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Cancer Risk Factors

Cancer Prevention and Alcohol Intake

Alcohol consumption is not recommended. If consumed, limit alcoholic drinks to less than two drinks a day for men and one for women. There is convincing evidence that drinking alcohol increases the risk of cancers of the mouth, pharynx, larynx, esophagus and liver. In addition, it probably increases the risk of cancers of the colon, rectum and breast. Drinking alcohol and smoking is a particularly troubling combination. Cancers of the mouth, pharynx, esophagus and larynx develop when sensitive tissues are directly exposed to alcohol in beverages. The relationship of alcohol intake to liver cancer has been recognized for some time.

Studies have proved that the drinking of alcoholic beverages can induce cancer. Risk of cancer development rises as the level of intake increases. The strongest cancer associations are with oral, pharyngeal, esophageal, and laryngeal cancer. People who drink and smoke greatly enhance their risk for developing cancer.

Alcohol is a recognized cause of  liver cancer. Studies have found small to modest increases in risks of breast cancer associated with drinking alcoholic beverages.

Moderation of intake is the key to cancer prevention related to alcohol-induced cancer. Because many of the cancers induced by alcohol result from heavy consumption, reducing levels of consumption will considerably lessen the cancer risk. Because of the interaction of alcohol and tobacco, smoking cessation will also reduce the effect of alcohol on oral, pharyngeal, esophageal, and laryngeal cancers.

Prevention and Diet

Much research has shown that the way people eat has a lot to do with how healthy they are-and how healthy they stay. Research has also shown that a diet low in fat, high in fiber, with plenty of fruits and vegetables, may help lower cancer risk, especially in the gastrointestinal and respiratory tracts.

Healthy eating recommendations:
  • Choose most of the foods you eat from plant sources. Eat five or more servings of fruits and vegetables every day.
  • Eat other unprocessed, plant-based foods such as breads, cereals, rice, pasta or beans several times per day.
  • Limit your intake of high-fat foods, particularly those from animal sources. Limit your consumption of meat, especially high-fat meats. Restrict red meats to about one serving per day.
  • Be physically active, achieve and maintain a healthy weight.
  • Limit your consumption of alcohol to no more than one drink per day for women and no more than two drinks per day for men.
  • Avoid salty foods.

For more information on a healthy diet, download the The U.S. Department of Agriculture's Nutrition and Your Health, Dietary Guidelines for Americans (PDF file: 588KB).

Prevention and Environmental Exposure

Environmental causes probably account for well over half of all types of cancer cases. Most environmental risks are determined by lifestyle choices (smoking, diet, etc.), while the rest arise in community and workplace settings. The degree of cancer hazard posed by these voluntary and involuntary risks depends on the concentration or intensity of the carcinogen and the exposure dose a person received. In situations where high levels of carcinogens are present and where exposures are extensive, significant hazards may exist, but where concentrations are low and exposures limited, hazards are often negligible. When low-dose exposures persist over time they can represent significant public health hazards (for example, exposure to secondhand tobacco smoke). Cancer prevention starts by eliminating known environmental risks such as smoking and other exposures to high level carcinogens.

Various chemicals (for example, benzene, asbestos, vinyl chloride, arsenic, aflatoxin) show definite evidence of human carcinogenicity; others are considered probable human carcinogens based on evidence from animal experiments (for example, chloroform, dichlorodiphenyl-trichloroethane [DDT], formaldehyde, polychlorinated biphenyls [PCBs], polycyclic aromatic hydrocarbons). Often in the past, direct evidence of human carcinogenicity has come from studies of workplace conditions involving sustained, high-dose exposures. Risks can be increased when particular exposures occur together (for example, asbestos exposure and cigarette smoking). Many different types of cancer can be caused by environmental factors. The best cancer prevention is to eliminate as many of these known risk factors from your every day life as possible.

Cancer Prevention and Exercise

The American Cancer Society recommends 30 minutes of physical activity most days. Studies have shown that physical activity can help protect against some cancers, either by balancing caloric intake with energy expenditure, or by other means. Studies have shown that being overweight can lead to an increased risk for cancers of the colon, prostate, endometrium, breast, and kidney. For cancer prevention and for overall healthy living it is wise to develop a daily exercise routine.
To learn how to Exercise For Your Health at the Cleveland Clinic Heart Center web site.

