Can we prevent cancer?

George Weiner, MD, University of Iowa Hospitals and Clinics
George Weiner, MD

George Weiner, MD, directs the Holden Comprehensive Cancer Center at the University of Iowa:

Is preventing cancer possible? Two announcements in the past year made me think a lot about this question.

A national pharmacy chain bravely stated they will stop selling tobacco products even though sales of such products contribute to their financial bottom line. Tobacco is the leading cause of preventable cancer deaths. Reducing the convenience of buying tobacco is an effective way of reducing use. The announcement was greeted by well-deserved and enthusiastic approval from several cancer organizations, including the American Cancer Society. Less encouraging were predictions by the National Cancer cancer rates graphicInstitute, the American Cancer Society, and the World Health Organization, all of whom say the worldwide burden of cancer will nearly double by 2030. This is due to a growing and aging population, increasing tobacco use, higher obesity rates, and limited cancer prevention and early detection efforts in many parts of the world.

So…can we really prevent cancer? The short answer is, “yes and no.” Yes – our choices have a major impact on our risk of getting cancer. More than 50 percent of cancer deaths are related to lifestyle choices. A healthy lifestyle reduces our chance of getting cancer. No – we do not know how to prevent all cases of cancer. We all know stories of people who did not get cancer despite doing everything wrong—smoking, poor diet, overweight, never getting screened for cancer. We know of others who developed cancer despite doing everything right—no tobacco, excellent diet, exercise, following cancer screening guidelines. In fact, some folks use such stories to claim “we can’t prevent cancer” and continue poor health choices. Because the word “prevention” can be interpreted as being absolute (“yes” or “no”), and therefore can be discounted, some advocates have advised use of the phrase “risk reduction” instead.

One such organization is C-Change, which includes leaders from the private, public, and non-for-profit sectors working together to eliminate cancer as a public health concern. As co-chair of a C-Change group that is focusing on comprehensive cancer control, this issue is especially engaging for me. But whether we say “prevention” or “risk reduction,” encouraging and supporting healthy choices at home and abroad will be vital to reducing the worldwide burden of cancer. Meanwhile, I need a small notebook to track my weight and exercise routine as I try to reduce my own risk of cancer and remain as physically fit as possible. I think I will make a special effort to pick one up at the pharmacy.

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 –Fall 2014