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Cancer in the news....

Half of all cancer deaths are preventable
by KRISTEN GERENCHER
MarketWatch

Cancer can strike anyone, even the fit and health-conscious, but dying from it is far from inevitable, according to a new report.

As many as half of cancer deaths could be prevented if more people made lifestyle changes such as avoiding smoking and excessive sun exposure, eating nutritiously and getting regular exercise and recommended health screenings, according to a study from the American Cancer Society.

Whether due to socioeconomic or personal challenges, many people have trouble following these common-sense health precautions, said Vilma Cokkinides, co-author of the report and program director of risk-factor surveillance for the American Cancer Society in Atlanta.

"What's astonishing is how small the numbers are in terms of the population actually doing these things," Cokkinides said. "It's a disconnect. . . . The awareness that theoretically half (of cancer deaths) could be prevented hasn't gotten in the mindset."

Smoking is by far the biggest sticking point because it increases the risk of many kinds of cancer, not just lung, and is expected to kill 170,000 this year. What's more, about a third of the 564,830 expected cancer deaths in 2006 will be related to poor diets, physical inactivity and obesity, which itself causes many chronic illnesses, the report said.

Americans have been receiving the anti-tobacco message for decades, but one in five adults still lights up. Despite calls for better nutrition and more physical activity to maintain a healthy weight, waistlines are growing dangerously wider. And few people do enough to protect their skin from the sun's harmful rays, leading to high rates of skin cancer.

People also fail to follow commonly recommended screenings based on age, family and medical history to catch cancer in its earliest, most treatable phases, the study said.

The ability to keep up with recommended screenings for colorectal, cervical and breast cancer - where evidence of effective treatment and reduced chance of death is greatest - is largely dependent on whether people have health insurance, Cokkinides said. "It's perhaps the single most important determinant."

Cancer's disease burden is significant. Last year, it cost the United States nearly $210 billion, according to estimates from the National Institutes of Health. The figure includes $74 billion in direct medical costs, $17.5 billion for lost productivity due to illness and $118.4 billion for productivity loss due to premature death.

To be sure, tasks such as maintaining a healthy weight can be difficult in environments that promote fast, unhealthful food and lack affordable fruits and vegetables, the study said.

Obesity has connections with postmenopausal breast cancer and colon cancer, Cokkinides said. Still, the number of children, teens and men who were overweight or obese grew significantly between 1999 and 2004, according to a study from the Centers for Disease Control and Prevention published in the April 5 issue of the Journal of the American Medical Association. Women's obesity rate appears to have leveled off, the study found.

Women's screening rates for breast and cervical cancer have increased over the years as awareness has grown, but the numbers are still modest. Only 55 percent of women 40 and older, the age at which annual screenings are supposed to begin, said they got a mammogram in the last year, the study said. Those who are uninsured, have the lowest incomes and least education as well as immigrants who've been in the country less than five years had even lower screening rates.

Colon and rectal cancers have a high survival rate when detected early, especially when precancerous polyps can be removed during colonoscopy. But only 39 percent of colon cancers are diagnosed at an early stage, when 90 percent of patients go on to survive at least five more years, according to the report.

Even when patients have a hereditary link with cancer, they can choose to have cancer-risk counseling that may help them take control if further prevention options or more aggressive screening is needed, said Dr. Jeffrey Weitzel, director of the Department of Clinical Cancer Genetics at the City of Hope Comprehensive Cancer Center in Duarte, Calif.

"Genetics isn't necessarily destiny," Weitzel said. "Advanced protocols . . . are designed to take what we know about breast cancer and epidemiology and turn it around in a way that might allow prevention."

Earlier diagnosis of breast cancer, for example, often allows not just for better odds of beating it altogether, but also better quality of life during treatment than was achievable even a few years ago, he said.

"Right now what we have is a good circumstance," Weitzel said. "We're having to try to figure out ever more carefully which of the early-stage patients truly need therapy and which could be spared, whereas previously we were hoping just to have a greater proportion of them be earlier-staged."

Weitzel recommended people interested in learning more about guidelines for screening and referrals, particularly those with a familial risk of cancer, visit the National Comprehensive Cancer Network's Web site at www.nccn.org or the City of Hope at www.cityof hope.org/ccgp.

As a general rule for those with a family history, "if there's cancer under the age of 50, breast or colon, that might warrant referral in cancer-risk counseling," he said. "That would be the starting point."

It's not just individuals who can improve their chances of surviving cancer by modifying their lifestyles and complying with recommended screenings. Social policies such as more statewide bans on indoor smoking and targeted cessation programs for teen smokers can help people develop healthier habits and, most importantly, stick to them to reduce their risk of dying from related disease, Cokkinides said.