Prevention and Family History

Cancer research shows that up to 15% of all cancers have a familial basis. That means that the cancer tends to occur among members of a family. Much of the time, different types of cancer occur apparently by chance, or in association with common family habits such as cigarette smoking. However, cancer research suggests that certain cancers can occur to excess in some families. For example, a woman whose mother and/or sisters (first-degree relatives) had breast cancer is 2-3 times more likely to develop breast cancer than a woman whose close female relatives have not had breast cancer. Many other cancers are associated with having a family history of that cancer. Breast, ovarian, prostate and colon are some of these cancers.

Cancer research shows that most cancers are caused by a variable mix of heredity and environmental factors. Cancers, such as lung cancers in cigarette smokers, while caused primarily by external factors, are still influenced by genes that modify an individual's risk of disease. Scientists are currently studying the complex ways in which genes and environment interact.

Family clusters of cancer development have been reported for virtually every form of cancer. In general, close relatives of a cancer patient have an increased risk for developing the same type of cancer. An inherited susceptibility often becomes apparent when cancers of the same body site or organ occur in multiple blood relatives. In familial cancers avoiding harmful exposures can help prevent or delay the onset of cancer. For example, members of melanoma-prone families who avoid significant ultraviolet radiation exposure can reduce substantially their risk of melanoma.

Cancer research shows several tumor suppressor genes have been identified, predominantly through studies of cancer-prone families with hereditary cancers. Major recent genetic discoveries include the identification of BRCA1, a gene for hereditary breast and ovarian cancer, the localization of BRCA2 and another breast cancer gene. Approximately 5 percent of breast or colon cancer patients might carry one or more inherited susceptibility genes. The discovery of these genes has increased greatly the numbers of cancer susceptibility gene carriers who can possibly be identified.

The primary purpose of identifying gene carriers would be to promote earlier detection of cancer and, since prognosis is correlated closely with stage of disease at diagnosis, increased survivability. However, identifying gene carriers in cancer-free populations is a new concept with many clinical, ethical, legal and psychosocial implications yet to be explored. Predisposition testing presents certain advantages when prevention and early detection measures are available. On the other hand, there is a great potential for harm – from loss of insurability and employability, psychological stress, social stigma or other consequences. As more and more inherited susceptibility genes are identified, their appropriate use will require careful evaluation. The challenge to research is to identify testing procedures and guidelines that maximize benefits while minimizing harm.

Cancer Prevention and Sexual Contact

Viruses passed from person to person through sexual contact may cause some kinds of cancer. Cancers are not caused by having sex itself, but by the virus that is passed from person to person. Viruses associated with cancer development are the herpes II virus, which causes genital herpes, the cytomegalovirus, which causes a different type of herpes, and the human papillomavirus (HPV), which causes genital warts. The roles of these viruses are not fully understood and generally people who get these viruses do not develop cancer. Of these viruses, however, HPVs pose the most risk and are associated with development of genital cancers, and some oral cancers. The best known sexually transmitted virus is the HIV (Human Immuno-deficiency Virus). For the best possible genital cancer prevention, protect yourself during sexual contact to avoid contracting these viruses associated with cancer development.

HIV stands for Human Immuno-deficiency Virus. This is a virus that people can be infected with and that they can then pass on to other people. When someone becomes infected with HIV it begins to attack their immune system which is the body's defense against illness. This process is not visible. When a person is infected with HIV they are likely as time goes by to be ill more and more often. A person is said to have AIDS (Acquired Immune Deficiency Syndrome) when, usually several years after first becoming infected with HIV, they have developed one of a number of particularly severe illnesses. Protect yourself from the viruses passed from person to person through sexual contact for the best genital cancer prevention.

The main ways that people become infected with HIV are by:

Having sexual intercourse with an infected partner
Injecting drugs using a needle or syringe that has already been used by someone who is infected

Medical advances have nearly eliminated blood transfusions as a source of HIV infection.

HIV infection carries with it a high susceptibility to certain cancers. For many years, Kaposi's Sarcoma was the most common HIV-related cancer. Now there is a growing incidence of AIDS-related Hodgkin's disease or AIDS-related Non-Hodgkin's lymphoma.

