The Fight Against Cancer: Whose Job Is It?
Karen Collins, MS, RD, CDN
American Institute for Cancer Research
The American Institute for Cancer Research (AICR) estimates that 30 to 40 percent of cancers are preventable. But if that much can be eliminated, who should take action and how? According to a new report from the Institute of Medicine (IOM), people need to change their habits for maximum cancer-stopping results. And health care providers, insurers, employers, policy makers and communities can also help.
Cancer screening tests canâ€™t prevent cancer, but by catching the diseaseâ€™s development in early stages, they can mean less drastic and more successful treatment. The IOM report, Fulfilling the Potential of Cancer Prevention and Early Detection, notes that screenings for breast, cervical and colorectal cancers are highly effective, yet greatly underused. The report recommends that health insurers offer more coverage for tests whose accuracy in detecting cancer is well supported. Reducing peopleâ€™s need to pay part of the screening costs might increase test use. In addition, the report urges health care administrators to develop effective screening reminder systems for physicians and patients.
Even if rates of screening improve, however, without large-scale preventive actions, cancer rates will increase alarmingly in the next 15 to 20 years. For instance, tobacco is a major cancer risk. The IOM report states that smoking cessation programs are effective for only 5 to 10 percent of those involved. Although thatâ€™s a small percentage of success, it ultimately adds up to a large number of individuals. Health care providers should follow smoking cessation guidelines to help smokers quit. Federal health programs should also cover smoking cessation. To discourage use of tobacco products even more, states should set prohibitively high taxes on them, and communities should reduce teen access to them. Attention to obesity, unhealthy diet and physical inactivity is also needed. Surveys show that many Americans are still unaware of the link between obesity and cancer risk. A recent study in the New England Journal of Medicine concludes that overweight and obesity may account for 14 to 20 percent of overall cancer deaths. Sedentary lifestyles may increase cancer incidence by making weight control more difficult and causing other more direct effects. A national strategy to address these issues is needed. There are also obvious changes that can occur at work, in communities and at school. Worksite fitness programs and on-site healthy eating choices are benefits that can pay off for employees and insurers. Communities can create comprehensive transportation plans with sidewalks, bike trails and safe places for physical activity. Funds are available to states to support these initiatives. Schools can institute healthy school lunches, physical education programs and after-school recreation. Overall, public understanding about the role of a healthy lifestyle needs to be strengthened. A few years ago, AICRâ€™s landmark report stressed the importance of a mostly plant-based diet with five to ten servings of fruits and vegetables daily. By providing phytochemicals, vitamins and fiber, this diet is strongly linked with a lower risk of cancer and better overall health. If people ate a mostly plant-based diet, exercised regularly and maintained a healthy weight, cancer rates could fall by 30 to 40 percent. Healthy lifestyles for lower cancer risk also involve limiting portions and avoiding excess alcohol, red meat and saturated fat. Although we are all responsible for our own conduct, the IOM report makes clear that we all â€“ health providers, insurers and individuals â€“ benefit by acting together to help prevent cancer.The American Institute for Cancer Research (AICR) offers a Nutrition Hotline (1-800-843-8114) 9 a.m. to 5 p.m. ET Monday-Friday. This free service allows you to ask questions about diet, nutrition and cancer. A registered dietitian will return your call, usually within 48 hours. AICR is the only major cancer charity focusing exclusively on the link between diet, nutrition and cancer. The Institute provides education programs that help millions of Americans learn to make changes for lower cancer risk. AICR also supports innovative research in cancer prevention and treatment at universities, hospitals and research centers across the U.S. The Institute has provided more than $65 million in funding for research in diet, nutrition and cancer. AICRâ€™s Web address is www.aicr.org. AICR is a member of the World Cancer Research Fund International.