Four in 10 cancers could be prevented through risk modification

July 19, 2024

Source: Islami, et al CA: Cancer Journal for Clinicians July 11, 2024 LINK

The American Cancer Society has updated its estimates of the portion of cancers in the US related to modifiable risks. Researchers used cancer incidence and mortality and risk factor prevalence from 2019 to create these estimates through multiple simulations. The analysis includes 30 types of cancer but excludes non-melanoma skin cancers. The authors avoided using 2020 data due to fewer overall diagnoses during the pandemic.

Tobacco remains the number one risk factor for preventable cancer, contributing to 344,000 cases each year. Excess body weight contributes to 136,000 cases of cancer, and alcohol consumption is associated with about 97,000 potentially preventable cases of cancer. Ultraviolet light (mostly from the sun) contributes to 83,000 cancers (not including non-melanoma skin cancers), and physical inactivity contributes to 55,000 cases of cancer a year. Second-hand smoke contributed to over 6,000 cases of lung cancer annually.

Modifiable risk factors contributed to a substantial portion of many types of cancer in this analysis, including

●      Tobacco: lung (84%), larynx (58%), pharynx (52%) and nasal (50%) 

●      Excess weight : uterine (43%), breast (11%)

●      Ultraviolet radiation: Melanoma (92%)

●      HPV: human papillomavirus (100%), anal (94%)

Other notable findings:

-        31,000 cases of breast cancer (11%) were associated with excess weight

-        24,000 cases of oral, esophageal, pharynx and larynx cancer were associated with low fruit and vegetable consumption (about 30% of each cancer)

About 96,000 cases of colorectal cancer (two-thirds of all cases) were associated with a potentially modifiable risk factor:

Source: Islami, et al CA: Cancer Journal for Clinicians July 11, 2024 LINK

Implications for employers:

-        Promoting tobacco cessation remains a cornerstone of employee health. Employers can encourage smoking cessation programs, and are required to offer these without cost sharing. Many smokers need multiple attempts to successfully quit, and most smokers want to quit.  The National Comprehensive Cancer Center recommends offering those who want to quit effective drug therapy (nicotine or varenicline (Chantix)) and multiple counseling sessions.

-        For companies with employees that are mostly sedentary (i.e. sitting at a desk), employers can encourage walking meetings or other ways to have employees stretch and move throughout their day.

-        Over time, more use of effective GLP-1s is likely to lower the rates of some cancers, although that will take time and depend on coverage and unit cost.

-        Alcohol causes a striking amount of cancer and can also be associated with  concerning workplace behaviors, so employers should be cautious about alcohol at work-related alcohol events.

-        Better nutrition lowers the risk of cancer, and employers that have on-site cafeterias or even vending machines can promote healthy food.

-        Cancer is multifactorial. Even though many cases of cancer are caused by potentially modifiable risks, we must avoid blaming those who are unfortunate enough to get cancer.

Thanks for reading.  You can find previous posts in the Employer Coverage archive

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Monday:   Influenza infections strongly associated with heart attacks