National Cancer Institute


Posted Date: Aug 31, 2013

General information about cancer prevention and descriptions of the concepts used in cancer-specific prevention summaries.

Cancer Prevention Overview

What is Prevention?

Cancer prevention is action taken to lower the chance of getting cancer. By preventing cancer, the number of new cases of cancer in a group or population is lowered. Hopefully, this will lower the number of deaths caused by cancer.

Cancer is not a single disease but a group of related diseases. Many things in our genes, our lifestyle, and the environment around us may increase or decrease our risk of getting cancer.

Scientists are studying many different ways to help prevent cancer, including the following:

Carcinogenesis

Key Points for this Section

  • Carcinogenesis is the process in which normal cells turn into cancer cells.
  • Changes (mutations) in genes occur during carcinogenesis.

Carcinogenesis is the process in which normal cells turn into cancer cells.

Carcino genesis is the series of steps that take place as a normal cell becomes a cancer cell. Cells are the smallest units of the body and they make up the body’s tissues. Each cell contains genes that guide the way the body grows, develops, and repairs itself. There are many genes that control whether a cell lives or dies, divides (multiplies), or takes on special functions, such as becoming a nerve cell or a muscle cell.

Changes (mutations) in genes occur during carcinogenesis.

Changes ( mutations) in genes can cause normal controls in cells to break down. When this happens, cells do not die when they should and new cells are produced when the body does not need them. The buildup of extra cells may cause a mass (tumor) to form.

Tumors can be benign or malignant (cancerous). Malignant tumor cells invade nearby tissues and spread to other parts of the body. Benign tumor cells do not invade nearby tissues or spread.

Risk Factors

Scientists study risk factors and protective factors to find ways to prevent new cancers from starting. Anything that increases your chance of developing cancer is called a cancer risk factor; anything that decreases your chance of developing cancer is called a cancer protective factor.

Some risk factors for cancer can be avoided, but many cannot. For example, both smoking and inheriting certain genes are risk factors for some types of cancer, but only smoking can be avoided. Risk factors that a person can control are called modifiable risk factors.

Many other factors in our environment, diet, and lifestyle may cause or prevent cancer. This summary reviews only the major cancer risk factors and protective factors that can be controlled or changed to reduce the risk of cancer. Risk factors that are not described in the summary include certain sexual behaviors, the use of estrogen, and being exposed to certain substances at work or to certain chemicals.

Key Points for this Section

  • Factors That are Known to Increase the Risk of Cancer
    • Cigarette Smoking and Tobacco Use
    • Infections
    • Radiation
    • Immunosuppressive Medicines
  • Factors That May Affect the Risk of Cancer
    • Diet
    • Alcohol
    • Physical Activity
    • Obesity
    • Environmental Risk Factors

Factors That are Known to Increase the Risk of Cancer

Cigarette Smoking and Tobacco Use

Tobacco use is strongly linked to an increased risk for many kinds of cancer. Smoking cigarettes is the leading cause of the following types of cancer:

Not smoking or quitting smoking lowers the risk of getting cancer and dying from cancer. Scientists believe that cigarette smoking causes about 30% of all cancer deaths in the United States.

See the following PDQ summaries for more information:

  • Lung Cancer Prevention
  • Cigarette Smoking: Health Risks and How to Quit

Infections

Certain viruses and bacteria are able to cause cancer. Viruses and other infection-causing agents cause more cases of cancer in the developing world (about 1 in 4 cases of cancer) than in developed nations (less than 1 in 10 cases of cancer). Examples of cancer-causing viruses and bacteria include:

Two vaccines to prevent infection by cancer-causing agents have already been developed and approved by the U.S. Food and Drug Administration (FDA). One is a vaccine to prevent infection with hepatitis B virus. The other protects against infection with strains of human papillomavirus (HPV) that cause cervical cancer. Scientists continue to work on vaccines against infections that cause cancer.

See the following PDQ summaries for more information:

  • Cervical Cancer Prevention
  • Liver (Hepatocellular) Cancer Prevention
  • Stomach (Gastric) Cancer Prevention
  • Oral Cancer Prevention

Radiation

Being exposed to radiation is a known cause of cancer. There are two main types of radiation linked with an increased risk for cancer:

  • Ultraviolet radiation from sunlight: This is the main cause of nonmelanoma skin cancers.
  • Ionizing radiation including: Medical radiation from tests to diagnose cancer such as x-rays, CT scans, fluoroscopy, and nuclear medicine scans.Radon gas in our homes.
    • Medical radiation from tests to diagnose cancer such as x-rays, CT scans, fluoroscopy, and nuclear medicine scans.
    • Radon gas in our homes.

