Wednesday, March 31, 2010

Why does my birth weight matter for cancer risk?

We know from studies of leukemia and some other cancers that people who were exposed to certain factors (such as to radiation) while in the womb (in utero) can have a greater risk of cancer as children and adults. More recently, interest has shifted from large one-time exposures to carcinogens (such as to atomic bomb radiation) to other more subtle factors, such as: older maternal age, maternal obesity, maternal pre-eclampsia during childbirth, higher child birthweight, and certain infections. Each of these factors is thought to alter a mother’s estrogen levels, which may in turn prime cells in the baby’s body for future cancer risk. On top of its possible effect on estrogen levels, a high birthweight may also be associated with in utero exposure to high levels of growth hormones, which like estrogen, can increase later risk of cancer.

A recent review of the research on this topic found that higher birthweight was associated with a fairly small increase in the risk of breast cancer, especially in premenopausal women. Specifically, the paper found that a 2.2 pound (1 kilogram) increase in birthweight raised the risk of breast cancer later in life by about 15 percent (study link) (1). This means that women who weighed, for example, 10 pounds at birth, had a 15 percent higher risk of breast cancer compared to women who weighed 7 pounds, 13 ounces.

Literature cited
1. Xue, F. and K.B. Michels, Intrauterine factors and risk of breast cancer: a systematic review and meta-analysis of current evidence. Lancet Oncol, 2007. 8(12): p. 1088-100.

Tuesday, March 30, 2010

Oral contraceptives reduce cancer deaths

A recent study in the British Medical Journal adds further evidence that use of oral contraceptives reduces cancer mortality (full study). In the long term study of over 46,000 women who were followed for up to 39 years, Hannaford and colleagues reported that women who used oral contraceptives (OCs)  had lower mortality from cancers of the ovary, uterine body and colon (Hannaford, Iversen et al. 2010). OC use was not related to breast cancer mortality.

Approximately half of the women who had used OCs had used them for more than 4 years, and the risk of cancer death decreased the longer women had used OCs. These data extend previous work from the Nurses’ Health Study, which showed no overall adverse effect from use of OCs (Colditz and for the NHS research group 1994).

Oral contraceptives are one of the most widely used medications. Use of oral contraceptives (OCs) for 5 years halves a woman’s risk of developing ovarian cancer (see figure) and substantially reduces the risk of endometrial cancer  (Collaborative Group on Epidemiological Studies of Ovarian, Beral et al. 2008).

Data source: Beral et al, 2008 (click figure to enlarge)

The protection is long lasting and in high income countries rates of use approach 80 per cent. Adverse effects are largely limited to an increased risk of breast cancer and stroke while women are currently using OCs, a risk which seems to disappear within about ten years of stopping. These side-effects are strongly age-dependent - being more common the older a woman is. Thus use of OCs during late teens and early 20s could be expanded for greater reduction in ovarian and endometrial cancers and overall net public health benefit (Kawachi, Colditz et al. 1994).

Strong scientific evidence supports several other medications as either causing cancer  (e.g. postmenopausal hormone therapy with estrogen plus progestin) (Colditz 2007), or reducing cancer (e.g aspirin and colon cancer) (Chan, Giovannucci et al. 2005).

Postmenopausal hormones
For combination oestrogen plus progestin, the International Agency for Research on Cancer (IARC) has now classified this combination hormone therapy as carcinogenic in humans (2007), and estimates indicate that the reduction in use of hormones after the widespread publicity of the results of the Women’s Health Initiative (stopped early due to excess breast cancer) accounts for approximately a 10 per cent decline in breast cancer incidence among women 40 to 70 years of age (Colditz 2007). Thus for this combination therapy evidence shows that risk rises with duration of use and that acting as a late promoter, removal of the drug leads to a rapid decline in incidence (Colditz 2007), though among women with longer durations of use risk may not return to that of women who have never used combination therapy (Colditz and Rosner 2000).

Other less widespread drugs may also contribute to cancer risk (e.g., DES), but the population impact will be substantially smaller than the examples based on much more widespread use described above.

For some medications that reduce cancer risk, the benefits have been limited to date to those who have had the specific indications to use the medication. Broader population strategies may be developed for more widespread protection, such as could be achieved if all women took oral contraceptives as a chemopreventive for a minimum of 5-years.

