It is now 2016, and Americans hope for a brighter, healthier new year. Are Americans healthier today than they were last year or the year before? Will there be fewer people diagnosed with cancer? According to the American Cancer Society, it is projected that in 2016 there will be 1,685,210 new cancer cases and 595,690 deaths due to cancer. This is an increase over previous years. While it is true that the death rate for several cancers has decreased (due mostly to better screening and earlier diagnosis), it is also true that several cancers are on the rise, including cancers of the thyroid, liver, pancreas, kidney, small intestine, tongue and tonsil in both women and men. In women, the incidence of endometrial, vulvar and anal cancer is rising. In men, there is an increase in the incidence of melanoma, multiple myeloma, male breast cancer, testicular cancer and throat cancer. It is also alarming that cancer-incidence rates in children have increased steadily since 1975. Leukemia, and cancers of the brain and other nervous-system tumors are the most frequently occurring childhood malignancies.
Cancer rates are strongly impacted by the rise in obesity. Unfortunately, obesity rates in America have increased over the past 10 years. Between 1999 and 2014, our nation’s obesity rate rose 24 percent among children and adults. Now, more than one-third (79 million) adults in the United States are obese. Why is this a problem? The answer is that obesity increases the risk of several types of cancer, type-2 diabetes, heart disease, and stroke. The Centers for Disease Control tells us that “obesity is common, serious and costly.” Yes, obesity also has a tremendous impact on America’s economy, costing America $147 million dollars in 2008 U.S. dollars. Obese individuals have medical costs that were $1,429 higher than those of normal weight.
What can be done to end America’s scourge of obesity and significantly reduce the risk of cancer? Graham Colditz, DrPH, MD, MPH, an internationally recognized leader in cancer prevention, is Chief of the Division of Public Health Sciences and Niess-Gain Professor of Surgery and Deputy Director of the Institute for Public Health at Washington University School of Medicine. As an epidemiologist and public-health expert, he has studied the impact of diet and physical activity on the risk of breast cancer and other cancers. He advises us to focus on vegetables, fruits, whole grains, beans, and nuts, and limit the amount of animal protein, and especially, red meat. Water should be a beverage of choice, while sugary drinks, such as soda, energy drinks and sports drinks should be avoided. Alcohol should also be avoided, or consumed very moderately.
Lorenzo Cohen, Ph.D., is theRichard E. Haynes Distinguished Professor in Clinical Cancer Prevention and Director of the Integrative Medicine Program at The University of Texas MD Anderson Cancer Center. Like Dr. Colditz, Dr. Cohen has advocated passionately for the prevention of cancer and other diseases through diet, exercise, and other lifestyle factors. Dr. Cohen agrees that a diet that is mainly composed of whole grains, a variety of vegetables and fruits, beans, tea (green and/or black), and nuts and seeds reduces the risk of cancer and other chronic diseases.
The United States official Dietary Guidelines for Americans, 2015-2020, reinforces the advice of Drs. Colditz and Cohen. The new guidelines also state that less than 10% of our daily calories should come from added sugars, and less than 10% of calories per day from saturated fats, and less than 2,300 milligrams (mg) per day of sodium.
However, the new guidelines do not warn that the consumption of red meat and processed meat should be avoided or limited because they increase cancer risk. Yet, the International Agency for Research on Cancer (IARC), a research division of the World Health Organization, announced in October 2015, that processed meats such as bacon, sausage, ham, and hot dogs cause cancer. Red meat was identified as “probably carcinogenic,” meaning it’s likely to cause cancer, as well.
This dietary information points out what we should be eating to reduce cancer risk. While government and public-health advocates strive to educate the public, and prevent disease, the food industry frequently acts in opposition to those goals, producing processed foods that are high in sugar, salt, artificial ingredients and calories. One good rule of thumb is to focus on those foods sold along the perimeter of a supermarket. Vegetables, fruits, fish, poultry, dairy products, and bread are generally positioned along the outer borders of grocery stores. Cereals, candies, and processed foods are displayed in the aisles of the stores. Of course, whole grains such as oats, quinoa, rice, and wheat products such as pasta are located in the store aisles, as well. Being an educated consumer is the best way to shop for nutritious, disease-preventing foods. Cooking simple, delicious meals at home is the key to maintaining your family’s healthy eating habits.