Scientists believe that ionizing radiation causes leukemia, thyroid cancer, and breast cancer in women. Ionizing radiation may also be linked to myeloma and cancers of the lung, stomach, colon, esophagus, bladder, and ovary. Being exposed to radiation from diagnostic x-rays increases the risk of cancer in patients and x-ray technicians.

The risk of cancer after being exposed to ionizing radiation from diagnostic x-rays is higher for younger age groups than for older age groups, and is higher for women than for men. The risk of cancer also increases with the number of diagnostic x-rays a patient is given and the radiation dose per x-ray.

See the following PDQ summaries for more information:

  • Breast Cancer Prevention
  • Skin Cancer Prevention

Immunosuppressive Medicines

Immunosuppressive medicines are linked to an increased risk of cancer. These medicines lower the body’s ability to stop cancer from forming. For example, immunosuppressive medicines may be used to keep a patient from rejecting an organ transplant.

Factors That May Affect the Risk of Cancer

Diet

The foods that you eat on a regular basis make up your diet. Diet is being studied as a risk factor for cancer. It is hard to study the effects of diet on cancer because a person’s diet includes foods that may protect against cancer and foods that may increase the risk of cancer.

It is also hard for people who take part in the studies to keep track of what they eat over a long period of time. This may explain why studies have different results about how diet affects the risk of cancer.

Some studies show that fruits and nonstarchy vegetables may protect against cancers of the mouth, esophagus, and stomach. Fruits may also protect against lung cancer.

Some studies have shown that a diet high in fat, proteins, calories, and red meat increases the risk of colorectal cancer, but other studies have not shown this.

It is not known if a diet low in fat and high in fiber, fruits, and vegetables lowers the risk of colorectal cancer.

See the following PDQ summaries for more information:

  • Breast Cancer Prevention
  • Colorectal Cancer Prevention

Alcohol

Studies have shown that drinking alcohol is linked to an increased risk of the following types of cancers:

Drinking alcohol may also increase the risk of liver cancer and female colorectal cancer.

See the following PDQ summaries for more information:

  • Breast Cancer Prevention
  • Colorectal Cancer Prevention
  • Esophageal Cancer Prevention
  • Oral Cancer Prevention
  • Liver (Hepatocellular) Cancer Prevention

Physical Activity

Studies show that people who are physically active have a lower risk of certain cancers than those who are not. It is not known if physical activity itself is the reason for this.

Studies show a strong link between physical activity and a lower risk of colorectal cancer. Some studies show that physical activity protects against postmenopausal breast cancer and endometrial cancer.

See the following PDQ summaries for more information:

  • Breast Cancer Prevention
  • Colorectal Cancer Prevention
  • Endometrial Cancer Prevention

Obesity

Studies show that obesity is linked to a higher risk of the following types of cancer:

  • Postmenopausal breast cancer.
  • Colorectal cancer.
  • Endometrial cancer.
  • Esophageal cancer.
  • Kidney cancer.
  • Pancreatic cancer.

Some studies show that obesity is also a risk factor for cancer of the gallbladder.

Studies do not show that losing weight lowers the risk of cancers that have been linked to obesity.

See the following PDQ summaries for more information:

  • Breast Cancer Prevention
  • Colorectal Cancer Prevention
  • Endometrial Cancer Prevention
  • Lung Cancer Prevention

Environmental Risk Factors

Being exposed to chemicals and other substances in the environment has been linked to some cancers:

  • Links between air pollution and cancer risk have been found. These include links between lung cancer and secondhand tobacco smoke, outdoor air pollution, and asbestos.
  • Drinking water that contains a large amount of arsenic has been linked to skin, bladder, and lung cancers.

Studies have been done to see if pesticides and other pollutants increase the risk of cancer. The results of those studies have been unclear because other factors can change the results of the studies.

Interventions That are Known to Lower Cancer Risk

An intervention is a treatment or action taken to prevent or treat disease, or improve health in other ways. Many studies are being done to find ways to keep cancer from starting or recurring (coming back).

Key Points for this Section

  • Chemoprevention is being studied in patients who have a high risk of developing cancer.
  • New ways to prevent cancer are being studied in clinical trials.

