Incidence of cancer is on the rise … but it can be reversed by adopting healthier lifestyles. Is it possible to bring about dramatic behaviour changes? YES !
By Dona Suri
Two studies on cancer incidence have been published recently — one in the US and one in the UK. The findings are sobering to say the least – which is why you ought to know about them.
First, some background about when cancer is most likely to show up. Statistics from the Center for Disease Control give a detailed picture:
- nearly 30 per cent of cancer diagnoses involve patients who are between the ages of 65 and 74.
- The 55-to-64 age group follows, accounting for about 24 per cent of cancer diagnoses.
- The 75-to-85 years group has nearly 19 per cent of diagnoses.
These are the Big Three age groups: together they rack up 72.5 per cent of all cancer diagnoses.
If you are still kicking at age 84, your chance of a cancer diagnosis falls to 7.7 per cent.
If you are below the age of 54, you are in the group that accounts for slightly less than 20 per cent of all cancer diagnoses.
The Under-50s are still statistically justified in thinking that they are comparatively safe but, according to studies that have come out in 2023, they are not as safe as they used to be.
An international study (204 countries) https://bmjoncology.bmj.com/content/2/1/e000049 published on September 5 of this year in the British Medical Journal (Oncology)* found a 79 per cent increase in new cases of cancer among the young over the past 30 years.
In 2019 …
- More than 1 million people under 50 died of cancer; that is slightly less than 28 percent above the 1990 figure.
- New cancer diagnoses among the Under-50s totalled 1.82 million; an increase of 79 percent on the 1990 figure.
- The highest rates of early onset cancers were in North America, Australasia, and Western Europe.
- Globally, the incidences of breast cancer increased to more than 2 million. It claimed the largest number of the new cases and largest number of deaths.
- Coming in not far behind breast cancer were windpipe, lung, stomach, and bowel cancers in terms of new cases. However, the death rate was higher for kidney and ovarian cancer.
- Over the 30-year period, early onset windpipe and prostate cancers showed the fastest rate of increase (estimated annual percentage changes of 2.28 percent and 2.23 percent, respectively).
Based on the observed trends for the past three decades, the researchers estimate that the global number of new early onset cancer cases and associated deaths will rise by a further 31 percent and 21 percent, respectively, in 2030, with the highest risk for those in their 40s.
The researchers stopped short of advancing reasons for the dramatic rise of early onset cancers but they list out the risk factors underlying the most common cancers among the under-50s. The factors are:
- Diets high in red meat and salt, low in fruit and milk;
- Alcohol consumption;
- Tobacco use,
- Physical inactivity,
- Excess weight,
- High blood sugar.
The study concludes:”Full understanding of the reasons driving the observed trends remains elusive, although lifestyle factors are likely contributing, and novel areas of research such as antibiotic usage, the gut microbiome, outdoor air pollution and early life exposures are being explored. … Prevention and early detection measures are urgently required, along with identifying optimal treatment strategies for early-onset cancers, which should include a holistic approach addressing the unique supportive care needs of younger patients.”
The second study
analyzed data for nine years (2010 to 2019). The results were published in the Journal of the American Medical Association of August 16, 2023.
This study looked at data for Americans only and it has good news and bad news:
The good news was that cancer rates in patients aged 50 years and older decreased between 2010 and 2019
The bad news was the incidence rates of early-onset cancers (the Under-40s) increased substantially over the study period.
This study tells the same story that came out in the British journal: among all early-onset cancers, breast cancer has the highest incidence, while the fastest rate of increase is seen in the number of gastrointestinal cancers.
The researchers took data from Surveillance, Epidemiology and End Results registries of 17 national cancer institutes for the period January 1, 2010 to December 31, 2019. This gave them 562,145 incidences of early-onset cancer (meaning cancer in people under the age of 50).
- The vast majority of early onset cancers were breast cancers.
- Gastrointestinal cancers had the fastest-growing incidence rates among all early-onset cancers.
- The 30-to-39 age-group was the worst affected: early onset cancers went up by 19 percent for people in the prime of life.
- The study found no change in the rate of incidence for people below age 30.
The researchers also crunched the numbers according to gender and ethnicity. Early onset rates for Asians/Pacific Islanders and Hispanic are up; for Blacks and Whites rates are down. Early onset rates for women are up; for men, they are down.
The study was silent on probable reasons for the increases and decreases.
A search on Google will turn up lots of numbers and percentages … cancer in the world, cancer in America, cancer by age, by gender, by ethnicity, by type. We can get a ton of information. The problem is that many of people would rather not know: These are the people who shudder and say “Can’t we just talk about something pleasant?”
