Prevention

12 Preventable Cancers

Lifestyle can have a huge influence on the risk of cancer overall.  Not all cancers, though, have known lifestyle components.  Outlined below are twelve of the more common cancers with lifestyle factors linked to their risk.  Some, like colon cancer, have a number of lifestyle factors, while others, like stomach cancer, have few.

The tables that appear with each cancer show the lifestyle factors that have been found through high quality research studies to be definitely or probably linked to the cancer.  Factors with less solid evidence aren’t listed.  The arrows associated with each factor show in general how much that factor affects the risk of the cancer.  Up arrows show that the factor increases risk.  Down arrows show that it decreases risk.

Bladder cancer

Approximately 74,000 new cases of bladder cancer are diagnosed each year in the United States.  While only a few lifestyle factors are linked to bladder cancer, they can have a large impact on risk.  Not smoking can greatly lower risk, as can avoiding water with a high arsenic content.  High arsenic levels are most common in well water, and all households with well water should have their drinking water tested.  For people who work with aromatic amines and other chemicals common in rubber and aluminum production, the best thing they can do is wear proper protective equipment in the workplace and be familiar with the chemicals they work with.

Bladder Cancer  
Lifestyle Risk Factors Risk
Smoking
Under 15 cigarettes per day
15-25 cigarettes per day ↑↑
Over 25 cigarettes per day ↑↑↑
Drinking high arsenic well water ↑↑
Unprotected exposure to aromatic amines and other chemicals common in rubber/aluminum production
5-20 years ↑↑
Over 20 years ↑↑↑
—   no increase in risk

↑  small increase in risk

↑↑  moderate increase in risk

↑↑↑  large increase in risk

↑↑↑↑ very large increase in risk

 

— no decrease in risk

↓  small decrease in risk

↓↓  moderate decrease in risk

↓↓↓  large decrease in risk

↓↓↓↓  very large decrease in risk

Breast cancer

Breast cancer is the most common cancer among women in the US. Around 230,000 American women are diagnosed with the disease each year, and it is a leading killer of women in midlife (ages 30 – 55).  Though relatively few lifestyle factors have been linked to the disease, lifestyle does have a very important impact on the risk of breast cancer.  This is especially so if healthy behaviors start in youth and young adulthood, when breast tissue is still developing and may be at its most susceptible to harms that can increase risk later in life.  Avoiding tobacco and alcohol can help protect against the disease.  Being physically active and keeping weight in check can lower risk.  In women who drink regular, taking a multivitamin may have benefits. Avoiding birth control pills and postmenopausal hormones can also lower risk, but balancing the risks and benefits of such medications is important, and people should talk to a doctor to better understand the balance.  For women who are able to do so, breastfeeding for a total of one year (all children combined) also seems to have breast health benefits.

For women at high risk of breast cancer, the prescription drugs tamoxifen and raloxifene can cut the risk of the disease by about half.

Lifestyle Risk Factors – Breast Cancer Risk
Weight Gain Since Age 18

(in postmenopausal women who haven’t taken postmenopausal hormones)

22-44 lbs ↑↑
45 lbs ↑↑
Currently taking birth control pills
Taking postmenopausal hormones
Estrogen alone for 5 or more years
Estrogen and progesterone for less than 5 years
Estrogen and progesterone for  5 or more years ↑↑
Drinking 1 or more servings of alcohol per day

Smoking

Being physically active 30 min or more on most days
Breastfeeding 1 year or more (all children combined)
Taking a daily multivitamin

(in those who drink alcohol regularly)

Taking tamoxifen/raloxifene for 5 or more years

(prescribed for high risk women)

↓↓↓
—   no increase in risk

↑   small increase in risk

↑↑  moderate increase in risk

↑↑↑   large increase in risk

↑↑↑↑  very large increase in risk

— no decrease in risk

↓  small decrease in risk

↓↓  moderate decrease in risk

↓↓↓  large decrease in risk

↓↓↓↓  very large decrease in risk

Cervical cancer

Cervical cancer is one of the most preventable types of cancer. Once a leading cause of cancer death in the US, cervical cancer rates have plummeted.  The main reason is the high percentage of American women getting regular Pap tests, which can help prevent the disease as well as catch it early when it’s most treatable. The relatively new human papillomavirus (HPV) vaccine shows great promise at further lowering rates of cervical cancer.  Not smoking, limiting the number of male sexual partners, and using condoms and/or diaphragms for birth control can help prevent the disease as well.

