Physical Activity Lowers Cancer Risk - More People Should Probably Know That

A new study has found that a large majority of the public may be unaware that lack of physical activity can increase the risk of cancer.

The study, out of Washington University in St. Louis and published Wednesday in the Journal of Health Communication, included a diverse sample of participants who were asked to list three diseases caused by physical inactivity. Just three percent of 351 respondents listed cancer, while over 60 percent listed diseases such as heart disease or diabetes.

These findings add to those of other studies and surveys that have shown that: while many people know that a healthy lifestyle overall can help prevent cancer, many are often unsure about the exact types of behaviors that can lower cancer risk.

A 2017 American Institute for Cancer Research (AICR) survey, for example, found that the vast majority of respondents knew that smoking and sun exposure increased cancer risk, yet well under half identified physical inactivity as a risk factor.

There is a large amount evidence, however, showing the benefit of regular physical activity in relation to cancer.  It can lower the risk of breast cancer, colon cancer, and endometrial cancer. It can help with weight control - a key cancer risk factor. And in cancer survivors, it can improve mood, boost energy level, and possibly lower the chance of recurrence.

Physical activity has been an integral part of the Siteman Cancer Center's Your Disease Risk tool since its launch in 2000, and regular physical activity is recommended throughout Siteman's 8IGHT WAYS cancer series (see below).

Erika Waters, lead author of the Washington University study and Associate Professor of Surgery at the School of Medicine, commented: "People might be more likely to exercise if they understand just how important physical activity is to their overall health - not just their heart health."

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Boston Nutrition Obesity Research Center: 25 Years of Progress on the Links Between Overweight and Cancer

At today's annual symposium of the Boston Nutrition Obesity Research Center (BNORC), CNiC's Dr. Graham Colditz delivered a plenary session talk reviewing BNOCR's 25-year contribution to the science on obesity and cancer.

A past associate director of the Center, Colditz also paid tribute to groundbreaking nutrition researcher, George Blackburn, who passed away in February 2017 and played a key leadership role in establishing BNORC and fostering its important work. In addition to discussing Blackburn's role in advancing such fields as obesity economics, chronic disease prevention, and bariatric surgery, Colditz also recounted how Blackburn's driven nature also translated to his driving habits on Boston's infamous roads, with oftentimes exciting results.

"George offered to drive me back to my office on Longwood Avenue," said Colditz. "I accepted, and am pleased to say I survived a dash through city traffic with George at the wheel, a harrowing experience I expect many other here have shared over the years." 

Despite the stress his driving may have caused in others, Blackburn, and BNORC in general, did a great deal to help shape our current understanding of health and prevention.  Key studies showed the important role of adult weight gain on the risk of heart disease and breast cancer - and that BMIs within the upper end of the "normal" weight range could still significantly increase the risk of diabetes and heart disease.

Findings like these played an important role in shaping national health policy, possibly most notably with the practical recommendation in the 1995 Dietary Guidelines for Americans that adults should "maintain or improve weight," rather than simply focus on trying to achieve a healthy weight, which is not practical for many people. Simply avoiding future gain could have large benefits across many types of diseases and across the nation.

Other advances the work of BNORC played a role in was in identifying links between overweight and cancer, with much of this work foundational to a 2016 International Agency for Research on Cancer (IARC) report detailing the strong association between excess weight and 13 different cancers, including: breast, colon and rectum, endometrial, esophageal (adenocarcinoma), gallbladder, gastric, kidney (renal cell), liver, multiple myeloma, ovary, pancreas, and thyroid.

As our understanding of the weight-cancer link grows, said Colditz, we may in the future be better able to personalize lifestyle recommendations for people - to help them lower their future risk of cancer or improve their prognosis as cancer survivors. As well, we may better be able to understand how to allocate resources across the population for maximum impact.

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"BNORC: Contribution over 25 years to evidence on obesity and cancer."- Graham A. Colditz, MD, DrPH. Boston Nutrition Obesity Research Center Annual Symposium and Tribute to George Blackburn, MD PhD, Boston, MA (July 10, 2017).

Large Study Further Confirms Overweight & Obesity Increase Risk of Premature Death

 A "normal" weight - with BMI between 22.5 and 24.9 - was linked to lowest risk

by Hank Dart

It turns out that a healthy weight is a healthy weight. That's the essential conclusion of a large and well-designed new study looking at long term weight and its relation to premature death.

