Study: Half of Cancer Deaths Preventable With Healthier Lifestyle

Half of all cancer deaths and 20% to 40% of cancer cases in the United States could potentially be prevented if individuals adopted healthier lifestyles, according to a study published in JAMA Oncology.

“These findings reinforce the predominate importance of lifestyle factors in determining cancer risk,” wrote the study authors Mingyang Song, MD, ScD, and Edward Giovannucci, MD, ScD, of the Harvard T.H. Chan School of Public Health and Harvard Medical School in Boston. “Therefore, primary prevention should remain a priority for cancer control.”

The lowest cancer risk group in the study consisted of individuals who were never-smokers or past smokers, consumed no or a moderate amount of alcohol (less than or equal to one and two drinks for women and men, respectively), had a body mass index (BMI) between 18.5 and 27.5, and maintained a moderate weekly exercise routine of at least 75 vigorous-intensity or 150 moderate-intensity minutes. All other individuals were categorized as high risk.

The researchers analyzed cancer and lifestyle data from the Nurses’ Health Study, the Health Professionals Follow-up Study, as well as US national cancer statistics to establish associations between cancer incidence and mortality and lifestyle.

The analysis included 89,571 women and 46,339 men from two cohorts. A total of 16,531 women and 11,731 men fell into the low-risk group, while 73,040 women and 34,608 men made up the high-risk group.

The authors calculated population-attributable risk (PAR), which is the fraction of cancer cases that wouldn’t occur if all individuals in the cohort had the healthy lifestyle traits of the low-risk group. 

The PARs for incidence and mortality of all cancers were 25% and 48% in women, and 33% and 44% in men, respectively, meaning that these percentages of cancers could be prevented. For lung cancer the PARs in women and men were 82% and 78%, respectively. The PARs in women and men were 29% and 20% for colorectal cancer, 30% and 29% for pancreatic cancer, and 36% and 44% for bladder cancer.

The PARs were 4% and 12% for breast cancer incidence and mortality.

Because the cohort study included only white individuals, these results may not necessarily be generalizable to other ethnic groups. The authors noted, however, that the lifestyle factors analyzed in the study were established risk factors for other ethnic groups as well.

“As a society, we need to avoid procrastination induced by thoughts that chance drives all cancer risk or that new medical discoveries are needed to make major gains against cancer, and instead we must embrace the opportunity to reduce our collective cancer toll by implementing effective prevention strategies and changing the way we live,” wrote Graham A. Colditz, MD, DrPH, and Siobhan Sutcliffe, PhD, of the Washington University School of Medicine in St. Louis, in an accompanying editorial. “It is these efforts that will be our fastest return on past investments in cancer research over the coming decades.”