Cancer prevention

Cancer prevention is the practice of taking active measures to decrease the incidence of cancer and mortality.[1][2] The practice of prevention depends on both individual efforts to improve lifestyle and seek preventive screening, and socioeconomic or public policy related to cancer prevention.[3] 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.[2]

The majority of cancer cases are due to the accumulation of environmental pollution being inherited as epigenetic damage and most of these environmental factors are controllable lifestyle choices.[4] 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.[5][6] Not all environmental causes are controllable, such as naturally occurring background radiation, and other cases of cancer are caused through hereditary genetic disorders. Current genetic engineering techniques under development may serve as preventive measures in the future.[7] Future preventive screening measures can be additionally improved by minimizing invasiveness and increasing specificity by taking individual biological makeup into account, also known as "population-based personalized cancer screening."[2]

Death rate adjusted for age for malignant cancer per 100,000 inhabitants in 2004.[8]

While anyone can get cancer,[9] age is one of the biggest factors that increases the risk of cancer: 3 out of 4 cancers are found in people aged 55 or older.

Preventative Measures

Dietary

Main article: Diet and cancer
Advertisement for a healthy diet to possibly reduce cancer risk

An average 35% of human cancer mortality is attributed to the diet of the individual.[10] 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.[11][12]

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.[13][14]The World Cancer Research Fund recommends a diet rich in fruits and vegetables to reduce the risk of cancer. A diet rich in foods of plant origin, including non-starchy fruits and vegetables, non-starchy roots and tubers, and whole grains, may have protective effects against cancer.[15] Consumption of coffee is associated with a reduced risk of liver cancer.[16] Substituting processed foods, such as biscuits, cakes or white bread – which are high in fat, sugars and refined starches – with a plant-based diet may reduce the risk of cancer.[15]

While many dietary recommendations have been proposed to reduce the risk of cancer, the evidence to support them is not definitive.[13][14] 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.[17][18] Although multiple epidemiological studies have found the strong anticancer effect of phytochemicals present in a variety of plants, conclusive evidence of its effectiveness would require human studies and clinical trials.[19] A 2014 meta-analysis did not find a relationship between fruits and vegetables and cancer.[20]

Physical activity

Research shows that regular physical activity helps to reduce up to 30%[21][22] of the risk of a variety of cancer types, such as colon cancer, breast cancer, lung cancer and endometrial cancer.[23][24] The guideline developed by a national panel of experts in cancer prevention research recommends moderate to vigorous physical activity as current research evidence indicates a higher risk of cancer for those with excess body fat and weight gain during adult life.[25] [26] The biological mechanisms underlying this association are still not well understood[24] 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.[24][27] As little as four minutes a day of exercise has been shown to reduce cancer risk by 17%.[28]

Medication and supplements

The concept that medications can be used to prevent cancer is attractive, and evidence supports their use in a few defined circumstances.[29][not specific enough to verify] 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.[30] Aspirin has been found to reduce the risk of death from cancer by about 7%.[31] 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.[32] Daily use of tamoxifen or raloxifene has been demonstrated to reduce the risk of developing breast cancer in high-risk women.[33] The benefit verses harm for 5-alpha-reductase inhibitor such as finasteride is not clear.[34] A study showing a proof-of-principle has also been done with the human proteins IFNalpha2a and macrophage-CSF, produced by genetically modified hens.[35]

Vitamins have not been found to be effective at preventing cancer,[36] although low blood levels of vitamin D are correlated with increased cancer risk.[37][38] Whether this relationship is causal and vitamin D supplementation is protective is not determined.[39] Beta-Carotene supplementation has been found to increase lung cancer rates in those who are high risk.[40] Folic acid supplementation has not been found effective in preventing colon cancer and may increase colon polyps.[41] A 2018 systematic review concluded that selenium has no beneficial effect in reducing the risk of cancer based on high quality evidence.[42]

Avoidance of carcinogens

The United States National Toxicology Program (NTP) has identified the chemical substances listed below as known human carcinogens in the NTP's 15th Report on Carcinogens. Simply because a substance has been designated as a carcinogen, however, does not mean that the substance will necessarily cause cancer. Many factors influence whether a person exposed to a carcinogen will develop cancer, including the amount and duration of the exposure and the individual’s genetic background.[43]

By types of carcinogen

Chemical carcinogens
Physical carcinogens
Oncogenic (cancer-causing) viruses

By exposure routes

Ingestion
  • Food
Inhalation
  • Outdoor air
Skin exposure
  • Air
  • Others (clothes, etc.)