What makes this seemingly common sense finding especially newsworthy is that it runs counter to some recent high-profile studies that have concluded that being overweight or slightly obese may actually provide the best protection against premature mortality, even more so than being at what is classified as a "normal" or "healthy" weight.

Not surprisingly, these past "obesity paradox" studies made a splash in both the media and scientific circles, grabbing headlines the world over.

Yet, many researchers had concerns about the design of these studies, and therefore the

trustworthiness of their findings. The main issue was that the studies did not seem to adequately take into account smoking status and pre-clinical disease, which can have an important impact on both weight and the risk of death. Pre-clinical disease is an illness that has not yet been diagnosed but that can lead to weight loss and increased risk of dying. And weight loss from such illness can happen many years before it is diagnosed. Likewise, smokers also tend to weigh less and have a higher risk of dying. Unless a study is designed correctly, each of these factors can incorrectly sway results to show that being a normal weight increases the risk of death, and being overweight lowers risk.

This new study, performed by researchers at the Harvard School of Public Health and Harvard Medical School, was design to address such issues by using participants' maximum weight over a 16-year period. This way, the impact of weight loss due to pre-clinical disease could be limited. A participant with a maximum weight in the "normal" category, for example, would not have gotten there by losing weight -- such as due to an unknown illness.

 

Following 225,000 middle-aged men and women for another 8 - 20 years, the researchers found a steady increase in risk of premature death with overweight and obesity, compared to normal weight (see figure). Underweight also increased risk in women. The lowest risk of premature death was with a body mass index (BMI) between 22.5 - 24.9, which is a weight of 148 - 164 pounds for someone 5 feet, 8 inches tall.

While these findings are not necessarily surprising - since they fall in line with the guidelines for healthy weight and unhealthy weight - they are quite an important counter to the widespread "obesity paradox" coverage. Next to smoking, weight is the most important health issue in the nation - and increasingly the globe. In addition to lowering quality of life, overweight and obesity increase the risk of heart disease, diabetes, stroke, osteoarthritis, liver disease, and thirteen different cancers. 

Working to maintain a healthy weight remains one of the best things people can do for their health and well-being.  While it's not easy, it's certainly worth it. 

See our recent post for simple tips to help keep weight in check.

 

Photo: Mini-me-7 by Marcel Oostervijk (CC License, CC BY-SA 2.0) (Edited: Cropped)

Compelling Evidence on Overweight & Cancer Compels Action

An editorial published in today's British Medical Journal (BMJ) by Cancer News in Context's Yikung Park and Graham Colditz makes the strong case that it's time to take action to combat weight-related cancers.  The editorial addresses a new "umbrella review," also published in the BMJ today, that found strong evidence that overweight and obesity increases the risk of 11 types of cancer.

The review, by Maria Kyrgiou and colleagues, collected and analyzed over 200 systemic reviews and meta-analyses that included data on 36 different cancers. Of these, the researchers found strong links between various measures of overweight and an increased risk of cancers of the esophagus (adenocarcinoma), stomach, colon, rectum, biliary tract, pancreas, breast, endometrium, ovary, and kidney, as well as multiple myeloma.

In their editorial, Park and Colditz, point out key differences between the conclusions of the umbrella review and a 2016 International Agency for Research on Cancer (IARC) report, which Colditz headed, and which concluded that there is sufficient evidence that overweight and obesity increased the risk of 13 types of cancer. Differences between the findings of the two papers, Park and Colditz write, could be related to differences in the type of studies included in the analyses and the methods used to assess the studies that were included. Among other things, the:

"IARC report clearly demonstrated the importance of assessing the quality of each meta-analysis, including search strategy, inclusion and exclusion criteria, and data extraction, which is often outside the scope of an umbrella review"

Despite some important differences between the IARC report and umbrella review, the findings of the new review further bolster the evidence that overweight and obesity cause cancer. As Park and Colditz write:

"Though some specifics remain to be worked out, the unavoidable conclusion from these data is that preventing excess adult weight gain can reduce the risk of cancer."

