Photo: Family Walk by Thomas Leth-Olsen  (CC License, CC BY 2.0)

Friday, September 2, 2016

Back to School Vaccinations: Don't Forget the HPV Vaccine

by Katy Henke

With Labor Day weekend bringing summer vacation to a close, parents are putting the finishing touches on preparation for the impending school year. In addition to school supplies and new clothing, parents should also be vaccinating their children prior to school starting. Vaccinations help prevent possible future infections and diseases. Prevention through vaccines is one of the best ways to help your child stay healthy during their lifetime and is recommended by multiple health organizations, such as the Centers for Disease Control and Prevention, the World Health Organization, and the National Cancer Institute.

Some of the more common vaccines parents may have heard of, and that some schools in the United States require, include Tdap, which protects against diphtheria and tetanus; IPV, which protects against polio; and MMR, which protects against measles, mumps, and rubella. These diseases have decreased in children and young adults throughout the years thanks to the use of vaccines. Influenza (flu) is another common virus that can help be reduced and infection prevented when children, teens, and adults receive the flu vaccine. Research continues to show that vaccines are important, safe, and effective for children and teens, and should be administered at appropriate ages. The CDC offers a quick vaccine guide for parents based on a child’s age.

A more recent vaccine, and one that’s often overlooked by many parents and doctors, is the human papillomavirus (HPV) vaccine. This vaccine protects against a specific strand of viruses that can cause cancer. The HPV virus affects one in four people. It’s estimated that 14 million people each year contract the HPV virus, which can lead to cervical and vaginal cancer in women, and penile cancer in men. More than 90 percent of sexually active men and 80 percent of sexually active women will contract a form of HPV at some point in their lives. Most HPV infections do go away on their own, but some don’t. The HPV vaccine helps protect and reduce these infection rates

The HPV vaccine series is recommended to both preteen boys and girls beginning around age 11 or 12, prior to when they would contract the HPV virus. This vaccine is a three-part series for both girls and boys, with the second shot given at one to two months after the first shot, and the final third shot given around six months after the first shot. Teenagers and young adults can also receive the vaccine up until age 26, so talk with your doctor today. The HPV vaccine will be most effective when the person being vaccinated receives all three shots.

Research continues to show that the HPV vaccine should very successfully prevent later adult cancers in preteens and young adults. Close to 100 percent of people who receive the vaccine will be protected against the types of HPV targeted by the vaccine. And studies have found that vaccination cuts the risk of cervical pre-cancer in about half.

The HPV vaccine is a safe and effective way to reduce the risk of cancer, yet vaccination rates are still low due in part to lack of knowledge and other barriers. Talk with your child’s doctor or your doctor today to learn if the HPV vaccine may help reduce their risk for cancer in the future.

Thursday, August 25, 2016

Dr. Graham Colditz Discusses Broad-Based Strategies for Cancer Prevention (Video)

Cancer News in Context's Dr. Graham Colditz speaks with ecancertv at the International Agency for Research on Cancer (IARC) 50th Anniversary Scientific Conference 2016 about the social and legislative surroundings of modern strategies in cancer prevention.

Wednesday, August 24, 2016

Weighty Evidence: New Report Further Highlights Importance of Overweight and Cancer Risk

A new international report released today further highlights the important role that overweight and obesity play in the development of cancer.  Produced by the International Agency for Research on Cancer (IARC) and released in the New England Journal of Medicine, the report, Body Fatness and Cancer — Viewpoint of the IARC Working Group, finds that approximately 4.5 million deaths worldwide are caused each year by cancers related to overweight and obesity.

For thirteen cancers, there was "sufficient" evidence to conclude that excess weight significantly increased risk of developing the disease. This was eight more cancers than was included in the similar IARC report published in 2002. Esophageal (adenocarcinoma) and uterine (corpus uteri) cancers had the highest risks.  Comparing the highest body mass index (BMI) category with the normal category, there was a nearly 5 times increased risk for developing esophageal cancer, and just over 7 times increased risk for uterine cancer.  Risk increases for other cancers ranged between a 10 percent increase in risk to a 80 percent increase in risk, and included cancers ranging from ovarian and breast cancer to pancreatic cancer and multiple myeloma.  

Cancer News in Context's Graham Colditz chaired the IARC working group that developed the statement.  In a Washington University School of Medicine media release about the findings of the working group, he stated:
“Significant numbers of the U.S. and the world’s population are overweight. This is another wake-up call. It’s time to take our health and our diets seriously.” 
Looking at the data as a whole, the report concludes that maintaining a healthy weight can lower cancer risk, and though solid evidence in humans is still developing -  that losing excess weight likely can as well.

Battling weight is a lifelong struggle for most people, and the US and global obesity epidemic has complex and multiple origins. To make real progress against the epidemic, we need to create a society that enables and fosters healthy activity and food choices.  Individual choice is just one part of the larger approach.  The Obesity Prevention Sourcedeveloped by our colleagues at the Harvard School of Public Health, provides a guidebook for tackling these broader issues, targeting policy makers, health professionals, and motivated citizens.

For those looking for help getting started with personal healthy choices for weight control, the federal site, Nutrition.gov, is a good place to begin - as is our own post: Some Simple Tips for Keeping Weight in Check.