More than 40% of cancer diagnoses and 44% of cancer deaths can be prevented by lifestyle changes and other modifiable risk factors, the American Cancer Society (ACS) reported in study findings published in CA: A Cancer Journal for Clinicians.
For the analysis, the study team looked at the 2019 incidence and mortality rates overall and for 30 types of cancers in U.S. adults aged 30 or older that were correlated with several potentially modifiable risk factors:
- Alcohol use
- Carcinogenic infections (i.e., Epstein-Barr virus, Helicobacter pylori, hepatitis B and C viruses, human herpes virus type 8, HIV, and human papillomavirus)
- Cigarette smoking and second-hand smoke
- Consumption of red and processed meats
- Excess body weight
- Exposure to ultraviolet (UV) radiation
- Low consumption of fruits, vegetables, fiber, and calcium
- Physical inactivity
Among overall cancer incidence and deaths, they found the following correlations:
| Modifiable Risk Factor | Cancer Incidence (%) | Cancer Deaths (%) |
| Cigarette smoking | 19.3 | 28.5 |
| Excess weight | 7.3 | 7.6 |
| Alcohol use | 5.4 | 4.1 |
| UV radiation | 4.6 | 1.3 |
| All dietary factors combined | 4.2 | 3.5 |
| All seven infections combined | < 3.8 | < 4 |
| Physical inactivity | 3.1 | 2.5 |
The cancer types most influenced by modifiable risk factors were:
| Incidence (N = 1,781,649) | Deaths (N = 595,737) |
| Lung (n = 201,660) | Lung (n = 122,740) |
| Female breast (n = 83,840) | Colorectal (n = 25,800) |
| Melanoma (n = 82,710) | Liver (n = 14,720) |
| Colorectal (n = 78,440) | Esophageal (n = 13,600) |
“These findings reinforce that the morbidity and premature mortality from cancer in the United States can be substantially reduced through broad and equitable implementation of known preventive initiatives, such as excise taxes on cigarettes to reduce smoking, screening for and treating hepatitis C virus infection, and vaccination against human papillomavirus infection,” the researchers concluded.
Although they said that further implementation research is needed to broadly recommend interventions, particularly for excess body weight, dietary factors, alcohol consumption, and physical inactivity, “tailored and mutually reinforcing interventions are more likely to mitigate these risk factors, especially in historically marginalized populations, which are usually disproportionally affected by these factors.” They also identified a need for additional research on common cancers with few established modifiable risk factors (e.g., prostate cancer, non-Hodgkin lymphoma), other potentially modifiable exposures (e.g., occupational carcinogens, air pollution, other environmental risk factors), long-term exposures, and interactions between risk factors.