The American Institute for Cancer Research estimates that overweight and obesity cause over 130,000 cancers each year in the United States, and millions annually lose their lives to weigh-related cancers worldwide. As the obesity epidemic continues largely unabated, the tragedy of these numbers will only worsen if we stay on the same course. Among other efforts to address the issue, Park and Colditz conclude, we need to tap the currently unmet potential of the healthcare system:

"Given the critical role of healthcare providers in obesity screening and prevention, clinicians, particularly those in primary care, can be a powerful force to lower the burden of obesity related cancers, as well as the many other chronic diseases linked to obesity such as diabetes, heart disease, and stroke. The data are clear. The time for action is now."

Doubling Down on Prevention: Heart Disease & Cancer's Shared Risk Factors

Even in parts of the country experiencing an early thaw, winter starts to feel a bit long by the end of February.  The days are still short. The temps are still low. And the trees are still mostly bare. 

Yet, even amidst all that, we can still take heart.  Not just because we're about to crest into March, and the first days of spring, but because February is literally "Heart" month.  American Heart Month - A federally designated month focused on raising awareness of the importance of heart disease and the steps that can help prevent and manage it. 

On top of this, February also happens to be Cancer Prevention Month, which is amazingly apt.  Heart disease and cancer are the first and second leading causes of death in the United States (see figure), together accounting for approximately 1.2 million deaths each year.  This takes an incredible toll on individuals and their families, as well as on the nation's health as a whole.  

Yet, at the same time, there's a positive message in the middle of the depressing numbers. Both heart disease and cancer are very preventable, which offers wonderful opportunities to make gains against the diseases. Approximately three quarters of heart disease and half of cancers could be avoided with overall healthy lifestyles. And most of the steps that lower the risk of one, also lower the risk of the other.

Shared health behaviors that can lower the risk of both heart disease and cancer, include:

• Avoiding tobacco (and secondhand smoke)

• Maintaining a healthy weight

• Being physically active

• Eating a healthy diet - rich in fruits, vegetables, and whole grains; and low in unhealthy fats and red/processed meat

• Getting screening tests, for certain cancers and heart disease risk factors - Talk with a doctor about which apply to you

• Considering taking a daily low-dose aspirin, if age 50 - 69 - But talk with a doctor first 

Health recommendations often fall into silos of information.  Breast cancer in this silo.  Heart disease in that one.  And colon cancer over there. This can make it easy to miss how important some basic healthy behaviors can be for preventing many key chronic diseases.  Yet it's hard to overstate the potential impact of a handful of healthy behaviors.

So, while we're getting ready to shed some layers and get outside more often as the calendar moves toward spring, why not use these last, focused days of winter to think about one or two things you can do to give a boost to your health and lower your risk of heart disease and cancer? 

• Add one more piece of fruit to your lunch a few days a week.  

• Buy that cereal that has whole gains as a first ingredient. 

• Search for some new meatless recipes to try.  

• Visit smokefree.gov for information about quitting smoking.  

• Tell yourself you're going to do something physically active every day -- no matter how small.  

• Call your clinic or doctor's office to see if you're up-to-date on recommended health screenings and make an appoint to get caught up if you're not. 

Doing these things is probably easier than you think, and the benefits of doing them probably greater. You've got this.

For more tips on making healthy changes, see 8IGHT WAYS to Stay Healthy and Prevent Cancer.  For personalized prevention plans and estimate of your risk of cancer, heart disease, and other conditions, see Your Disease Risk.

The Importance of Taking an Honest Look at Your Child's Weight

It's not news that parents can sometimes have blinders on when it comes to their kids. It's only natural that we look for all the positives in our children and downplay any possible negatives.

And this is just what seems to be happening with parents and the loaded issue of their child's weight.  Parents of overweight kids can have real trouble understanding that their child is actually overweight.  One 2013 review of studies found that over 60 percent of parents of overweight kids didn't know that their child was overweight.  And for young kids (ages 2 - 6 years), this number rose to over 85 percent.

While a child's weight has no bearing on his or her character or worth, it can have important lifelong implications for health.  Overweight children are at much greater risk of becoming overweight adults, which can then put them at increased risk for a host of weight-related issues ranging from diabetes and cancer to stigmatization and lower lifetime earnings.

With 17 percent of US youth ages 2 - 19 obese and nearly 6 percent extremely obese, it's important that parents, health professionals, and health systems try to be honest about childhood weight so that children have the chance to build healthy behaviors that will benefit them throughout life.

