Cancer Prevention Possible Through Lifestyle Control, Says JAMA Oncology Study

Research published in the journal JAMA Oncology argues that major lifestyle changes can significantly delay the onset of cancer.

To prove their hypothesis, the authors designed a prospective cohort study that analyzed cancer and lifestyle data from 3 sources:

• Nurses’ Health Study
• Health Professionals Follow-up Study
• US national cancer statistics

The authors divided the all-white participants into 2 cohorts (89,571 women and 46,339 men)—low-risk group and high-risk group—based on whether they had a “healthy lifestyle” pattern. The low-risk group (healthy lifestyle) had to meet the following criteria:

• Never or past smokers (less than 5-pack years)
• No or moderate alcohol drinking (1 or less drink per day for women, 2 or less drinks per day for men)
• Body mass index of between 18.5 and 27.5
• Weekly aerobic activity of 75 vigorous-intensity or 150 moderate-intensity minutes

The authors then estimated the proportion of cases and deaths of carcinomas (except skin, brain, lymphatic, hematologic, and nonfatal prostate malignancies) that could potentially be prevented by calculating the population-attributable risks (PARs). This was a comparison of incidence and mortality of total and major individual carcinomas between the 2 cohorts.

Only 16,531 women and 11,731 men fell in the low-risk group, the authors observed. The PARs for incidence and mortality of total carcinomas were 25% (low-risk) and 48% (high-risk) in women, and 33% (low-risk) and 44% (high-risk) in men. The following were the PARs statistics for the individual cancers:

• 82% for women and 78% for men for lung
• 29% and 20% for colon and rectum
• 30% and 29% for pancreas
• 36% and 44% for bladder

Similar trends were observed for mortality, the authors report. The PARs were 4% and 12% for breast cancer incidence and mortality, and 21% for fatal prostate cancer.

These are significant numbers, considering that a majority of these cancers have very high mortality risks, primarily as a result of delayed detection due to a lack of specific symptoms. Based on their findings the authors believe that a substantial cancer burden can be prevented through lifestyle modification in the United States.

Reference

Song M, Giovannucci E. Preventable incidence and mortality of carcinoma associated with lifestyle factors among white adults in the United States. JAMA Oncol. 2016;2(9):1154-1161. doi: 10.1001/jamaoncol.2016.0843.