Aspirin has been extensively studied in observational studies that address duration of use, dose, and magnitude of risk reduction. This evidence is consistent with evidence from randomized primary prevention trials showing that the use of 300 mg or more of aspirin a day for 5 years or more is effective in preventing colon cancer; reducing risk by approximately 25 per cent (Flossmann and Rothwell 2007). A latency of about 10 years is observed between onset of use of aspirin and the reduction in cancer. Like all chemoprevention strategies, risks and benefits must be balanced (Glasziou and Irwig 1995). To date, the risk-benefit considerations of cardiovascular disease, bleeding complications, stomach pain and heart burn caused by aspirin have precluded recommendations for aspirin use as a widespread prevention strategy (Gralow, Ozols et al. 2008).

Selective estrogen receptor modulators (SERMs)
Selective estrogen receptor modulators (SERMs), such as tamoxifen and raloxifene, have been shown in randomized controlled prevention trials to reduce incidence of pre-invasive and invasive breast cancer (Fisher, Costantino et al. 1998; Martino, Cauley et al. 2004). While tamoxifen increases risk of uterine cancer, this is not so for raloxifene and the risk profile for raloxifene looks considerably safer (Chen, Rosner et al. 2007).

Based on these risks and benefits of therapy, we have estimated the potential for risk reduction among women over age 50 who are postmenopausal. Our estimates indicate that if the trade-off of excess adverse events versus cases of breast cancer prevented must be less than 1, then approximately 30 per cent of the 27 million women between ages 50 and 69 in the United States have benefits exceeding risks, and would achieve a 50 percent reduction in the burden of breast cancer by taking a SERM. This is a population benefit of 42,900 fewer cases of invasive breast cancer among the more than 7 million women with sufficiently high risk to justify chemoprevention (Chen, Rosner et al. 2007).

The reduction in breast cancer risk observed in the chemoprevention randomized trials is very rapid; within 2 years of beginning SERM therapy, incidence curves have clearly separated. This is consistent with the pharmacologic action of these agents inhibiting estrogen receptors. Importantly these agents show protection against estrogen receptor (ER) positive breast cancers (risk reduction up to 76 per cent) and no protection against receptor negative cancers (Martino, Cauley et al. 2004).

While statistical models to predict and classify risk of breast cancer have been developed and validated, to date, prediction of receptor positive tumors is no more accurate than prediction of risk overall (Colditz, Rosner et al. 2004).  Refining risk stratification and developing tools to aid women in considering trade-offs of risks and benefits of chemoprevention therapy are necessary next steps to informed choices for prevention for women at elevated risk of breast cancer.

While all drugs have risks and benefits, some of the agents described here have the potential to substantially reduce risk of cancer. Balancing risks and benefits remains an important decisions that should be reviewed with a heath care provider.

Literature cited
Chan, A. T., E. L. Giovannucci, et al. (2005). "Long-term use of aspirin and nonsteroidal anti-inflammatory drugs and risk of colorectal cancer." JAMA 294(8): 914-923.
Chen, W. Y., B. Rosner, et al. (2007). "Moving forward with breast cancer prevention." Cancer 109(12): 2387-2391.
Colditz, G. and for the NHS research group (1994). "Oral contraceptive use and mortality during twelve years of follow-up." Ann Intern med 120: 821-826.
Colditz, G. A. (2007). "Decline in breast cancer incidence due to removal of promoter: combination estrogen plus progestin." Breast Cancer Res 9(4): 108.
Colditz, G. A. and B. Rosner (2000). "Cumulative risk of breast cancer to age 70 years according to risk factor status: data from the Nurses' Health Study." Am J Epidemiol 152(10): 950-964.
Colditz, G. A., B. A. Rosner, et al. (2004). "Risk factors for breast cancer according to estrogen and progesterone receptor status." J Natl Cancer Inst 96(3): 218-228.
Collaborative Group on Epidemiological Studies of Ovarian, C., V. Beral, et al. (2008). "Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23,257 women with ovarian cancer and 87,303 controls." Lancet 371(9609): 303-314.
Fisher, B., J. P. Costantino, et al. (1998). "Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study." J Natl Cancer Inst 90(18): 1371-1388.
Flossmann, E. and P. M. Rothwell (2007). "Effect of aspirin on long-term risk of colorectal cancer: consistent evidence from randomised and observational studies." Lancet 369(9573): 1603-1613.
Glasziou, P. P. and L. M. Irwig (1995). "An evidence based approach to individualising treatment." BMJ 311(7016): 1356-1359.
Gralow, J., R. F. Ozols, et al. (2008). "Clinical cancer advances 2007: major research advances in cancer treatment, prevention, and screening--a report from the American Society of Clinical Oncology." J Clin Oncol 26(2): 313-325.
Hannaford, P. C., L. Iversen, et al. (2010). "Mortality among contraceptive pill users: cohort evidence from Royal College of General Practitioners' Oral Contraception Study." BMJ 340: c927.
International Agency for Research on Cancer (2007). "Combined estrogen-progestogen contraceptives and combined estrogen-progestogen menopausal therapy." IARC Monogr Eval Carcinog Risks Hum 91: 1-528.
Kawachi, I., G. A. Colditz, et al. (1994). "Long-term benefits and risks of alternative methods of fertility control in the United States." Contraception 50(1): 1-16.
Martino, S., J. A. Cauley, et al. (2004). "Continuing outcomes relevant to Evista: breast cancer incidence in postmenopausal osteoporotic women in a randomized trial of raloxifene." J Natl Cancer Inst 96(23): 1751-1761.