Lifestyle Risk Factors Risk
Smoking
Over 25 cigarettes per day
Having 3 or more male sexual partners over lifetime ↑↑↑
Using diaphragm/condom as main method of birth control ↓↓
Having had a Pap test within the last 3 – 5 years ↓↓
Getting the HPV vaccine (typically at age 11-12) ↓↓↓↓
—   no increase in risk

↑   small increase in risk

↑↑ moderate increase in risk

↑↑↑  large increase in risk

↑↑↑↑  very large increase in risk

— no decrease in risk

↓  small decrease in risk

↓↓  moderate decrease in risk

↓↓↓  large decrease in risk

↓↓↓↓  very large decrease in risk

Colon cancer

A full 75 percent of colon cancers could be avoided with healthy lifestyles.  Keeping weight in check, getting regular exercise, and avoiding too much alcohol and red meat can go a long way toward preventing the disease.  Taking a daily multivitamin and getting enough calcium and vitamin D can also lower risk, as can taking a daily aspirin (but check with a doctor beforehand).

Using birth control pills for a long period of time can lower risk. In postmenopausal women, avoiding postmenopausal hormones can protect against the disease as well.  However, balancing the risks and benefits of such medications is important, and people should talk to a doctor to better understand the balance.

The single best way to lower the risk of colon cancer is to have colon cancer screening tests performed regularly from age 50 on.  Talking to a doctor about the specific tests can help patients decide which of the colon cancer tests are right for them (colonoscopy, sigmoidoscopy, virtual colonoscopy, or fecal occult blood test) (see Screening).

Lifestyle Risk Factors – Colon Cancer Risk
Being obese (BMI = 30 or higher) ↑↑
Eating 3 or more servings of red meat per week
Drinking 2 or more servings of alcohol per day

Smoking

Taking a daily multivitamin ↓↓
Getting enough calcium ( about 1,000 – 1200 mg per day)
Getting enough vitamin D (about 1,000 mg per day) ↓↓
Being physically active 30 min or more on most days ↓↓
Taking aspirin every day for 15 years or longer
Taking birth control pills for over  5 years (women only)
Taking postmenopausal hormones 5 yrs or longer (women only)

Estrogen-alone hormones

Estrogen plus progestin hormones

 

↓↓

Getting screened regularly after age 50 with approved test(s)

(like, colonoscopy, sigmoidoscopy, virtual colonoscopy, or FOBT)

↓↓
—   no increase in risk

↑  small increase in risk

↑↑  moderate increase in risk

↑↑↑  large increase in risk

↑↑↑↑  very large increase in risk

— no decrease in risk

↓  small decrease in risk

↓↓  moderate decrease in risk

↓↓↓  large decrease in risk

↓↓↓↓  very large decrease in risk

Kidney cancer

Kidney cancer is fairly rare in the US.  Even so, over 61,000 Americans are diagnosed with the disease each year.  Steps people can take to lower their risk of kidney cancer include keeping weight in check, not smoking, and avoiding (or keeping under control) high blood pressure.  Exposure to certain occupational chemicals may also increase risk.

Lifestyle Risk Factors Risk
Being obese (BMI = 30 or higher) ↑↑
Smoking
15-25 cigarettes per day
Over 25 cigarettes/day ↑↑
Having high blood pressure (hypertension) ↑↑
—   no increase in risk

↑  small increase in risk

↑↑  moderate increase in risk

↑↑↑  large increase in risk

↑↑↑↑  very large increase in risk

— no decrease in risk

↓  small decrease in risk

↓↓  moderate decrease in risk

↓↓↓  large decrease in risk

↓↓↓↓  very large decrease in risk

Lung cancer

Not smoking is clearly the single most important thing people can do to prevent lung cancer.  Even for those who used to smoke, quitting has huge benefits.  Risk begins to drop after two years, and after 15 – 20 years risk, is practically equal to that of someone who never smoked.   While hard, quitting is far from impossible.  Seeing a doctor for help can double, and even triple, chances of quitting for good.