Vaccination

Anti-cancer vaccines can be preventive or be used as therapeutic treatment.[2] 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.[44] Human papillomavirus vaccine (Gardasil and Cervarix) decreases the risk of developing cervical cancer.[44] The hepatitis B vaccine prevents infection with hepatitis B virus and thus decreases the risk of liver cancer.[44] The administration of human papillomavirus and hepatitis B vaccinations is recommended when resources allow.[45]

Some cancer vaccines are usually immunoglobulin-based and target antigens specific to cancer or abnormal human cells.[2][46] These vaccines may be given to treat cancer during the progression of disease to boost the immune system's ability to recognize and attack cancer antigens as foreign entities. Antibodies for cancer cell vaccines may be taken from the patient's own body (autologous vaccine) or from another patient (allogeneic vaccine).[44] Several autologous vaccines, such as Oncophage for kidney cancer and Vitespen for a variety of cancers, have either been released or are undergoing clinical trial. FDA-approved vaccines, such as Sipuleucel-T for metastasizing prostate cancer or Nivolumab for melanoma and lung cancer can act either by targeting over-expressed or mutated proteins or by temporarily inhibiting immune checkpoints to boost immune activity.[2][47]

Screening

Main article: Cancer screening

Screening procedures, commonly sought for more prevalent cancers, such as colon, breast, and cervical, have greatly improved in the past few decades from advances in biomarker identification and detection.[2] Early detection of pancreatic cancer biomarkers was accomplished using a SERS-based immunoassay approach.[48] A SERS-based multiplex protein biomarker detection platform in a microfluidic chip can be used to detect several protein biomarkers to predict the type of disease and critical biomarkers and increase the chance of diagnosis between diseases with similar biomarkers (e.g. pancreatic cancer, ovarian cancer, and pancreatitis).[49]

To improve the chances of detecting cancer early, all eligible people should take advantage of cancer screening services. However, overall uptake of cancer screening among the general population is not widespread, especially among disadvantaged groups (e.g. those with low income, mental illnesses, or are from different ethnic groups) who face different barriers that lead to lower attendance rates.[50]

Cervical cancer

Cervical cancer is usually screened through in vitro examination of the cells of the cervix (e.g. Pap smear), colposcopy, or direct inspection of the cervix (after application of dilute acetic acid), or testing for HPV, the oncogenic virus that is the necessary cause of cervical cancer.[44] Screening is recommended for women over 21 years, initially women between 21–29 years old are encouraged to receive Pap smear screens every three years, and those over 29 every five years.[2] For women older than the age of 65 and with no history of cervical cancer or abnormality, and with an appropriate precedence of negative Pap test results may cease regular screening.[51]

Still, adherence to recommended screening plans depends on age and may be linked to "educational level, culture, psychosocial issues, and marital status," further emphasizing the importance of addressing these challenges in regards to cancer screening.[2]

Colorectal cancer

Colorectal cancer is most often screened with the fecal occult blood test (FOBT). Variants of this test include guaiac-based FOBT (gFOBT), the fecal immunochemical test (FIT), and stool DNA testing (sDNA).[52] Further testing includes flexible sigmoidoscopy (FS), total colonoscopy (TC), or computed tomography (CT) scans if a total colonoscopy is non-ideal. A recommended age at which to begin screening is 50 years. However, this is highly dependent on medical history and exposure to risk factors for colorectal cancer. Effective screening has been shown to reduce the incidence of colorectal cancer by 33% and colorectal cancer mortality by 43%.[2]