The headline most people would like to see is “Scientists discover magic pill that prevents all cancers”.
Suppose the headline were “We already know how to prevent many, many types of cancers”. This would be a story about what people can do – personally – to increase their chances of remaining cancer-free. The companion piece would be headlined “We are not applying our present knowledge of cancer prevention: Why?”
A dramatic Nobel-prize winning breakthrough is not the only way to keep people disease-free. In 1900, the incidence of typhoid fever was approximately 100 per 100,000 people; by 1920, it had decreased to 33.8, and by 1950, to 1.7. This raging killer was not vanquished by any pill or vaccine; the “miracle” was accomplished by the provision of clean water and effective sewage systems. Simple measures, splendid result. Suppose it were possible to halve the incidence of cancer just by acting on the knowledge we already have? Public health experts say it can be done. In fact, some health improvement measures have already shown results.
Tobacco contains nicotine; nicotine triggers release of dopamine, a feel-good hormone. People like nicotine; they get addicted to it and it is not easy to give it up – even when they know that lung cancer is strongly linked to smoking. Convincing people to never start smoking in the first place is easier than getting them to shake the habit. “Don’t start and if you do, quit” encapsulates the huge effort undertaken in America since the 1990s. Legislation and tax measures have played a role; makers of films and television programs eliminated scenes of people smoking; managements strictly enforced the ban on smoking in their establishments. Advertising agencies brought the same level of expertise to anti-tobacco campaigns that they once devoted to marketing cigarettes.
The effort has paid off. The number of Americans who smoke has declined from 20.9 percent (nearly 21 of every 100 adults) in 2005 to 11.5 percent (nearly 12 of every 100 adults) in 2021. A National Institute for Health press release (2021 July 8) reported “During 2001 to 2018, declines in lung cancer death rates accelerated, and death rates declined considerably in more recent years … It is the result of progress across the entire cancer continuum — from reduced smoking rates … to discoveries such as targeted drug therapies and immune checkpoint inhibitors.”
The same constellation of measures that cut down smoking, namely, legislation, taxation, education, media and marketing, can be mobilised to change other behaviours from health-threatening to health-promoting.
But putting these measures into action will not be easy. Looking at the legislation side of the effort, legislators, state and federal, are members of political parties; they and their parties need money to fight elections. Donations come from big, rich donors whose wealth comes from big, rich companies. To what extent will government be ready to legislate if proposed measures run contrary to powerful interests?
How to make consumers want stuff … stuff that they are going to pay for at point of sale, and pay for again, in the shape of medical bills, and pay for again, in the shape of shorter, debilitated lives. If you have enough money to influence legislators, you also have enough money to hire ace manipulators aka “marketing wizards” — men and women whose bread and butter depend on their proven ability to persuade. If anybody can make bad choices irresistible ….
The tobacco industry fought anti-smoking efforts tooth and nail and it is still fighting. Big Tobacco now pushes vaping to teenagers.
Manufacturers of food products invest millions to figure out how to make people crave their products and consume more. The companies are certainly not thinking of YOUR bottom line.
Many companies – chiefly the entertainment and gaming industries – have a vital interest in keeping people glued to their seats –. It’s difficult to consume their products if you are moving about.
Distilleries and breweries go to great lengths to attract customers. Alcohol marketing is brilliant. People tune in to the Super Bowl just to see the Budweiser ad. Booze is on TV and in the movies: everybody, everywhere, all the time.
Scene: Home. Hero enters. Pours drink.
Scene: Senator X’s office. Senator X to Hero: “Drink?”
Scene: Hero fixes smouldering gaze on curvy babe. Drink, smooch, drink.
Scene you will NEVER see: Hero sees his liver PET scan; doc shakes head. Cut to tombstone.
To overcome all the interests that profit from unhealthy lifestyle choices, the Healthy Living campaigners will need long-term, insistent backing from the public. This is where they are up against deeply ingrained cultural values that go back millennia. Face it: Who celebrates their birthday with an enormous salad?
But let’s be optimistic. Skills are amoral: they can be used for good or ill. The skills needed to manipulate the public are well understood, and highly developed; marketing genius just needs to be directed in the right way.
The tremendous reduction in smoking within a period of about 20 years shows that it IS possible to bring about dramatic behaviour changes. We know the ways that behaviour has to change in order to reverse the rising incidence of all kinds of cancer … and promote better health generally.
If there is one ad campaign we can really get behind, here it is:
Eating healthy is COOL !
Little or no alcohol is COOL !
Exercising is COOL !
Living to an active, healthy ripe old age is COOL !