Bottom Line of New Study: Colon Cancer is Quite Preventable

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A large proportion of colon cancer is preventable with healthy lifestyle choices, even without taking into account the benefits of screening.  That's the finding in a new analysis from the large Nurses' Health Study released in print last week in Cancer Causes & Control.  The analysis, done by researchers from Stanford and Harvard Universities, calculated the percentage of colon cancers in women that could be attributable to a combination of lifestyle choices that have been found in previous research to be established risk factors for the disease: overweight/obesity, lack of physical activity, alcohol intake, smoking, low multivitamin use, and low calcium intake.

Comparing women who had only one or none of these risk factors with women having two or more, the researchers found that 37 percent of colon cancer cases in women could be avoided through healthy lifestyle choices.  This proportion was even higher when aspirin use was considered.  Though not a lifestyle choice, per se, long term aspirin use has been shown in many well-designed studies to lower the risk of colon cancer.  When aspirin use of just twice a week for six years or more was added to the analysis, the percentage of cancers estimated as preventable rose to 43 percent.

These percentages are quite significant and do not even take into account the further benefit of colon cancer screening, which in addition to catching cancer early can also prevent the disease by finding (and removing) pre-cancerous growths.

Though some other analyses have estimated even greater proportions of cases potentially preventable, these new findings still demonstrate that colon cancer is a very preventable cancer - and with lifestyle choices that many women can follow.  Key steps for lowering the risk of colon cancer include:

• Getting screened, beginning at age 50, or earlier if you have a family history.  Talk to a doctor about which screening test is right for you and when you should start screening.  
• Keeping weight in check
• Not smoking
• Being physically active
• Drinking only moderately, if at all
• Limiting red meat, especially processed meat
• Getting enough calcium and vitamin D
• Considering a multivitamin

Regular aspirin use has also been found to lower the risk of colon cancer, but it has some important risks as well (such as serious bleeding). One recent analysis, though, suggests that regular aspirin use may have overall health benefits for some older adults. However, it's important that anyone considering taking aspirin regularly talk to a doctor about the potential risks and benefits before doing so.   

For more on screening and other steps to prevent colon cancer, see 8IGHT WAYS to Prevent Colon Cancer (PDF version).

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Top photo: Flickr/thomasletholsen

Making Strides in HPV Vaccination but Still a Long Way to Go

bPhoto: Melissa P

by Hank Dart

A federal report released at the end of July shows promising trends in rates of HPV vaccination in United States adolescents, but rates varied greatly between certain regions and left much room for improvement overall, especially for boys.

The recommended schedule for HPV (human papillomavirus) vaccination, which protects against cervical and other cancers, is three doses preferably beginning in early adolescence.   

  

Between 2013 and 2014, the report found that the number of girls ages 13 - 17 receiving all three doses of the vaccine increased around three full percentage points, from 37 percent to close to 40 percent.  Boys aged 13 – 17 increased by an even greater amount – 8 percentage points – but remained low compared to girls – at around 22 percent.   

Washington DC was the state/district with the highest rates of girls receiving three full doses, at 57 percent, with Tennessee having the lowest rate, at 20 percent.

The report goes on to highlight that most regions with increases in rates of vaccination developed and put in place multifaceted strategies specifically intended to improve use of the vaccine.  Among other efforts, these included approaches like, provider education, public outreach, automated vaccination reminders, and integration of vaccination goals into cancer control plans. 

Overall, these latest numbers are heartening but show that there is still a great deal that needs to be done.  Only 20 percent of adolescent boys and 40 percent of adolescent girls in the United States are getting the full protection from the HPV vaccine.  Given that HPV is a common infection and the primary cause of cervical cancer – as well as a risk factor for vaginal, penile, anal, and oropharyngeal cancers – it’s a great missed opportunity for prevention. 

Coverage of other standard vaccinations in these age groups in the United States can reach as high as 88 percent.  And that type of coverage should be possible with the HPV vaccine, for both boys and girls.  It will, however, take a concerted effort to do so.  These new numbers show it will most likely be worth it.

Reference

Reagan-Steiner, S et al. National, Regional, State, andSelected Local Area Vaccination Coverage Among Adolescents Aged 13 – 17 Years –United States, 2014. MMWR; 64:29; July 31, 2015.

More Than Zero: New Evidence That Any Amount of Physical Activity is Better Than None

Results from a large analysis released yesterday further confirm that getting even small amounts of physical activity is better than getting none if your goal is to live longer.

In the new paper, which combined results from nine cohort studies, researchers focussed on the possible mortality benefits of varying levels of physical activity in people age 60 and older. With over 120,000 participants followed an average of 10 years, the analysis found that compared to older adults getting zero exercise, those getting about 75 minutes a week of moderate-to-vigorous activity had a 22 percent lower risk of premature death.  Though it's unclear exactly why, women showed a greater reduction (32 percent) for this same activity level compared to men (14 percent).

What is notable about these findings is that 75 minutes a week of activity (15 minutes a day) is half the amount recommended by most exercise guidelines focussed on health.  And there are an increasing number of studies demonstrating the benefits of getting even just small amounts of physical activity on a regular basis - as long as it's more than zero.  We even posted a story in 2010 about a study that found that cycling just 5 minutes a day could significantly help with weight control.

Of course, reaching recommended levels of physical activity - and even going beyond them - has an even greater impact on health, well-being, and weight control.  In the current analysis in older adults, for example, the risk of dying further dropped to 28 percent in those getting recommended levels of activity of 150 minutes per week, with risk dropping 35 percent for those in the highest level of activity.

So, getting 150 minutes per week or more of moderate activity remains an important goal. But, to many people, especially those who've been sedentary for a long time or have health issues, 150 minutes per week can feel daunting.  Add to this the intimidating images we're exposed to on social media and television of sculpted Crossfit bodies and featherweight marathoners, and it can feel like fitness is an unattainable goal.   But what this study and others like it now show is that there is real benefit when someone simply moves from doing nothing to doing something.  And that's something almost everyone can do.  And it's a great place to start.

Photo: Creative Common License; Flickr/Nimo_ji

The full analysis appeared early online in the British Journal of Sports Medicine.