Breast cancer

The estimated number of new breast cancer cases in the US in 2018 is predicted to be more than 1.7 million, with more than six hundred thousand deaths.[53] Factors such as breast size, reduced physical activity, obesity and overweight status, infertility and never having had children, hormone replacement therapy (HRT), and genetics are risk factors for breast cancer.[2] Mammograms are widely used to screen for breast cancer, and are recommended for women 50–74 years of age by the US Preventive Services Task Force (USPSTF). However, the USPSTF does not recommend mammograms for women 40–49 years old due to the possibility of overdiagnosis.[2][54]

Pollution control

Government

Industries

Preventable causes of cancer

As of 2017, tobacco use, diet and nutrition, physical activity, obesity/overweight status, infectious agents, and chemical and physical carcinogens have been reported to be the leading areas where cancer prevention can be practiced through enacting positive lifestyle changes, getting appropriate regular screening, and getting vaccinated.[55]

The development of many common cancers are incited by such risk factors. For example, consumption of tobacco and alcohol, a medical history of genital warts and STDs, immunosuppression, unprotected sex, and early age of first sexual intercourse and pregnancy all may serve as risk factors for cervical cancer. Obesity, red meat or processed meat consumption, tobacco and alcohol, and a medical history of inflammatory bowel diseases are all risk factors for colorectal cancer (CRC). On the other hand, exercise and consumption of vegetables may help decrease the risk of CRC.[2]

Several preventable causes of cancer were highlighted in Doll and Peto's landmark 1981 study,[5] estimating that 75 – 80% of cancers in the United States could be prevented by avoidance of 11 different factors. A 2013 review of more recent cancer prevention literature by Schottenfeld et al.,[56] summarizing studies reported between 2000 and 2010, points to most of the same avoidable factors identified by Doll and Peto. However, Schottenfeld et al. considered fewer factors (e.g. non inclusion of diet) in their review than Doll and Peto, and indicated that avoidance of these fewer factors would result in prevention of 60% of cancer deaths. The table below indicates the proportions of cancer deaths attributed to different factors, summarizing the observations of Doll and Peto, Shottenfeld et al. and several other authors, and shows the influence of major lifestyle factors on the prevention of cancer, such as tobacco, an unhealthy diet, obesity and infections.

Proportions of cancer deaths in the United States attributed to different factors
Factor Doll &
Peto[5][needs update]		 Schottenfeld
et al.[56]		 Other reports
Tobacco 30% 30% 38% men, 23% women,[57] 30%,[58] 25-30%[6]
Unhealthy diet 35% - 32%,[59] 10%,[60] 30-35%[6]
Obesity * 10% 14% women, 20% men, among non-smokers,[61] 10-20%,[6] 19-20% United States, 16-18% Great Britain, 13% Brazil, 11-12% China[62]
Infection† 10% 5-8% 7-10%,[63] 8% developed nations, 26% developing nations,[58] 10% high income, 25% African[6]
Alcohol 3% 3-4% 3.6%,[58] 8% USA, 20% France[64]
Occupational exposures 4% 3-5% 2-10%, may be 15-20% in men[65]
Radiation (solar and ionizing) 3% 3-4% up to 10%[6]
Physical inactivity * <5% 7%[66]
Reproductive and sexual behavior 1-13% - -
Pollution 2%[needs update] - -
Medicines and medical procedures 1% - -
Industrial products <1%[needs update] - -
Food additives <1%[needs update] - -

*Included in diet

†Carcinogenic infections include: for the uterine cervix (human papillomavirus [HPV]), liver (hepatitis B virus [HBV] and hepatitis C virus [HCV]), stomach (Helicobacter pylori [H pylori]), lymphoid tissues (Epstein-Barr virus [EBV]), nasopharynx (EBV), urinary bladder (Schistosoma hematobium), and biliary tract (Opisthorchis viverrini, Clonorchis sinensis)

History of cancer prevention

Cancer has been thought to be a preventable disease since the time of Roman physician Galen, who observed that an unhealthy diet was correlated with cancer incidence. In 1713, Italian physician Ramazzini hypothesized that abstinence caused lower rates of cervical cancer in nuns. Further observation in the 18th century led to the discovery that certain chemicals, such as tobacco, soot and tar (leading to scrotal cancer in chimney sweeps, as reported by Percivall Pott in 1775), could serve as carcinogens for humans. Although Pott suggested preventive measures for chimney sweeps (wearing clothes to prevent contact bodily contact with soot), his suggestions were only put into practice in Holland, resulting in decreasing rates of scrotal cancer in chimney sweeps. Later, the 19th century brought on the onset of the classification of chemical carcinogens.[67]