For those who don’t smoke, avoiding regular exposure to secondhand smoke can help protect against lung cancer.  A diet rich in fruits and vegetables has also been found to lower risk.

Unprotected exposure to asbestos, radon, and chemicals common in some smelting/manufacturing jobs are also very important risk factors for lung cancer.  For people who must work with these substances, the best thing they can do is wear proper protective equipment in the workplace and be familiar with the substances they work with.

Lifestyle Risk Factors – Lung Cancer Risk
Smoking
Under 15 cigarettes per day ↑↑
15-25 cigarettes per day ↑↑↑
Over 25 cigarettes per day ↑↑↑↑
Former smoking  (quit over 20 years ago)
Regular exposure to secondhand smoke
Smoking 1 or more cigars per day
Eating 5 or more servings of fruits/vegetables per day
Working unprotected with asbestos
 Under 5 years ↑↑
5-20 years ↑↑↑
Over 20 years ↑↑↑↑
Working unprotected with: aluminum, beryllium, bis(chloromethyl) ether and chloromethyl ether, cadmium, chromium, coke, mustard gas, radon, silica, or sulfuric acid mist,
Under 5 years ↑↑
5-20 years ↑↑↑
Over 20 years ↑↑↑↑
Working unprotected with: arsenic smelting, coal gasification, iron or steel founding,
Under 5 years ↑↑
5-20 years ↑↑↑
Over 20 years ↑↑↑↑
—   no increase in risk

↑  small increase in risk

↑↑  moderate increase in risk

↑↑↑ large increase in risk

↑↑↑↑  very large increase in risk

—  no decrease in risk

↓  small decrease in risk

↓↓  moderate decrease in risk

↓↓↓  large decrease in risk

↓↓↓↓  very large decrease in risk

Ovarian cancer

While there are steps women can take to lower the risk of ovarian cancer, most of them – apart from weight – aren’t considered pure lifestyle choices.  They are things many women have control over, but they are complicated choices with many different interests to consider outside of lowering the risk of cancer.  These include breast feeding, taking birth control pills, having the fallopian tubes tied, and having a hysterectomy.  For most of these, talking with a doctor beforehand about the overall risks and benefits is an important step.

Controllable Risk Factors – Ovarian Cancer Risk
Being overweight/obese (BMI = 25 or higher)

Breastfeeding 1 year or more (all children combined)

Taking birth control pills for 5 yrs or more
Having fallopian tubes tied ↓↓
Having a hysterectomy
—   no increase in risk

↑  small increase in risk

↑↑  moderate increase in risk

↑↑↑  large increase in risk

↑↑↑↑  very large increase in risk

— no decrease in risk

↓  small decrease in risk

↓↓  moderate decrease in risk

↓↓↓  large decrease in risk

↓↓↓↓  very large decrease in risk

Pancreatic cancer

Pancreatic cancer is a fairly rare disease that is also fairly scary, since it’s often very aggressive and hard to treat.  Yet, there are some steps people can take that can lower the risk of pancreatic cancer.  Keeping weight in check, not smoking, and eating a diet rich in vegetables can help lower risk.  Taking steps to avoid diabetes can also help (like exercising more and choosing more whole grain foods).

Lifestyle Risk Factors – Pancreatic Cancer Risk
Being obese (BMI = 30 or higher) ↑↑
Smoking
15-25 cigarettes/day
Over 25 cigarettes/day ↑↑
Having diabetes or problems with high blood sugar ↑↑
Eating 3 or more servings of vegetables per day ↓↓
—   no increase in risk

↑  small increase in risk

↑↑  moderate increase in risk

↑↑↑  large increase in risk

↑↑↑↑  very large increase in risk

— no decrease in risk

↓ small decrease in risk

↓↓  moderate decrease in risk

↓↓↓  large decrease in risk

↓↓↓↓  very large decrease in risk

Prostate cancer

Prostate cancer is the most common cancer in United States men.  Over 220,000 new cases are diagnosed each year, and although the disease isn’t usually fatal, diagnosis and treatment of the disease takes a huge toll on many men’s quality of life.  As with breast cancer in women, frustratingly few lifestyle factors have been linked to prostate cancer, but men can take a few key steps to lower their risk. These include keeping weight in check, eating a diet low in animal fat, eating more tomato-based foods, and avoiding too much calcium by sticking to the recommended 1000-1200 mg/day for most adults.