Monday, March 29, 2010

Should I be worried about stomach cancer?

While stomach (or gastric) cancer is the fourth most common cancer globally (it is the most common cancer in China and nearly half of global cases occur there), it is much less common in developed countries, including the US (where it is not in the ten most common cancer diagnoses). Stomach cancer constitutes less than 2% of cancer cases diagnosed in the US. The absolute risk of stomach cancer in the US is quite low with approximately 5 cases per 100,000 individuals (in contrast with colon cancer where the incidence is approximately 45 cases per 100,000 individuals).

Global rates of stomach cancer in 2002, females & males; maps courtesy of IARC (click on each to enlarge)

What are risk factors for stomach cancer?
The leading cause of stomach cancer is infection with helicobacter pylori (H pylori), a bacteria. Rates of H pylori infection have declined significantly in developed countries, contributing to the decline in stomach cancer rates. Also contributing to the decline in the developed world is the use of refrigeration (instead of salt) to reserve foods, significantly reducing individual salt intake. Salt and salty food intake are likely causes of stomach cancer. There is also good evidence that intake of non-starchy (e.g. green leafy vegetables, tomatoes) and allium (i.e. onions and garlic) vegetables reduce risk of stomach cancer. Evidence also indicates that a high intake of fruit protects against stomach cancer. As with many cancers, tobacco use is a clear risk factor for stomach cancer.

Can I get tested for stomach cancer?
There is currently no good screening test for stomach cancer. Unfortunately, stomach cancer often shows no outward signs or symptoms in the early stages. However, if you experience any of the following, you should talk with your doctor:

  • Indigestion or a burning sensation (heartburn)
  • Discomfort or pain in the abdomen
  • Nausea or vomiting
  • Diarrhea or constipation
  • Bloating of the stomach after meals
  • Loss of appetite
  • Weakness and tiredness
  • Vomiting blood

Other web resources

Thursday, March 25, 2010

Metformin reduces cancer risk

The anti-diabetic drug metformin is associated with reduced cancer incidence. In a UK based study of 4085 type 2 diabetics who used metformin from 1994 to 2003, investigators compared the incidence of cancer in those diebetics to the rate of cancer in diabetics who did not use metformin. The risk of cancer was reduced by 40 percent among those who took metformin (1). In a study of 1353 patients with type 2 diabetes in the Netherlands, during 9.6 years of follow-up, cancer deaths were significantly reduced among those who took metformin (2).

Among mechanisms for such a benefit are the inhibition of cancer cell growth and suppression of erb-2 oncoprotein overexpression and inhibition of mTOR (3-5). A search using the medical literature search engine, PubMed, shows over 800 papers addressing metformin and cancer ranging from human studies, as noted above, to animal models and tissue culture studies. This rapidly expanding area of laboratory and human evidence points to a role for metformin among diabetic patients. The call for clinical trials is well justified (6).