In the early 20th century, physical and biological carcinogens, such as X-ray radiation or the Rous Sarcoma Virus discovered 1911, were identified. Despite observed correlation of environmental or chemical factors with cancer development, there was a deficit of formal prevention research and lifestyle changes for cancer prevention were not feasible during this time.[67]

In Europe, in 1987 the European Commission launched the European Code Against Cancer to help educate the public about actions they can take to reduce their risk of getting cancer.[68] The first version of the code covered 10 recommendations covering tobacco, alcohol, diet, weight, sun exposure, exposure to known carcinogens, early detection and participation in organized breast and cervical cancer screening programs.[69] In the early 1990s, the European School of Oncology led a review of the code and added details about the scientific evidence behind each of the recommendations.[69] Later updates were coordinated by the International Agency for Research on Cancer. The fourth edition of the code, [1], developed in 2012‒2013, also includes recommendations on participation in vaccination programs for hepatitis B (infants) and human papillomavirus (girls), breast feeding and hormone replacement therapy, and participation in organized colorectal cancer screening programs.

See also

References

  1. ^ "Cancer prevention: 7 steps to reduce your risk". Mayo Clinic. 27 September 2008. Retrieved 30 January 2010.[unreliable medical source?]
  2. ^ a b c d e f g h i j k l m Valle I, Tramalloni D, Bragazzi NL (June 2015). "Cancer prevention: state of the art and future prospects". Journal of Preventive Medicine and Hygiene. 56 (1): E21–7. PMC 4718348. PMID 26789828.
  3. ^ "Cancer Prevention & Early Detection Facts & Figures 2017-18" (PDF). Cancer.org. April 1, 2017.
  4. ^ Danaei G, Vander Hoorn S, Lopez AD, Murray CJ, Ezzati M (2005). "Causes of cancer in the world: comparative risk assessment of nine behavioural and environmental risk factors". Lancet. 366 (9499): 1784–93. doi:10.1016/S0140-6736(05)67725-2. PMID 16298215. S2CID 17354479.
  5. ^ a b c Doll R, Peto R (1981). "The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today". J. Natl. Cancer Inst. 66 (6): 1191–308. doi:10.1093/jnci/66.6.1192. PMID 7017215.
  6. ^ a b c d e f Anand P, Kunnumakkara AB, Kunnumakara AB, Sundaram C, Harikumar KB, Tharakan ST, Lai OS, Sung B, Aggarwal BB (2008). "Cancer is a preventable disease that requires major lifestyle changes". Pharm. Res. 25 (9): 2097–116. doi:10.1007/s11095-008-9661-9. PMC 2515569. PMID 18626751. (Erratum: doi:10.1007/s11095-008-9690-4, PMID 18626751. If the erratum has been checked and does not affect the cited material, please replace {{erratum|...}} with {{erratum|...|checked=yes}}.)
  7. ^ "CRISPR Gene-Editing Tool May Help Improve Cancer Immunotherapy". National Cancer Institute. 2017-03-20. Retrieved 2018-03-09.
  8. ^ "WHO Disease and injury country estimates". World Health Organization. 2009. Retrieved 11 November 2009.
  9. ^ "Cancer Prevention". 2014-02-12. Archived from the original on 2018-06-17. Retrieved 2014-11-07.
  10. ^ Surh YJ (2003). "Cancer chemoprevention with dietary phytochemicals". Nature Reviews Cancer. 3 (10): 768–780. doi:10.1038/nrc1189. PMID 14570043.