For parents, a good place to start is the CDC’s BMI Calculator for Child and Teen.  This tool uses a special calculation of weight, height, gender, and age to estimate whether a child is underweight, normal weight, overweight, or obese.  Because children are still growing and developing, these labels are not always perfectly accurate, so it’s important to bring up any concerns about your child’s weight directly with a healthcare provider.

Additional tips:

• Keep track of your child’s weight, but don't obsess about it, and bring up any concerns with a health care provider.
• Help your children focus on healthy food choices and healthy activities rather than on weight and body image.
• Give your children the chance to be physically active every day.
• Limit sweets and processed foods, which are often high in calories as well as carbohydrates that can stimulate hunger.
• Limit TV, tablet, computer, and other screen time to under two hours a day. The less, the better.
• Help your children get enough sleep by setting a bed time and sticking to it every day. Keeping electronics out of the bedroom also helps.

It's a simple step really -- taking an honest look at our child's weight.  But it can be a key step for helping a child move toward lifelong good health.

Photo: Family Walk by Thomas Leth-Olsen  (CC License, CC BY 2.0)

Weighty Evidence: New Report Further Highlights Importance of Overweight and Cancer Risk

A new international report released today further highlights the important role that overweight and obesity play in the development of cancer.  Produced by the International Agency for Research on Cancer (IARC) and released in the New England Journal of Medicine, the report, Body Fatness and Cancer — Viewpoint of the IARC Working Group, finds that approximately 4.5 million deaths worldwide are caused each year by cancers related to overweight and obesity.

For thirteen cancers, there was "sufficient" evidence to conclude that excess weight significantly increased risk of developing the disease. This was eight more cancers than was included in the similar IARC report published in 2002. Esophageal (adenocarcinoma) and uterine (corpus uteri) cancers had the highest risks.  Comparing the highest body mass index (BMI) category with the normal category, there was a nearly 5 times increased risk for developing esophageal cancer, and just over 7 times increased risk for uterine cancer.  Risk increases for other cancers ranged between a 10 percent increase in risk to a 80 percent increase in risk, and included cancers ranging from ovarian and breast cancer to pancreatic cancer and multiple myeloma.  

Cancer News in Context's Graham Colditz chaired the IARC working group that developed the statement.  In a Washington University School of Medicine media release about the findings of the working group, he stated:

“Significant numbers of the U.S. and the world’s population are overweight. This is another wake-up call. It’s time to take our health and our diets seriously.” 

Looking at the data as a whole, the report concludes that maintaining a healthy weight can lower cancer risk, and though solid evidence in humans is still developing -  that losing excess weight likely can as well.

Battling weight is a lifelong struggle for most people, and the US and global obesity epidemic has complex and multiple origins. To make real progress against the epidemic, we need to create a society that enables and fosters healthy activity and food choices.  Individual choice is just one part of the larger approach.  The Obesity Prevention Source, developed by our colleagues at the Harvard School of Public Health, provides a guidebook for tackling these broader issues, targeting policy makers, health professionals, and motivated citizens.

For those looking for help getting started with personal healthy choices for weight control, the federal site, Nutrition.gov, is a good place to begin - as is our own post: Some Simple Tips for Keeping Weight in Check.

Some Simple Tips for Keeping Weight in Check

Although keeping weight in check can be a tall order in this day of dollar menus and smartphones, it’s well worth the effort.  The cancer benefits alone are huge.  When the impact on heart disease, diabetes, blood pressure, and good old-fashioned quality of life are added, the benefits become enormous.  Try these simple steps:

• ‪Exercise, exercise, exercise. Being active is one of the best ways of controlling weight.
• Watch the calories. It sounds simple, but it’s worth saying: calories matter when in comes to weight gain and weight loss. When you sit down for a snack or meal, take some time to think about how much you’re eating and when you’ve had enough.
• Weigh yourself – every day. Weighing yourself regularly can help you keep on track with your weight goals.
• ‪Go Mediterranean. A diet rich in fruits, vegetables, whole grains, and healthy oils (like olive oil) can make you feel full, help regulate your appetite, and actually taste really good.
• ‪Choose smaller portions and eat more slowly. Slow down and give your body a chance to feel full before you move on to seconds.
• ‪Be a mindful eater. Food is big business, its main goal is to get you to eat.  Try to listen to what your body is telling you, not what the food business wants you to hear.