Literature cited

1. Libby G, Donnelly LA, Donnan PT, Alessi DR, Morris AD, Evans JM. New users of metformin are at low risk of incident cancer: a cohort study among people with type 2 diabetes. Diabetes Care. Sep 2009;32(9):1620-1625.
2. Landman GW, Kleefstra N, van Hateren KJ, Groenier KH, Gans RO, Bilo HJ. Metformin associated with lower cancer mortality in type 2 diabetes: ZODIAC-16. Diabetes Care. Feb 2010;33(2):322-326.
3. Alimova IN, Liu B, Fan Z, et al. Metformin inhibits breast cancer cell growth, colony formation and induces cell cycle arrest in vitro. Cell Cycle. Mar 15 2009;8(6):909-915.
4. Vazquez-Martin A, Oliveras-Ferraros C, Menendez JA. The antidiabetic drug metformin suppresses HER2 (erbB-2) oncoprotein overexpression via inhibition of the mTOR effector p70S6K1 in human breast carcinoma cells. Cell Cycle. Jan 1 2009;8(1):88-96.
5. Vazquez-Martin A, Oliveras-Ferraros C, del Barco S, Martin-Castillo B, Menendez JA. mTOR inhibitors and the anti-diabetic biguanide metformin: new insights into the molecular management of breast cancer resistance to the HER2 tyrosine kinase inhibitor lapatinib (Tykerb). Clin Transl Oncol. Jul 2009;11(7):455-459.
6. Goodwin PJ, Ligibel JA, Stambolic V. Metformin in breast cancer: time for action. J Clin Oncol. Jul 10 2009;27(20):3271-3273.

Regular care improves cancer prevention

In a recent study, Karen Emmons and Colleagues evaluate colorectal cancer screening behaviors among 695 low-income, multiethnic adults aged 50 years and over who were primarily insured (97%). Provider's recommendation was significantly associated with being up-to-date with colorectal cancer screening. Provider's understanding of patient's social context was assessed by how well participants felt that their provider knew (a) their responsibilities at work, home, or school; (b) their worries about health; and (c) them as a person and their values and beliefs. The level of provider understanding was significantly associated with current screening. Participants who reported that their provider knew them well were significantly more likely to be current with colon cancer screening compared to those who did not. These findings show that when a provider understands their patient's social context (their broader lives, as it were), adherence to colorectal cancer screening improves. Maintaining a regular primary care provider, therefore, can improve colorectal cancer screening rates and significantly further reduce the burden of this cancer on society.

Sunday, March 21, 2010

Cancer Prevention Works

The recent Annual Report to the Nation featuring colon cancer trends ( highlights the success of prevention in reducing colorectal cancer incidence and mortality. Colorectal cancer is the third most frequently diagnosed cancer and the second leading cause of cancer death in the United States for men and women combined. In the US, an estimated 147,000 individuals were diagnosed with colorectal cancer last year and approximately 50,000 men and women died from this disease. More than 90% of new cases are diagnosed in men and women 50 years of age and older.

While overall cancer incidence has decreased at 0.7% per year from 1999 to 2006; colorectal cancer has declined steadily since 1984 and quickened the decline since 2002. Incidence of new cases has decreased between 2 and 4 percent per year for colorectal cancer. Overall from 1975 to 2000, incidence decreased by 22%. Deaths from colorectal cancer have decreased too. From 1975 to 2000 deaths decreased by just over a quarter (about 26%).

The message? Prevention works! 

Recent estimates show that the decrease in mortality can be divided between change in risk factors, screening, and improvements in treatment. Change in risk factors explains more than one third of the reduction in colorectal cancer mortality. Screening accounts for another half of the reduction, and treatment accounts for about one tenth.

We and others have advocated lifestyle changes and use of screening to prevent colorectal cancer. Projections suggest that with continued expansion of access to screening and improvements in risk factors the downwards trend will continue. Go to to learn more about your risk and things you can do to reduce the risk of colorectal cancer.

  • Get regular screening tests beginning at age 50 (or earlier if you have a family history.)
  • Be physically active for at least 30 minutes every day
  • Maintain a healthy weight
  • Limit the amount of alcohol you drink
  • Limit red meat to less than 3 servings a week
  • Take a multivitamin with folate every day
  • Make sure you get enough calcium and vitamin D
  • Take an aspirin every day (check with your doctor first)
More details on the decline in colorectal cancer can be found at:

Thursday, March 18, 2010

Adolescent diet prevents breast cancer

A new study of adolescent diet and subsequent risk of precursor lesions for breast cancer shows that women who had higher intake of fiber earlier in life have lower cancer risk. Data from the Nurses' Health Study show that women in the highest quintile of adolescent fiber intake had a 25% lower risk of proliferative benign breast disease. This significant reduction in risk was seen regardless of the source of fiber. 

