Cancer Prevention: Major Initiatives and Looking into the Future

Carolyn Cook Gotay

Expert Rev Pharmacoeconomics Outcomes Res. 2010;10(2):143-154.

Abstract and Introduction

Abstract

Cancer is one of the major causes of death in countries across the world. However, at least half of cancers could be prevented. This article reviews the relationship between cancer incidence and the major risk factors: tobacco use, exposure to infections, nutrition, obesity and physical activity. Several major current cancer prevention initiatives are presented, including the effort for global tobacco control, vaccination programs for human papilloma virus, chemoprevention, and cohort studies to identify and elucidate cancer causes. Two concerns that cross the cancer prevention research spectrum are the importance of social determinants of health, and the potential role of genetic factors in explaining cancer incidence and guiding intervention development. In the future, optimism is warranted regarding cancer prevention. If currently known criteria are applied and extended, significant reductions in cancer rates are possible.

1 2 3 4 5 6

Next Section

Cite this: Cancer Prevention: Major Initiatives and Looking into the Future - Medscape - Apr 01, 2010.

Table 1. Lifestyle factors strongly linked with cancer incidence.
Factor	Cancers affected^†	Ref.
Tobacco	Lung, oral cavity, nasal cavity, pharynx, larynx, esophagus, stomach, pancreas, liver, bladder, kidney, uterine cervix, myeloid leukemia	^[1]
Nutrition Alcohol Fruits/vegetables Red meat	Mouth, pharynx, larynx, esophagus, colorectum, breast, liver Mouth, pharynx, larynx, esophagus, stomach, lung Colorectum	^[5]
Obesity^‡	Esophagus, pancreas, colorectum, breast (post-menopausal), endomentrium, kidney, gallbladder, pancreas	^[5]
Physical activity^§	Colon, breast (postmenopausal), endometrium	^[5]

^†Cancers are linked with a 'large' or 'moderate' risk for tobacco, or a 'convincing' or 'probable' risk for nutrition, obesity and physical activity.
^‡Includes body fatness and abdominal fatness.
^§Physical activity is a protective behavior that reduces cancer risk.

Table 2. Infectious agents, associated cancers and cancer control strategies.
Agent	Cancer(s) attributed to infectious agent^†	Selected cancer control strategies^‡
Helicobacter pylori	Stomach	Food safety, treatment of H. pylori infections through antibiotics
Human papillomaviruses (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 66)	Cervical Vulva and vagina Penile Anus Oral cavity Oropharynx	Vaccination, safe sexual practices, use of Pap testing (and newer techniques) for early detection of preneoplastic and neoplastic lesions
Hepatitis viruses (B and C)	Liver	Vaccination (Hep B), reduce exposure to contaminated blood
Epstein–Barr virus	Burkitt lymphoma Hodgkin lymphoma Nasopharyngeal	Malaria eradication, awareness and education, early diagnosis
HIV and human herpes virus 8	Kaposi sarcoma NonHodgkin lymphoma	Safe sexual practices, reduce exposure to contaminated blood, early diagnosis
Liver flukes	Liver	Improve water safety, change dietary practices, awareness and education
Human T-lymphotropic virus type-1	Acute T-cell leukemia	Screen blood, prevent breastfeeding by affected mothers
Schistomes	Bladder	Improve water safety, awareness and education

^†Data from ^[11].
^‡Strategies were selected to illustrate range of possible approaches – see full report for more complete discussion.^[12]

Table 3. Cancer attributable to infections.
Infection-related sites	Developed world		Developing world
Infection-related sites	Total cases	Attributable to infection (n)	Total cases	Attributable to infection (n)
Liver	110,400	48,000	513,100	475,000
Cervix	83,400	83,400	409,400	409,400
Stomach	311,200	192,000	619,200	400,000
Kaposi sarcoma/NHL	151,100	19,250	149,200	104,590
Anogenital	38,000	22,450	58,700	31,430
Nasopharynx	7200	6500	72,600	71,600
Mouth/oropharynx	115,500	5600	210,700	8800
Hodgkin lymphoma	28,000	11,500	34,300	17,100
Bladder	225,200	0	131,000	10,600
Total cancers: all sites	5,016,000	389,000 (7.7%)	5,828,000	1,527,000 (26.3%)

NHL: Non-Hodgkin lymphoma.
Data from ^[104].

Comments

Commenting is limited to medical professionals. To comment please Log-in.

Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.