ACS Cancer Prevention Blueprint Targets Controllable Risk Factors

The American Cancer Society (ACS) National Cancer Control Blueprint is a series of papers published in CA: A Cancer Journal for Clinicians. The goal of these papers is to describe evidence that will support creating a cancer control plan for the United States and putting the plan into action. This is the third story on cancer.org about the ACS Blueprint. The first story was about the blueprint’s goals. The second was about how well cancer control is working in the US.

Some people may feel helpless against cancer and think they’ll only be able to conquer that fear when a cure is found. In fact, you may be able to lower your chance of getting many types of cancer. The ACS Cancer Prevention Blueprint describes what we know about risk factors for cancer that can be controlled. It also outlines cancer prevention strategies proven to help people avoid those risk factors. These strategies include choices each person can try to lower their risks for certain cancers. They also include actions and health policies that can be made at the city, state, and local community levels.  

Controllable, or modifiable, risk factors are those that people can try to change by making healthier choices, like exercising more and drinking less alcohol. “Adopting a healthy lifestyle and sticking with it may help reduce your risk of getting cancer,” says Susan Gapstur, PhD, MPH. She’s the lead co-author of the Cancer Prevention Blueprint. Gapstur is a Senior Vice President at the ACS. 

Tobacco: Avoid the Leading Cause of Cancer Deaths

Using tobacco is still the leading cause of cancer. It’s also the most preventable cause of death from cancer. The blueprint notes that one of the most effective ways to reduce tobacco use is by raising taxes on tobacco products. When they cost more, fewer people (especially young people) may start to smoke. People may smoke less or even quit, and people who don't smoke may be exposed to less secondhand smoke.

The prevention blueprint urges everyone to follow this advice.

1. Don’t start. Do not smoke cigarettes, and do not use e-cigarettes or smokeless tobacco, such as chewing tobacco. Get this message to your kids, says Jeffrey Drope, PhD. He’s the ACS Scientific Vice President for Economic and Health Policy Research.
2. If you use tobacco, do your best to quit. There are many ways to quit. You’re more likely to succeed if you combine a way to change your habits with a  quitting aid, such as FDA-approved nicotine replacement therapy (NRT) and prescription medicines, along with counseling  and other types of support.  Keep at it—for most people, it takes multiple tries to stop.
3. Do less harm. “Research strongly suggests that, compared to using regular cigarettes, e-cigarettes are less harmful,” says Cliff Douglas. He’s director of the ACS Tobacco Control Center. “So, if you’ve tried many times to stop smoking, or you’re not willing to quit,” he says, “e-cigarettes may be a less harmful option.” However, he adds, no one knows yet how harmful these products are when you use them for a long time. The ACS strongly discourages smoking cigarettes and using e-cigarettes in the same periods of time. For best health, your goal should be to not use any tobacco products, including e-cigarettes. Both Drope and Douglas are co-authors of the ACS Preventing Cancer Blueprint.

Smoking also leads to many other chronic diseases. They include breathing problems such as asthma and chronic obstructive pulmonary disease (COPD), heart disease, type 2 diabetes, stroke, and even eye problems that can result in blindness. “People who don’t smoke are much less likely to get these diseases,” Drope says.

Alcohol: Limit What You Drink to Help Prevent 7 Types of Cancers

Many people don’t realize that alcohol is a risk factor for cancer. “Drinking even small amounts of alcohol increases your chance for getting certain types of cancer” says Gapstur. In fact, ACS researchers found about 16% of all breast cancers are caused by alcohol use.

If you choose to drink alcoholic beverages, the ACS recommends.

• Women should have no more than 1 drink a day.
• Men should have no more than 2 drinks a day.

Just as with tobacco, raising taxes on alcohol reduces the amount that people drink. “Studies show that a higher price for alcohol has other benefits too. It also reduces motor vehicle crashes and violence,” Gapstur says.

Avoid Excess Weight: A Lifelong Goal for Cancer Control

Researchers have shown that being overweight or obese can cause 13 types of cancers. For some cancers, the risk is very high. For instance, being overweight or obese causes as much as 60% of endometrial cancers.

Being overweight or obese can increase your risk for getting cancer in many ways. One of the main ways is that excess weight causes the body to make and circulate more estrogen and insulin, and both these hormones can make it easier for some cancers to grow. Gapstur says that’s one reason why it’s important to maintain a healthy weight throughout life.

That starts in childhood. “We know that kids who are heavy are more likely to become heavy adults. So, it’s important for parents to help their children learn good habits about healthy eating and staying active early in life.”

We are still trying to understand whether adults who are overweight or obese can reduce their chances of getting cancer if they lose weight, Gapstur says. “What research has shown is that losing weight lessens your chances of getting some other chronic diseases. And some of those diseases, such as diabetes, may increase your chance of getting some types of cancer.”

Eat Less Meat and More Plants

Certain foods are linked to a higher or lower risk for some types of cancer. Based on this evidence, the ACS recommends:

• Eat at least 5 servings of fruit and vegetables each day.
• Choose whole grains over refined grains. For example, choose whole-grain breads, pasta, and cereals (such as barley and oats). Choose brown rice instead of white rice.
• Limit how much processed and red meat you eat. Processed meats include bacon, sausage, lunch meats, and hot dogs. (Researchers have found a strong link between processed meats and colorectal cancer, and a likely link between red meat and colorectal cancer.)

“We know that a person’s choices occur within the context of a larger environment,” Gapstur says. That’s why the ACS also recommends that communities and health care policies work to increase access to affordable, healthy foods, and restricting marketing of foods with low nutritional value.

Move More

Research shows that not being physically active increases your chance of getting some types of cancer. This includes colon and breast cancer and maybe several others. Here’s what the ACS recommends for adults and children:

• Adopt a physically active lifestyle, and
• Limit the amount of time you’re inactive. This includes the time you spend sitting or lying down to watch TV or other types of screen-based entertainment.

The good news is that doing any kind activity beyond your usual ones can benefit your health, Gapstur adds.

Overall, Gapstur says, the key message is that prevention has the potential to substantially reduce the number of people diagnosed with and dying from cancer each year.