Large-Scale Problem: Obesity Rates Still Increasing in Certain Groups

by Hank Dart

The course of the obesity epidemic in the United States has been so bad for so many years that even minor victories have been cause for celebration. But despite some bright spots in the most recent Centers for Disease Control and Prevention reports on national rates of obesity (on adults, on youth), there's little celebrating going on.  The reason?  Some striking milestones in the rates of obesity in both women and teenagers.

The rate of obesity in US women -- which for most of the past decade rested around 35 percent -- has now surpassed 40 percent -- rising from 35.7 percent in 2005/6 to 40.5 percent in 2013/14, the most recent years for which there are data. And this overall number doesn't tell the complete picture, as the burden of obesity isn't shared equally across all groups.  The rate of obesity is around 38.2 percent in white women, 46.9 percent in Hispanic women, and 57.2 percent in black women.  Asian women have the lowest rate, at around 12.4 percent.

While the numbers in men are concerning as well, they've stabilized somewhat over the past decade, bouncing around the mid-30s, with the most recent report finding that 35 percent of men in the United States are obese. As with women, the numbers for men vary by age, with Asians having the lowest rate (12.6%) and blacks the highest (38%).

The new numbers for youth are not quite as striking - but remain concerning as well.  They show that over the past 25 years the rate of obesity in adolescents and teenagers has nearly doubled -- from 10.5 percent to 20.6 percent -- with the overall rate of obesity in youth ages 2 - 19 years old now at 17 percent, up from 10 percent in 1988.

There are, however, two positive trends in younger kids, with rates of obesity dropping since 2004 in 2 - 5 year olds and leveling off since 2008 in 6 - 11 year olds.

The overall picture of obesity in America, however, can be quite discouraging, even for the optimists who tend to work in public health. The epidemic began over two decades ago, and no efforts so far have been able to make real strides in reversing it. And the health, quality of life, and fiscal implications are enormous.

In a recent Viewpoint in the Journal of the American Medical Association, David Ludwig, MD of Harvard Medical School and the New Balance Foundation Obesity Prevention Center writes that the latest evidence may support predictions that the obesity epidemic and its health consequences may begin to shorten life expectancy in coming generations. While advances in the treatment of obesity-related chronic diseases like heart disease, diabetes, stroke, and cancer have kept mortality rates of these disease relatively stable or on the decline, a new provisional report on death rates suggests that mortality rates may now be increasing for some diseases.  The obesity epidemic could be creating more disease, and more serious disease, that advances in treatment can no longer keep up with.

Making progress against the epidemic is going to be essential if we are to help prevent growing rates of disease in the years and decades ahead.

In addition to bolstering research on the causes and prevention of weight gain, we need to support efforts that help people make and maintain healthy food and activity choices.  As with the fight against tobacco, this means multi-pronged, multi-layered approaches - such as improved food and activity offerings in schools and workplaces, taxes on unhealthy foods, subsides for healthy foods, widespread communication campaigns, and infrastructure that allows people to easily and safely fit activity into their days.  The social, financial, and structural environment that surrounds us is key to making and sustaining healthy behaviors.

Stemming the tied of weight gain in the US will not be easy, but it's essential that as a society we garner the will to put in place a concerted effort that will benefit current and future generations.

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See also:

Other Cancer News in Context posts addressing cancer, chronic disease, and weight.

Potential of Prevention: Only 3 Percent of Us Meet 4 Key Health Behaviors

by Katy Henke

When it comes to leading a healthy lifestyle, let's just say that Americans have a lot of room for improvement. That's according to a recent study published in Mayo Clinic Proceedings that found that only 2.7 percent of U.S. adults practice four key behaviors that can improve health and lower the risk of important chronic diseases.

The study analyzed data from more than 4,700 people who volunteered for the U.S. National Health and Nutrition Survey. Researchers were specifically interested in learning how many Americans follow four key guidelines for living healthy: not smoking, eating a healthy diet, exercising a moderate amount, and keeping body fat in a healthy range.

Around 34 percent did one of these healthy behaviors. Around 37 percent did two. Just under 3 percent did all four. And 11 percent did none at all.