  11. ^ Zheng W, Lee SA (2009). "Well-done meat intake, heterocyclic amine exposure, and cancer risk". Nutr Cancer. 61 (4): 437–46. doi:10.1080/01635580802710741. PMC 2769029. PMID 19838915.
  12. ^ Ferguson LR (February 2010). "Meat and cancer". Meat Sci. 84 (2): 308–13. doi:10.1016/j.meatsci.2009.06.032. PMID 20374790.
  13. ^ a b Kushi LH, Doyle C, McCullough M, et al. (2012). "American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity". CA Cancer J Clin. 62 (1): 30–67. doi:10.3322/caac.20140. PMID 22237782.
  14. ^ a b Wicki A, Hagmann J (September 2011). "Diet and cancer". Swiss Medical Weekly. 141: w13250. doi:10.4414/smw.2011.13250. PMID 21904992.
  15. ^ a b "Eat wholegrains, vegetables, fruit and beans". World Cancer Research Fund International. 2023. Retrieved 2 September 2024.
  16. ^ Larsson SC, Wolk A (May 2007). "Coffee consumption and risk of liver cancer: a meta-analysis". Gastroenterology. 132 (5): 1740–5. doi:10.1053/j.gastro.2007.03.044. PMID 17484871.
  17. ^ Cappellani A, Di Vita M, Zanghi A, Cavallaro A, Piccolo G, Veroux M, Berretta M, Malaguarnera M, Canzonieri V, Lo Menzo E (2012). "Diet, obesity and breast cancer: an update". Front Biosci. 4 (1): 90–108. doi:10.2741/253. PMID 22202045.
  18. ^ Key TJ (January 2011). "Fruit and vegetables and cancer risk". Br. J. Cancer. 104 (1): 6–11. doi:10.1038/sj.bjc.6606032. PMC 3039795. PMID 21119663.
  19. ^ Rudzińska, A. et al. (2023) ‘Phytochemicals in cancer treatment and cancer prevention —review on Epidemiological Data and clinical trials’, Nutrients, 15(8), p. 1896. doi:10.3390/nu15081896.
  20. ^ Wang X, Ouyang Y, Liu J, Zhu M, Zhao G, Bao W, Hu FB (July 2014). "Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies". BMJ. 349: g4490. doi:10.1136/bmj.g4490. PMC 4115152. PMID 25073782.
  21. ^ Moore SC, Lee IM, Weiderpass E, Campbell PT, Sampson JN, Kitahara CM, et al. (June 2016). "Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults". JAMA Internal Medicine. 176 (6): 816–25. doi:10.1001/jamainternmed.2016.1548. PMC 5812009. PMID 27183032.
  22. ^ Kruk J, Czerniak U (2013). "Physical activity and its relation to cancer risk: updating the evidence". Asian Pacific Journal of Cancer Prevention. 14 (7): 3993–4003. doi:10.7314/APJCP.2013.14.7.3993. PMID 23991944.
  23. ^ "Exercise Linked With Lower Risk of 13 Types of Cancer". www.cancer.org. Retrieved 2018-03-03.
  24. ^ a b c "Physical Activity and Cancer". National Cancer Institute. Retrieved 2018-03-03.
  25. ^ Rock, Cheryl L.; Thomson, Cynthia; Gansler, Ted; Gapstur, Susan M.; McCullough, Marjorie L.; Patel, Alpa V.; Andrews, Kimberly S.; Bandera, Elisa V.; Spees, Colleen K.; Robien, Kimberly; Hartman, Sheri; Sullivan, Kristen; Grant, Barbara L.; Hamilton, Kathryn K.; Kushi, Lawrence H. (2020). "American Cancer Society guideline for diet and physical activity for cancer prevention". CA: A Cancer Journal for Clinicians. 70 (4): 245–271. doi:10.3322/caac.21591. ISSN 0007-9235. PMID 32515498.
  26. ^ Friedenreich, Christine M.; Ryder-Burbidge, Charlotte; McNeil, Jessica (2021). "Physical activity, obesity and sedentary behavior in cancer etiology: epidemiologic evidence and biologic mechanisms". Molecular Oncology. 15 (3): 790–800. doi:10.1002/1878-0261.12772. ISSN 1574-7891. PMC 7931121. PMID 32741068.