Chemoprevention is being studied in patients who have a high risk of developing cancer.

Chemoprevention is the use of substances to lower the risk of cancer, or keep it from recurring. The substances may be natural or made in the laboratory. Some chemopreventive agents are tested in people who are at high risk for a certain type of cancer. The risk may be because of a precancerous condition, family history, or lifestyle factors.

Some chemoprevention studies have shown good results. For example, selective estrogen receptor modulators (SERMS) such as tamoxifen or raloxifene have been shown to reduce the risk of breast cancer in women at high risk. Finasteride and dutasteride have been shown to reduce the risk of prostate cancer.

See the following PDQ summaries for more information:

  • Breast Cancer Prevention
  • Prostate Cancer Prevention

New ways to prevent cancer are being studied in clinical trials.

Chemoprevention agents that are being studied in clinical trials include COX-2 inhibitors. They are being studied for the prevention of colorectal and breast cancer. Aspirin is being studied for the prevention of colorectal cancer.

See the following PDQ summaries for more information:

  • Breast Cancer Prevention
  • Colorectal Cancer Prevention

Clinical trials are taking place in many parts of the country. Check NCI's PDQ Cancer Clinical Trials Registry for cancer prevention trials that are now accepting patients.

See the NCI Web site for more information about cancer prevention.

Interventions That Are Not Known to Lower Cancer Risk

Key Points for this Section

  • Vitamin and dietary supplements have not been shown to prevent cancer.
  • New ways to prevent cancer are being studied in clinical trials.

Vitamin and dietary supplements have not been shown to prevent cancer.

An intervention is a treatment or action taken to prevent or treat disease, or improve health in other ways.

There is not enough proof that taking multivitamin and mineral supplements or single vitamins or minerals can prevent cancer. The following vitamins and mineral supplements have been studied, but have not been shown to lower the risk of cancer:

The Selenium and Vitamin E Cancer Prevention Trial (SELECT) found that vitamin E taken alone increased the risk of prostate cancer. The risk continued even after the men stopped taking vitamin E. Taking selenium with vitamin E or taking selenium alone did not increase the risk of prostate cancer.

Vitamin D has also been studied to see if it has anticancer effects. Skin exposed to sunshine can make vitamin D. Vitamin D can also be consumed in the diet and in dietary supplements. Taking vitamin D in doses from 400-1100 IU/ day has not been shown to lower the risk of cancer.

The VITamin D and OmegA-3 TriaL (VITAL) is under way to study whether taking vitamin D (2000 IU/ day) and omega-3 fatty acids from marine (oily fish) sources lowers the risk of cancer.

The Physicians' Health Study found that men who have had cancer in the past and take a multivitamin daily may have a slightly lower risk of having a second cancer.

See the following PDQ summaries for more information:

  • Breast Cancer Prevention
  • Colorectal Cancer Prevention
  • Lung Cancer Prevention
  • Prostate Cancer Prevention

New ways to prevent cancer are being studied in clinical trials.

Clinical trials are taking place in many parts of the country. Check NCI's list of cancer clinical trials for cancer prevention trials that are now accepting patients.

See the NCI Web site for more information about cancer prevention.

Changes to This Summary (03/29/2013)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Changes were made to this summary to match those made to the health professional version.

Questions or Comments About This Summary

If you have questions or comments about this summary, please send them to Cancer.gov through the Web site’s Contact Form. We can respond only to email messages written in English.

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About PDQ

PDQ is a comprehensive cancer database available on NCI's Web site.

PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.

PDQ contains cancer information summaries.

The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.

Images in the PDQ summaries are used with permission of the author(s), artist, and/or publisher for use within the PDQ summaries only. Permission to use images outside the context of PDQ information must be obtained from the owner(s) and cannot be granted by the National Cancer Institute. Information about using the illustrations in the PDQ summaries, along with many other cancer-related images, are available in Visuals Online, a collection of over 2,000 scientific images.

The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.

Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.

PDQ also contains information on clinical trials.

A clinical trial is a study to answer a scientific question, such as whether a certain drug or nutrient can prevent cancer. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients and those who are at risk for cancer. During prevention clinical trials, information is collected about the effects of a new prevention method and how well it works. If a clinical trial shows that a new method is better than one currently being used, the new method may become "standard." People who are at high risk for a certain type of cancer may want to think about taking part in a clinical trial.

Listings of clinical trials are included in PDQ and are available online at NCI's Web site. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).

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