What these results show is that the great majority of Americans can make changes in their lifestyles that can have an important impact on their risk of the most common diseases in the US, including heart disease, stroke, type 2 diabetes, and cancer. At least half of these diseases can be prevented by things we can all do.

So what can we do to create a healthy lifestyle? It’s pretty straightforward.

1. If you smoke, try quitting immediately. Quitting can be the best thing you do for your overall health. Contact 1-800-QUIT-NOW or smokefree.gov today for ways to quit and support along the way.
2. Exercise regularly. It’s recommended that adults exercise at a moderate level for 150 minutes each week. Think of that as 30 minutes each day for 5 days a week. Walk with your family after dinner, play games with your children or dance at home. Any amount is better than none.
3. Eat a healthy diet. Focus on fruits, vegetables, and whole grains. Remember to cut back on red meats and unhealthy saturated and trans fats. Consider a multivitamin with folate for a little boost to your diet.
4. Maintain a healthy weight. Focus on exercising daily and eating a healthy diet. It's also important to watch portions, eat slowly, and be especially mindful of how much you eat. Calories really matter. 

In addition to these four strategies, check out Your Disease Risk, an online prevention tool that estimates your risk of important chronic diseases and offers personalized tips for lowering risk.

Change can be hard. And living a healthy lifestyle isn't always easy -- Just ask the 97 percent of folks who missed perfect marks in this latest study. But decades of research show that it’s worth the effort, greatly lowering the risk of many diseases and improving overall health.

Get started today, and you'll be well on your way to a healthier you.

Photo: Dallas Farmers Market 2 by Allen Sheffield (CC License, CC BY 2.0)

Siteman Cancer Center's Program for the Elimination of Cancer Disparities Celebrates 10 Years

by Katy Henke

2015 marked 10 years for The Program for the Elimination of Cancer Disparities (PECaD). PECaD, a National Cancer Institute-funded program, works to eliminate cancer disparities through cancer prevention and treatment. To celebrate 10 years of accomplishment and collaboration in the community, PECaD hosted an evening of achievement on September 15, 2015, presenting updates, overviews and recognition to those who have been involved with the organization throughout the years.

Dr. Graham Colditz welcoming attendees to the celebration.

 During the celebration, individuals were updated on the three community partnerships that have active participation in the community, addressing breast cancer, prostate cancer, and colorectal cancer. The partnerships were able to recognize key individuals for their participation and dedication in helping promote cancer education and prevention. A tribute was also included for those individuals who PECaD has lost throughout the years.

The evening  recognized recent community research fellows training graduates as well. This PECaD program aims to engage community members in a 15-week curriculum that focuses on teaching community members the basics of community-based participatory research in order to help underserved populations. Throughout PECaD’s existence, over 100 community members have completed this course, which has led to pilot projects in the community continuing the PECaD mission.

PECaD focuses on strengthening community partnerships to help reduce cancer disparities by working with individuals, organizations, cancer survivors, and advocates as well as researchers to create awareness, promote prevention, screenings and education, and provide resources to the community. In collaboration with  the Siteman Cancer Center, PECaD attends community outreach events, provides training to clinicians and community members as well as continues cancer disparities research and quality improvement efforts.

In 10 years of community engagement and support, PECaD has grown exponentially - and continues to do so. Over the past year alone, among other accomplishments (see infographic), PECaD has placed 17 billboards with cancer prevention messages, developed new partnerships with community organization, published 30 scientific papers, and trained community members as research fellows.

 

(full size PDF)

PECaD is funded by the NCI (U54 CA153460), the Foundation for Barnes-Jewish Hospital, Washington University School of Medicine and the Siteman Cancer Center. Click Here to learn more about PECaD.

New Study Shows Being Sedentary is Bad for Physical and Fiscal Health

Creative Commons photo (cropped): Flickr/hjl

There is no magic bullet that will guarantee good health.  That's just an unfortunate fact of life.  But there is something that can help stave off heart disease, diabetes, cancer, osteoporosis, and depression, while also helping us maintain a higher quality of life as we get older.  And it's largely free and accessible to just about everyone: physical activity.

We've written a lot over the years here on Cancer News in Context about the benefits of being active, but not very much about the economic costs of being inactive - both for individuals and for the nation as a whole.  Yet, with the nation growing older and health care costs continuing to accelerate, there's a fantastic need to highlight effective and simple approaches to address such issues. And a new study out this month in Progress in Cardiovascular Diseases highlights just how important regular physical activity is to the physical and economic health of the nation.