Experts agree that physical activity is another key element in reducing the risk for cancer, diabetes, heart disease, and other diseases.
In particular, physical activity is associated with a reduced risk of cancer of the colon, breast, endometrium, lung, and prostate, and probably many other cancers, as well.
So, we can control our diet and our physical activity each day, end smoking, protect our skin from the sun, and thereby help reduce our cancer risk.
What about the factors that we cannot control? The harmful chemicals in our cleaning agents, personal-care products, cosmetics, clothing, toys, furniture, flooring and much more are a source of great concern. Consumers are not always aware of the chemical composition of the products they purchase, because manufacturers are not required to list on product labels all the ingredients contained in a given product. That means that we are able to purchase many common household and personal care products that contain “endocrine-disrupting chemicals” that affect our hormones and endocrine systems. Many of these hormones are “trans-generational,” meaning that they pass from pregnant woman to fetus through the placenta and breast milk.
According to the World Health Organization’s report on endocrine-disrupting chemicals in 2012, the rates of “endocrine-related cancers,” including breast, prostate, endometrial, ovarian, testicular and thyroid cancers, are increasing around the globe.
Contrary to what we would expect responsible government to do, most of the more than 80,000 chemicals manufactured in the United States are unstudied and unregulated. Yet, nearly 800 chemicals are known or suspected of affecting human hormones, and other deleterious effects are suspected of being caused by many other chemicals.
There is reason to believe that endocrine-disrupting chemicals are affecting fertility in both women and men. A large number of young men in some countries have low quality of semen, which decreases their ability to father children. Genital malformations in infant boys, including non-descending testes and penile abnormalities, have increased over time, as well as earlier breast development in girls. Obesity and type-2 diabetes have increased dramatically in the United States and worldwide in the last 40 years, and endocrine-disrupting chemicals are thought to be a significant factor contributing to this alarming rise.
What can be done to change this situation, which endangers children and adults? Government intervention is an essential element in protecting children and adults from harmful chemicals linked to cancer and other serious illnesses. Government bans or restrictions on lead, PCBs, chloropyrifos, and tributylin, for example, have contributed to decreases in a wide array of disorders in humans and wildlife. Effective federal and state laws are needed to regulate harmful chemicals, and prevent them from harming consumers. Let the 2016 “moon shot for cancer” emphasize the need to focus on prevention as the most effective way to reduce cancer incidence in America.
While industry and government call for more evidence of harms caused by endocrine-disrupting chemicals, they do not offer solutions to increase our scientific and medical knowledge and understanding. A coordinated, collaborative international effort is needed, that would combine the talents and resources of experts in many fields to clarify the role of cancer risk factors including endocrine disrupting chemicals and their profound effects on humans and wildlife.
On February 4th, National Cancer Prevention Day will be marked on Capitol Hill with an event sponsored by Less Cancer, a not-for-profit organization dedicated to the reduction of cancer risk through education and advocacy.
I will moderate a panel of highly acclaimed experts in cancer prevention. This year, the panel will include Drs. Colditz and Cohen, who will both share their insights on the influence of diet, exercise, and other lifestyle factors on the development of cancer. Other panelists include Dr. John Groopman, of Johns Hopkins Bloomberg School of Public Health, and Dr. David Christiani of the Harvard T.H.Chan School of Public Health, two experts in the field of environmental exposures and their effects on cancer incidence.
All four panelists will contribute to a dynamic conversation that will offer insights and practical advice to our audience. Change begins with knowledge, and National Cancer Prevention Day provides an excellent opportunity to highlight the preventable causes of cancer. Dr. John Groopman is also this year’s Ronald B. Herberman Memorial Speaker. Meghan O’Hara, director of The C Word Movie, will receive Less Cancer’s Leadership Award.
On February 4th and every day, let’s strive to be stronger, smarter, and healthier. Prevention is the key to a more vibrant America.