One possible mechanism supported by results from a randomized controlled clinical trial on diet and sex hormones among adolescent girls, showed lower estrogen levels at the year 5 follow-up in the intervention group who had a low fat and high fiber diet than the usual care group. Together these findings support the hypothesis that dietary intake of fiber and nuts during adolescence influences subsequent risk of breast disease and may suggest a viable means for breast cancer prevention.

See: Su, Tamimi, et al. Cancer Causes and Control. March 14. 2010.

Key measures to focus cancer prevention

Several measures that are currently poorly defined in many of our studies that focus on prevention are now a priority for us to achieve the goal of preventing the majority of cancer. These are summarized below and in a recent article (

Prevention Questions
Methods issues
Which exposure?
Refined measures
Validation and error correction strategies.
Change by how much?
Observational cohorts ideally across broad range of exposure
Consortium adds value of broader exposure (e.g., EPIC and diet pooling project).
Among whom? At what age must exposure be changed?
Level of exposure.
Time course of exposure and disease development
Consortium adds power to evaluate effects of age. Intermediate endpoints refine temporal relations.
How long must change be sustained?
Duration of altered exposure to modify cancer incidence
Repeated assessment, updating exposure, refines measures of duration and continuing adherence.
Does risk reduction persist after cessation of exposure?
Updated exposure in cohort essential to address this question.
Follow-up of participants after intervention in trail setting adds insights here too.

Tuesday, March 16, 2010

Weight control for cancer prevention

Obesity is increasing at epidemic rates around the world (International Agency for Research on Cancer 2002). Within the US, the epidemic is clearly shown spreading across the country (see map).

United States, data from 2003-2004 report that 66 percent of adults are overweight or obese (BMI ≥25) and 32 per cent of adults are obese (BMI ≥ 30), with a rising trend since 1988 (Ogden, Carroll et al. 2006). Overweight and obesity cause a substantial proportion of several cancers, including oesophageal, colorectal, endometrial, kidney and postmenopausal breast cancers (International Agency for Research on Cancer 2002). Additional evidence from combining prospective data on up to 6 million men and women shows that overweight and obesity also drive risk of lymphoma, multiple myeloma and advanced prostate cancer (Renehan, Tyson et al. 2008).

Public health recommendations call for adults to stay within the recommended BMI range (18.5-24.9) and avoid weight gain. Accordingly, in its Global Strategy on Diet, Physical Activity, and Health, the WHO identifies energy balance and maintenance of a healthy weight as a public health priority and charges member states to develop and support multisectoral programs to address weight, diet, and physical activity; thereby decreasing noncommunicable disease world wide (World Health Organization 2004).

Programmatic and realistic recommendations include interventions that integrate physical activity and diet for more sustained behaviour change. At the grade school level, Gortmaker and colleagues have successfully integrated approaches to diet, activity, and TV viewing into the school curriculum, achieving a sustained intervention and significant increases in fruit and vegetable consumption, reduction in TV viewing (Gortmaker, Cheung et al. 1999) and in a second study also reducing obesity (Gortmaker, Peterson et al. 1999) . In adult populations, a randomized trial achieved sustained weight reduction over two years through diet and activity interventions by health care providers, and resulted in reduced progression to diabetes among men and women at elevated risk (Knowler, Barrett-Connor et al. 2002).

Whole community interventions are exemplified by one in Belgium that included multiple strategies (media campaign, environmental approaches, use of pedometers, and local projects) and resulted in a significant increase in the proportion of the population achieving a target of 10,000 steps per day (De Cocker, De Bourdeaudhuij et al. 2007).

CDC recommendations for combating overweight and obesity can be found at These include community based strategies; school based obesity prevention; and clinical guidelines.

Sugar sweetened beverages
Given the preponderance of evidence that sugar-sweetened beverages increase the risk of obesity and diabetes, a growing number of interventions are now focused on strategies to reduce intake through substitution of other beverages that do not contribute to the excess energy intake. In addition to individual behaviour change, strategies that alter access through limiting on-school campus sale and increasing taxation or removing tax protection may further reinforce behaviour change.

Benefits of weight loss
Because of limited success in achieving sustained weight loss, cancer outcomes have been rarely studied. One important finding from the Nurses’ Health Study shows that weight loss after menopause that is sustained results in a significant reduction in incidence of breast cancer in the short term (Eliassen, Colditz et al. 2006). This is consistent with changes in hormone levels with weight loss. The time course of risk reduction for other cancers or precursor lesions remains to be clarified.