The Ongoing Challenge to Secure Resources for Cancer Prevention

The ongoing challenge of garnering appropriate resources and recognition for cancer prevention was highlighted yet again by a recently released paper in the Journal of Cancer Policy titled Cancer economics, policy and politics: What informs the debate? Perspectives from the EU, Canada and US.

The overall goal of this paper was to assess the factors that are informing and influencing the political debate on cancer economics in the United States, Canada, and Europe.  That the analysis focuses on cancer diagnosis and treatment isn't surprising.  What is surprising, however, is that a paper on the economics of the burden of cancer and cancer care almost completely ignores prevention.

If there is one thing that has become clear over the past decade it is that cancer is a problem we will not be able to treat our way out of.  With the aging population, prevalence of the disease is increasing so much, and the disease itself is simply so diverse, that therapies are very unlikely to have a major impact on cancer burden population-wide in the foreseeable future.

We know enough today, however, to prevent at least half of all cancer cases.  Yet, the word "prevention" appears exactly once in this paper, and the concept of prevention appears only in passing in a handful of places throughout.

Of course, this single paper isn't responsible for cancer prevention not receiving its due attention.  It is, however, an example of many cancer-related policy papers that don't fully acknowledge the potential of prevention in reducing population-wide cancer burden.

As CNiC's Graham Colditz stated in his recent paper: Carpe Diem: Time to Seize the Opportunity for Cancer Prevention:

"What is currently lacking is the political will to allocate resources, prioritize incentives and rewards, and implement regulations that reinforce behaviors that will prevent cancer. Given that we know today that 50% or more of cancer is preventable, gathering political support for prevention should be our highest priority. One likely reason for its current limited support is simply the nature of prevention. Its success is marked by silent victories. Those who do not get cancer do not have compelling stories of survival that often accompany cancer treatment. And the understated approach of prevention—putting into practice the knowledge we already have—does not garner the same political and research excitement associated with newer technologies and the hunt for undiscovered and unproven cancer risk factors. 

Of course, research across the full spectrum of cancer is essential and needs to continue. Cancer prevention, however, must be funded in proportion to its potential effect. If we do not act, with the aging United States population, the number of new cancer cases diagnosed annually will double within 35 years."

To make true headway against the burden of cancer - especially in the face of economic realities - it's time for such a vision for prevention to become reality. 

Becoming a Stand-Up: Fighting Disease with Desks

It was hard to miss the headlines this summer telling us that a new federal study confirmed what many disgruntled office workers had long suspected - that their desk jobs may just be killing them.  While the headlines were a bit overblown, they did capture the essence of what more and more evidence is showing, being consistently sedentary for long stretches of time increases the risk of heart disease, cancer, and early death.

In this latest study, women who sat for six hours or more each day were nearly 40 percent more likely to die during the 14 year study period than those who sat less than three hours per day.  Men who sat for six hours or more were 20 percent more likely to die.  

Perhaps most surprising to many, hitting the gym, walking, or doing other physical activities didn't counteract the effects of sitting, though not exercising certainly made the effects of sitting even worse, more than doubling the risk of dying.

With these results, many office workers and their bosses have taken note, and there seems to be a move in corporate America - as well as in home offices - to try to improve health by cutting back on sit-time, largely through innovations in desks.  Forbes.com alone ran at least five stories over the past spring and summer on stand-up desks, including one reviewing some of the current crop that may be seen in both corner offices and cubicles alike.  In October, Wired magazine posted specs on what to look for in stand up desks, including home-spun inexpensive alternatives. And this past Sunday, the New York Times ran an article on the growing acceptance of stand-up desks in the workplace - even the space-gobbling and pricey treadmill desks.

It's a common refrain here on CNiC that our surroundings can have a profound impact on the health choices we all make - or don't make.  It's hard to exercise if there are no sidewalks or parks in your neighborhood.  It's hard to eat healthy food during the day if there's nothing but fast food choices around your school or workplace.

With around 80 percent of US jobs now requiring little if any physical activity, beginning to change the office environment and culture around sitting could have an important impact on employee wellness as well as nationwide health.  Of course, we still need more sidewalks, parks, and produce stands but more stand up desks is still a good move in the right direction.