  27. ^ Winzer BM, Whiteman DC, Reeves MM, Paratz JD (June 2011). "Physical activity and cancer prevention: a systematic review of clinical trials". Cancer Causes & Control. 22 (6): 811–26. doi:10.1007/s10552-011-9761-4. PMID 21461921. S2CID 8687281.
  28. ^ Abbott, Brianna (2023-07-27). "Lower Your Cancer Risk With Just Four Minutes of Exercise". Wall Street Journal. ISSN 0099-9660. Retrieved 2023-07-28.
  29. ^ Holland Chp.33.[full citation needed]
  30. ^ Rostom A, Dubé C, Lewin G, Tsertsvadze A, Barrowman N, Code C, Sampson M, Moher D (March 2007). "Nonsteroidal anti-inflammatory drugs and cyclooxygenase-2 inhibitors for primary prevention of colorectal cancer: a systematic review prepared for the U.S. Preventive Services Task Force". Annals of Internal Medicine. 146 (5): 376–389. doi:10.7326/0003-4819-146-5-200703060-00010. PMID 17339623. S2CID 23290390.
  31. ^ Rothwell PM, Fowkes FG, Belch JF, Ogawa H, Warlow CP, Meade TW (January 2011). "Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials". Lancet. 377 (9759): 31–41. doi:10.1016/S0140-6736(10)62110-1. PMID 21144578. S2CID 22950940.
  32. ^ Cooper K, Squires H, Carroll C, Papaioannou D, Booth A, Logan RF, Maguire C, Hind D, Tappenden P (June 2010). "Chemoprevention of colorectal cancer: systematic review and economic evaluation". Health Technol Assess. 14 (32): 1–206. doi:10.3310/hta14320. PMID 20594533.
  33. ^ Thomsen A, Kolesar JM (December 2008). "Chemoprevention of breast cancer". Am J Health Syst Pharm. 65 (23): 2221–2228. doi:10.2146/ajhp070663. PMID 19020189.
  34. ^ Wilt TJ, MacDonald R, Hagerty K, Schellhammer P, Kramer BS (2008). Wilt TJ (ed.). "Five-alpha-reductase Inhibitors for prostate cancer prevention". Cochrane Database Syst Rev (2): CD007091. doi:10.1002/14651858.CD007091. PMC 11270836. PMID 18425978.
  35. ^ Hen eggs with human proteins offer drug hope
  36. ^ "Vitamins and minerals: not for cancer or cardiovascular prevention". Prescrire Int. 19 (108): 182. August 2010. PMID 20939459.
  37. ^ Giovannucci E, Liu Y, Rimm EB, Hollis BW, Fuchs CS, Stampfer MJ, Willett WC (April 2006). "Prospective study of predictors of vitamin D status and cancer incidence and mortality in men". J. Natl. Cancer Inst. 98 (7): 451–459. CiteSeerX 10.1.1.594.1654. doi:10.1093/jnci/djj101. PMID 16595781.
  38. ^ "Vitamin D Has Role in Colon Cancer Prevention". Archived from the original on 4 December 2006. Retrieved 27 July 2007.
  39. ^ Schwartz GG, Blot WJ (April 2006). "Vitamin D status and cancer incidence and mortality: something new under the sun". J. Natl. Cancer Inst. 98 (7): 428–30. doi:10.1093/jnci/djj127. PMID 16595770.
  40. ^ Fritz H, Kennedy D, Fergusson D, Fernandes R, Doucette S, Cooley K, Seely A, Sagar S, Wong R, Seely D (2011). Minna JD (ed.). "Vitamin A and retinoid derivatives for lung cancer: a systematic review and meta analysis". PLOS ONE. 6 (6): e21107. Bibcode:2011PLoSO...621107F. doi:10.1371/journal.pone.0021107. PMC 3124481. PMID 21738614.