Fifteen to 20 percent of all cancer deaths are due to overweight and obesity; and there is trong evidence that weight loss improves quality of life (Fine, Colditz et al. 1999) and reduces risk of diabetes, heart disease, and stroke. Thus, maintaining a health weight, avoiding further weight gain through the adult years, and reducing weight all are top priorities for cancer prevention. The strong evidence that women who lose weight after menopause significantly reduce their risk of breast cancer adds urgency to our implementing approaches to help women keep weight off after menopause.

Literature cited
De Cocker, K. A., I. M. De Bourdeaudhuij, et al. (2007). "Effects of "10,000 steps Ghent": a whole-community intervention." Am J Prev Med 33(6): 455-463.
Eliassen, A. H., G. A. Colditz, et al. (2006). "Adult weight change and risk of postmenopausal breast cancer." JAMA 296(2): 193-201.
Fine, J., G. Colditz, et al. (1999). "A prospective study of weight change and health-related quality of life in women." JAMA 282: 2136-2142.
Gortmaker, S. L., L. W. Cheung, et al. (1999). "Impact of a school-based interdisciplinary intervention on diet and physical activity among urban primary school children: eat well and keep moving." Arch Pediatr Adolesc Med 153(9): 975-983.
Gortmaker, S. L., K. Peterson, et al. (1999). "Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health." Arch Pediatr Adolesc Med 153(4): 409-418.
International Agency for Research on Cancer (2002). Weight Control and Physical Activity. Lyon, International Agency for Research on Cancer.
Knowler, W. C., E. Barrett-Connor, et al. (2002). "Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin." N Engl J Med 346(6): 393-403.
Ogden, C. L., M. D. Carroll, et al. (2006). "Prevalence of overweight and obesity in the United States, 1999-2004." JAMA 295(13): 1549-1555.
Renehan, A. G., M. Tyson, et al. (2008). "Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies." Lancet 371(9612): 569-578.
World Health Organization (2004). Global Strategy on Diet, Physical Activity, and Health. Geneva, World Health Organization

Saturday, March 13, 2010

Worksite wellness and occupational health assessment saves lives

Comprehensive worksite health promotion addressing occupational health issues, smoking cessation, diet and activity has shown a reduction in cancer risk in blue-collar workers (Sorensen et al. Cancer Causes and Control. 2002). If these results were applied in all similar settings then we would see a substantial reduction in lung cancer in the coming years. See:

Workplace health promotion

Media coverage of the obesity epidemic in Australia and the resulting cancer burden nicely emphasizes the role of workplace changes that can help promote wellness -

Growing evidence shows such workplace wellness programs save money and reduce costs for the health system. This is a win-win situation. David Cutler and colleagues write in Health Affairs (Jan 2010): "Amid soaring health spending, there is growing interest in workplace disease prevention and wellness programs to improve health and lower costs. In a critical meta-analysis of the literature on costs and savings associated with such programs, we found that medical costs fall by about $3.27 for every dollar spent on wellness programs and that absenteeism costs fall by about $2.73 for every dollar spent. Although further exploration of the mechanisms at work and broader applicability of the findings is needed, this return on investment suggests that the wider adoption of such programs could prove beneficial for budgets and productivity as well as health outcomes." These data clearly show it is time to act across all types of workplace.

Since we live in communities, we should also remember that school-based programs that help our children grow up healthier are an important adjunct to workplace programs.

Wednesday, March 10, 2010

"8 Ways to Prevent Cancer" - Talk at Sydney University

Graham Colditz, MD, DrPH had the privilege to give a talk this afternoon at Sydney University, Australia, on "8 Ways to Prevent Cancer." The talk detailed the evidence behind, and multi-layered issues involved in, cancer prevention efforts. Dr. Colditz's slides from the talk (link).

Sunday, March 7, 2010

3222.0 - Population Projections, Australia, 2006 to 2101

Australian population growth projection leads to increasing burden of cancer for health services and for the community. The continuing growth through births and migration lead to projections that the Australian population will substantially increase in size and in age over the next 50 years. By 2056 5% percent or more of the population will be aged 85 or older compared to only 1.6 percent in 2007. Because the risk of cancer increases with age a larger number of older Australians will result in more cases of cancer diagnosed each year, even if the risk at a given age holds steady. Therefore, efforts to reduce risk and prevent cancer must be an even higher priority to avoid this burden on society and the pain and suffering for individuals.

3222.0 - Population Projections, Australia, 2006 to 2101