Gynecology  Preventive check-ups  Cancer prevention

November 19, 2005

Dr. Majid Ezzati, lead investigator, said some risks are more prevalent in wealthy countries. People in richer countries are more likely to smoke, consume more alcohol, to be obese and to avoid physical activity. In low- and middle-income nations, sexual transmission of the human papilloma virus is a leading risk factor for cervical cancer, the most common malignancy among women in some parts of the world.

Ezzati and colleagues found if risk factors were avoided, 2.43 million people might survive. His team studied cancer mortality in 2001 in seven World Bank regions. They found that 12 types of cancer, and particularly the four leading forms - lung, breast, colon and prostate - have strong links to avoidable risks.

"Primary prevention through lifestyle and environmental interventions remains the main route for reducing the global cancer burden," Ezzati said in a statement Friday.

Dr. James D'Olimpio of North Shore University Hospital in Manhasset said risks must be put into perspective. "The data on some of that is a little softer than the data on smoking," said D'Olimpio, an attending oncologist and director of supportive oncology at the hospital's Don Monti Cancer Center.

For instance, the scientific literature has not strongly shown which fruits and vegetables are most protective, though data suggest that people whose diets are dominated by these foods are less likely to develop cancer. And while environmental causes are strongly suspected in many types of cancers, D'Olimpio said there is a need for stronger studies.

The evidence, nevertheless, is very strong when it comes to smoking, even for cancers most would not associate with the habit, D'Olimpio said. In addition to lung cancer, he cited smoking as the underlying causes of bladder and pancreatic cancers. Other studies have strongly linked smoking to certain forms of lymphoma.

Poor dietary choices, he added, not only lead to obesity but can profoundly influence tumor growth. Processed meats and other refined foods can adversely affect the colon, triggering cancer development.

"Physical inactivity leads to obesity - and it is rampant," D'Olimpio said. "There is a correlation between obesity and breast and ovarian cancers.

"Lifestyle issues have a much broader impact on breast cancer than most people think," he continued. "Alcohol consumption plays a very large role in breast cancer, especially with obesity." When an obese woman is also a drinker, her breast cancer risk escalates dramatically, D'Olimpio said.

Ezzati's team suggests implementing higher taxes on cigarettes and alcohol and limiting ads that entice youngsters to smoke and drink.