  41. ^ Cole BF, Baron JA, Sandler RS, Haile RW, Ahnen DJ, Bresalier RS, McKeown-Eyssen G, Summers RW, Rothstein RI, Burke CA, Snover DC, Church TR, Allen JI, Robertson DJ, Beck GJ, Bond JH, Byers T, Mandel JS, Mott LA, Pearson LH, Barry EL, Rees JR, Marcon N, Saibil F, Ueland PM, Greenberg ER (June 2007). "Folic acid for the prevention of colorectal adenomas: a randomized clinical trial". JAMA. 297 (21): 2351–2359. doi:10.1001/jama.297.21.2351. PMID 17551129.
  42. ^ Vinceti, Marco; Filippini, Tommaso; Del Giovane, Cinzia; Dennert, Gabriele; Zwahlen, Marcel; Brinkman, Maree; Zeegers, Maurice Pa; Horneber, Markus; D'Amico, Roberto (January 2018). "Selenium for preventing cancer". The Cochrane Database of Systematic Reviews. 1 (1): CD005195. doi:10.1002/14651858.CD005195.pub4. ISSN 1469-493X. PMC 6491296. PMID 29376219.
  43. ^ "Cancer-Causing Substances in the Environment". NCI. National Cancer Institute of the United States. 17 Jun 2022. Retrieved 4 Jun 2024. Public Domain This article incorporates text from this source, which is in the public domain.
  44. ^ a b c d e "Cancer Vaccine Fact Sheet". NCI. 8 June 2006. Archived from the original on 25 October 2008. Retrieved 15 November 2008.
  45. ^ Lertkhachonsuk AA, Yip CH, Khuhaprema T, Chen DS, Plummer M, Jee SH, Toi M, Wilailak S (2013). "Cancer prevention in Asia: resource-stratified guidelines from the Asian Oncology Summit 2013". Lancet Oncology. 14 (12): e497–507. doi:10.1016/S1470-2045(13)70350-4. PMID 24176569.
  46. ^ "What's new in cancer immunotherapy research?". www.cancer.org. Retrieved 2018-03-09.
  47. ^ Pardoll DM (March 2012). "The blockade of immune checkpoints in cancer immunotherapy". Nature Reviews. Cancer. 12 (4): 252–264. doi:10.1038/nrc3239. PMC 4856023. PMID 22437870.
  48. ^ Banaei, N.; et al. (September 2017). "Multiplex detection of pancreatic cancer biomarkers using a SERS-based immunoassay". Nanotechnology. 28 (45): 455101. Bibcode:2017Nanot..28S5101B. doi:10.1088/1361-6528/aa8e8c. PMID 28937361. S2CID 206086640.
  49. ^ Banaei, N.; et al. (January 2019). "Machine learning algorithms enhance the specificity of cancer biomarker detection using SERS-based immunoassays in microfluidic chips". RSC Advances. 9 (4): 1859–1868. Bibcode:2019RSCAd...9.1859B. doi:10.1039/c8ra08930b. PMC 9059745. PMID 35516124.
  50. ^ "Catching cancer early: how research could help us improve". NIHR Evidence (Plain English summary). 2021-11-10. doi:10.3310/collection_48071. S2CID 244006179.
  51. ^ "Ages 65 Years and Older: Exams and Screening Tests - ACOG". www.acog.org. Retrieved 2018-04-21.
  52. ^ Janz T, Lu K, Povlow MR, Urso B (December 2016). "A Review of Colorectal Cancer Detection Modalities, Stool DNA, and Fecal Immunochemistry Testing in Adults Over the Age of 50". Cureus. 8 (12): e931. doi:10.7759/cureus.931. PMC 5235652. PMID 28097082.
  53. ^ "Cancer Facts & Figures 2018" (PDF).
  54. ^ "Final Update Summary: Breast Cancer: Screening - US Preventive Services Task Force". www.uspreventiveservicestaskforce.org. Archived from the original on 2018-03-10. Retrieved 2018-04-21.
  55. ^ "Cancer Prevention & Early Detection Facts & Figures 2017-18" (PDF). Cancer.org. April 1, 2017.
  56. ^ a b Schottenfeld D, Beebe-Dimmer JL, Buffler PA, Omenn GS (2013). "Current perspective on the global and United States cancer burden attributable to lifestyle and environmental risk factors". Annu Rev Public Health. 34: 97–117. doi:10.1146/annurev-publhealth-031912-114350. PMID 23514316.