Lifestyle Risk Factors – Prostate Cancer Risk
Being overweight/obese (BMI = 25 or higher)

(advanced cancer)

 

Eating 5 or more servings of food with animal fat per day

 

 

↑↑

Getting too much calcium (Over1500mg per day) ↑↑
Eating 5 or more servings of tomato-based foods per week ↓↓
—   no increase in risk

↑  small increase in risk

↑↑  moderate increase in risk

↑↑↑  large increase in risk

↑↑↑↑  very large increase in risk

— no decrease in risk

↓  small decrease in risk

↓↓  moderate decrease in risk

↓↓↓  large decrease in risk

↓↓↓↓  very large decrease in risk

Skin cancer: Melanoma

Sun protection is key to lowering the risk of melanoma, the most serious, deadly form of skin cancer.  It is, of course, most important to protect children from sunburns, but to lower risk of all types of skin cancer, both children and adults should avoid as much exposure as possible during peak burning hours (10am – 4pm); wear long sleeve shirts, long pants, and wide-brimmed hats; and properly apply broad-spectrum sun screen. Also important is avoiding tanning bed use, especially in youth and early adulthood.

Lifestyle Risk Factors – Skin Cancer: Melanoma Risk
Having had repeated severe sunburns as a child

Indoor tanning

Ever indoor tanned

Indoor tanned before age 35                 years

↑↑↑

 

↑↑

—   no increase in risk

↑   small increase in risk

↑↑  moderate increase in risk

↑↑↑  large increase in risk

↑↑↑↑  very large increase in risk

— no decrease in risk

↓  small decrease in risk

↓↓  moderate decrease in risk

↓↓↓  large decrease in risk

↓↓↓↓  very large decrease in risk

Stomach cancer

Though fairly rare in the United States, stomach cancer is one of the most common cancers worldwide. The most important risk factor for stomach cancer is infection with a bacterium called Helicobacter pylori (H pylori).  While it can be difficult to avoid getting H pylori, especially for populations in developing countries, treating it can greatly lower the risk from the infection.  Treatment usually involves a combination of antibiotics and drugs that lowers acid levels in the stomach.  Not smoking and eating a low sodium diet can also help protect against stomach cancer.  Eating a diet rich in fruits and vegetables may also be beneficial.

Lifestyle Risk Factors – Stomach Cancer Risk
Smoking ↑↑
Quit Smoking
Under 20 years ago
20 years ago or longer
Having H pylori infection
untreated ↑↑↑
treated ↑↑
Getting too much sodium  (2300mg or more per day) ↑↑
—   no increase in risk

↑  small increase in risk

↑↑  moderate increase in risk

↑↑↑  large increase in risk

↑↑↑↑  very large increase in risk

— no decrease in risk

↓  small decrease in risk

↓↓  moderate decrease in risk

↓↓↓  large decrease in risk

↓↓↓↓  very large decrease in risk

Uterine cancer

Uterine cancer (also called endometrial cancer) is one of the most common cancers in women.  Of the traditional lifestyle factors, keeping weight in check and avoiding diabetes with healthy behaviors like exercise and healthy diet can help lower the risk of uterine cancer.  As for less traditional lifestyle factors, taking birth control pills for a long period can lower risk of the disease; and in postmenopausal women, avoiding postmenopausal hormones can protect against the disease.  However, balancing the risks and benefits of such medications is important, and people should talk to a doctor to better understand the balance.

Lifestyle Risk Factors – Uterine Cancer Risk
Being obese (BMI = 30 or higher) ↑↑
Taking postmenopausal hormones 10 yrs or longer
Having diabetes or problems with high blood sugar

Being physically active 30 min or more on most days

↑↑

Taking birth control pills for 5 yrs or longer ↓↓
—   no increase in risk

↑  small increase in risk

↑↑  moderate increase in risk

↑↑↑  large increase in risk

↑↑↑↑  very large increase in risk

— no decrease in risk

↓  small decrease in risk

↓↓  moderate decrease in risk

↓↓↓  large decrease in risk

↓↓↓↓  very large decrease in risk