Cancer prevention

Cancer prevention is the practice of taking active measures to decrease the incidence of cancer and mortality. The practice of prevention is dependent upon both individual efforts to improve lifestyle and seek preventative screening, and socioeconomic or public policy related to cancer prevention. Globalized cancer prevention is regarded as a critical objective due to its applicability to large populations, reducing long term effects of cancer by promoting proactive health practices and behaviors, and its perceived cost-effectiveness and viability for all socioeconomic classes. Cancer prevention is the practice of taking active measures to decrease the incidence of cancer and mortality. The practice of prevention is dependent upon both individual efforts to improve lifestyle and seek preventative screening, and socioeconomic or public policy related to cancer prevention. Globalized cancer prevention is regarded as a critical objective due to its applicability to large populations, reducing long term effects of cancer by promoting proactive health practices and behaviors, and its perceived cost-effectiveness and viability for all socioeconomic classes. The majority of cancer cases are due to environmental risk factors, and many, but not all, of these environmental factors are controllable lifestyle choices. Greater than a reported 75% of cancer deaths could be prevented by avoiding risk factors including: tobacco, overweight / obesity, an insufficient diet, physical inactivity, alcohol, sexually transmitted infections, and air pollution. Not all environmental causes are controllable, such as naturally occurring background radiation, and other cases of cancer are caused through hereditary genetic disorders. Current gene editing techniques under development may serve as preventative measures in the future. Future preventative screening measures can be additionally improved by minimizing invasiveness and increasing specificity by taking individual biologic make up into account, also known as 'population-based personalized cancer screening.' Anyone can get cancer, the age is one of the biggest factors that can make a person more likely to get cancer: 3 out of 4 cancers are found in people aged 55 or older. While many dietary recommendations have been proposed to reduce the risk of cancer, the evidence to support them is not definitive. The primary dietary factors that increase risk are obesity and alcohol consumption; with a diet low in fruits and vegetables and high in red meat being implicated but not confirmed. A 2014 meta-analysis did not find a relationship between fruits and vegetables and cancer. Consumption of coffee is associated with a reduced risk of liver cancer. Studies have linked excessive consumption of red or processed meat to an increased risk of breast cancer, colon cancer, and pancreatic cancer, a phenomenon which could be due to the presence of carcinogens in meats cooked at high temperatures. Dietary recommendations for cancer prevention typically include an emphasis on vegetables, fruit, whole grains, and fish, and an avoidance of processed and red meat (beef, pork, lamb), animal fats, and refined carbohydrates. Research shows that regular physical activity helps to reduce up to 30% the risk of a variety of cancer types, such as colon cancer, breast cancer, lung cancer and endometrium cancer. The biological mechanisms underlying this association are still not well understood but different biological pathways involved in cancer have been studied suggesting that physical activity reduces cancer risk by helping weight control, reducing hormones such as estrogen and insulin, reducing inflammation and strengthening the immune system. The concept that medications can be used to prevent cancer is attractive, and evidence supports their use in a few defined circumstances. In the general population, NSAIDs reduce the risk of colorectal cancer however due to the cardiovascular and gastrointestinal side effects they cause overall harm when used for prevention. Aspirin has been found to reduce the risk of death from cancer by about 7%. COX-2 inhibitor may decrease the rate of polyp formation in people with familial adenomatous polyposis however are associated with the same adverse effects as NSAIDs. Daily use of tamoxifen or raloxifene has been demonstrated to reduce the risk of developing breast cancer in high-risk women. The benefit verses harm for 5-alpha-reductase inhibitor such as finasteride is not clear. A study showing a proof-of-principle has also been done with the human proteins IFNalpha2a and macrophage-CSF, produced by genetically modified hens. Vitamins have not been found to be effective at preventing cancer, although low blood levels of vitamin D are correlated with increased cancer risk. Whether this relationship is causal and vitamin D supplementation is protective is not determined. Beta-Carotene supplementation has been found to increase lung cancer rates in those who are high risk. Folic acid supplementation has not been found effective in preventing colon cancer and may increase colon polyps. A 2018 systematic review concluded that selenium has no beneficial effect in reducing the risk of cancer based on high quality evidence. However, more studies are needed to determine whether individuals with a specific genetic background or nutritional status may benefit, and whether certain formulations of selenium may have an effect on risk. Anti-cancer vaccines can be preventative / prophylactic or be used as therapeutic treatment. All such vaccines incite adaptive immunity by enhancing cytotoxic T lymphocyte (CTL) recognition and activity against tumor-associated or tumor-specific antigens (TAA and TSAs). Vaccines have been developed that prevent infection by some carcinogenic viruses. Human papillomavirus vaccine (Gardasil and Cervarix) decreases the risk of developing cervical cancer. The hepatitis B vaccine prevents infection with hepatitis B virus and thus decreases the risk of liver cancer. The administration of human papillomavirus and hepatitis B vaccinations is recommended when resources allow.