  57. ^ Shopland DR (1995). "Tobacco use and its contribution to early cancer mortality with a special emphasis on cigarette smoking". Environ. Health Perspect. 103 (Suppl 8): 131–42. Bibcode:1995EnvHP.103S.131S. doi:10.1289/ehp.95103s8131. PMC 1518977. PMID 8741773.
  58. ^ a b c Parsa N (2012). "Environmental factors inducing human cancers". Iran. J. Public Health. 41 (11): 1–9. PMC 3521879. PMID 23304670.
  59. ^ Willett WC (1995). "Diet, nutrition, and avoidable cancer". Environ. Health Perspect. 103 (Suppl 8): 165–70. Bibcode:1995EnvHP.103S.165W. doi:10.1289/ehp.95103s8165. PMC 1518978. PMID 8741778.
  60. ^ Trichopoulou A, Lagiou P, Kuper H, Trichopoulos D (2000). "Cancer and Mediterranean dietary traditions". Cancer Epidemiol. Biomarkers Prev. 9 (9): 869–73. PMID 11008902.
  61. ^ Song M, Giovannucci E (2016). "Estimating the Influence of Obesity on Cancer Risk: Stratification by Smoking Is Critical". J. Clin. Oncol. 34 (27): 3237–9. doi:10.1200/JCO.2016.67.6916. PMID 27458311.
  62. ^ "2.7.1 Body fatness and foods and drinks that promote weight gain". Policy and Action for Cancer Prevention. Food, Nutrition, and Physical Activity: a Global Perspective. Washington DC, USA: World Cancer Research Fund/American Institute for Cancer Research. 2009. p. 22. ISBN 978-0-9722522-4-9.
  63. ^ Schottenfeld D, Beebe-Dimmer J (2006). "Chronic inflammation: a common and important factor in the pathogenesis of neoplasia". CA Cancer J Clin. 56 (2): 69–83. doi:10.3322/canjclin.56.2.69. PMID 16514135.
  64. ^ Tuyns AJ (1979). "Epidemiology of alcohol and cancer". Cancer Res. 39 (7 Pt 2): 2840–3. PMID 445490.
  65. ^ Irigaray P, Newby JA, Clapp R, Hardell L, Howard V, Montagnier L, Epstein S, Belpomme D (2007). "Lifestyle-related factors and environmental agents causing cancer: an overview". Biomed. Pharmacother. 61 (10): 640–58. doi:10.1016/j.biopha.2007.10.006. PMID 18055160.
  66. ^ Moore SC, Lee IM, Weiderpass E, Campbell PT, Sampson JN, Kitahara CM, Keadle SK, Arem H, Berrington de Gonzalez A, Hartge P, Adami HO, Blair CK, Borch KB, Boyd E, Check DP, Fournier A, Freedman ND, Gunter M, Johannson M, Khaw KT, Linet MS, Orsini N, Park Y, Riboli E, Robien K, Schairer C, Sesso H, Spriggs M, Van Dusen R, Wolk A, Matthews CE, Patel AV (2016). "Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults". JAMA Intern Med. 176 (6): 816–25. doi:10.1001/jamainternmed.2016.1548. PMC 5812009. PMID 27183032.
  67. ^ a b Bode AM, Dong Z (July 2009). "Cancer prevention research - then and now". Nature Reviews. Cancer. 9 (7): 508–16. doi:10.1038/nrc2646. PMC 2838238. PMID 19536108.
  68. ^ Unspecified (8 May 1990). Europe against cancer programme: Report on the implementation of the first plan of action, 1987-1989 (PDF) (Report). Communication from the European Commission to the Council, the European Parliament and the Economic and Social Committee. COM (90) 185 final. Via Archive of European Integration (AEI)
  69. ^ a b Boyle, Peter; et al. (September 1995). "European School of Oncology Advisory Report to the European Commission for the "Europe Against Cancer Programme", European Code Against Cancer". Eur J Cancer. 31 (9): 1395‒1403. doi:10.1016/0959-8049(95)00334-F. PMID 7577062.
Wikimedia Commons has media related to Cancer prevention.