Friday, February 27, 2009

First, everybody quits smoking. Then...

Americans could suffer one-third fewer cancers if we would just clean up our act. More exercise, more nutritious food – and the resultant decrease in obesity --could prevent about a third of all cancers in the U.S., according to a new report from the World Cancer Research Fund and the American Institute for Cancer Research (AICR).

The report: Food, Nutrition, Physical Activity and the Prevention of Cancer was presented on Capitol hill this morning.

Not blaming the victim
While their 2007 report on the science of cancer pinned down the avoidable causes, the current report emphasizes the social and cultural barriers to healthy patterns of behavior. "The 2007 expert report identified the specific choices that people can make to protect themselves against cancer, but actually making those healthy choices remains difficult for many people," said Shiriki Kumanyika, Ph.D.

"The policy report takes the next step -- it identifies opportunities for us as a society to make those choices easier," she said. Kumanyika, from the University of Pennsylvania School of Medicine, is a member of the report’s writing panel.

As they searched the international literature, authors asked two specific questions
  • What factors shape the patterns of behavior that affect cancer risk (diet, physical activity and body fatness)?
  • What effects have specific interventions had on those patterns of behavior?

You say “nanny state,” I say “village
To put the findings into action we need to ask: what kinds of social changes are effective?
At Yale, the Rudd Center studies obesity-fighting public health interventions in a politically sophisticated manner. (Full disclosure: I know this because I have a friend working hard on his PhD there!) The AICR media package includes recommendations -- and there are more for government than anybody. In addition to the obvious agriculture & health departments, the authors ascribe accountability to national and regional agencies responsible for science, employment, social security, housing, education, foreign affairs, home affairs, justice, urban and rural planning and development. Whew!

Not all cancers are created equal
As the table shows, the rates of obesity’s impact differ. And we know, of course that the rates of incidence of various cancers vary dramatically. Both high-impact and high-incidence cancers present opportunities to reduce suffering and, dare I say it, expense.

I hope to read crunches of these numbers soon. I’d love to see what 38 percent of breast cancers looks like in raw numbers. And I’d be similarly interested to see the incidence of pancreatic cancer put into this perspective. Since we know we have lousy screening and inadequate treatment options for pancreatic cancer, preventing it could make a particularly noticeable impact.

Hello, Congresswoman
Given our new national health policy interest in preventive medicine, I hope policymakers take advantage of this opportunity to absorb the information and its implications and take action.

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