Cancer Prevention and Smoking

Tobacco use, particularly smoking, is the single most preventable cause of death in the United States. Cigarette smoking alone is directly responsible for at least one-third of all cancer deaths annually in the United States. Cancer prevention starts with not starting the bad habit of smoking, or quitting smoking.
Cigarette smoking is the most significant cause of lung cancer and the leading cause of lung cancer death in both men and women. Smoking is also responsible for most cancers of the larynx, oral cavity, and esophagus. In addition, it is highly associated with the development of, and deaths from bladder, kidney, pancreatic and cervical cancers.

The health risks of cigarette smoking are not limited to smokers-exposure to "secondhand smoke" significantly increases a non-smoker's risk for developing lung cancer. In addition, smokeless tobacco such as snuff or chewing tobacco is associated with increased risk for developing cancers of the oral cavity, pharynx (throat), larynx (voice box), and esophagus.

Pipe and cigar smokers experience substantially elevated risks for cancers of the oral cavity, larynx, pharynx, and esophagus, which equal and often exceed the risks observed in regular cigarette smokers. Pipe and cigar smokers experience a slightly increased risk for lung cancer; however, among pipe and cigar smokers who inhale, the risk of lung cancer is on the same order of magnitude found in cigarette smokers.

Nearly one-third of all cancer deaths expected to occur each year in the United States, are directly linked to cigarette smoking. Additional deaths can be attributed to smokeless tobacco, pipe and cigar smoking. In short, all forms of tobacco use are hazardous, but the hazards are magnified when smoke from the tobacco is inhaled. Furthermore, the nicotine in tobacco is addictive, which makes it extremely difficult for most users to stop the behavior once it has been adopted as part of their lifestyle.

The best cancer prevention is clearly to never start smoking. Word of Mouth, an innovative school-based tobacco prevention program, aims to help children remain tobacco-free for life. The program targets children in grades 4-8, a time when children are most at risk for initiating tobacco use. For more information on this program, visit the Word of Mouth web site.

The Health Benefits of Quitting Smoking

Quitting smoking greatly reduces the risks for cancer and is the first step of cancer prevention. For example, within a year of quitting, a former smoker's risk of heart disease is reduced by nearly 50 percent compared to someone who continues to smoke. Unfortunately, the risks for lung cancer do not decrease as rapidly, but the sooner one quits smoking, the quicker one begins to benefit. Usually, after 10 to 15 years off cigarettes, most former smokers' health status is not significantly different from that of a lifelong nonsmoker. Any residual risk following cessation is strongly dependent on total previous exposure to cigarette smoke, length of time off cigarettes, and the health status of the individual at the time of cessation.

For more on stopping smoking, visit The Cleveland Clinic Department of Psychiatry and Psychology's Smoking Cessation Program.

Cancer Prevention and Sun Exposure

Skin cancer is the most common form of cancer in the United States. Skin cancer is a tumor or growth of abnormal cells in the skin. Most experts agree that the primary cause of skin cancer is exposure to the sun. However, additional risks for developing cancer are repeated exposure to tanning beds, x-ray radiation, exposure to certain chemical toxins, and a family history of skin cancer. The easiest skin cancer prevention is the use of sunscreens and avoiding tanning beds. Prevention and early detection are the best ways to reduce your risk for skin cancer.

Types of Skin Cancer


The Three Types of Skin Cancer

There are three main types of skin cancer: basal cell carcinoma, squamous cell carcinoma and melanoma. Basal cell and squamous cell cancers are the less serious types and make up 95% of all skin cancers. Also referred to as non-melanoma skin cancers, they are highly curable when treated early.

Melanoma, made up of pigment cells called melanocytes, is the most serious form of skin cancer and causes 75% of all skin cancer deaths. Left untreated, it can spread to other organs and is difficult to control.

Skin Cancer Prevention:

Prevention is avoiding the sun (especially between 10:00 a.m. and 4:00 p.m.) and using sunscreens with a sun protection factor (SPF) of at least 30. It is very important to apply sunscreen to young children and infants after 6 months of age.

Other prevention tips include:

  • Apply sunscreen 30 minutes before you go outside
  • Wear hats with brims to protect your face and ears
  • Wear long-sleeved shirts and pants to protect your arms and legs
  • Wear sunglasses to protect your eyes
  • Use a lip balm with sunscreen
  • Avoid exposure to sunlamps and tanning beds
ABCD-The Alphabet of Melanoma Detection

Check all moles for these features:

  1. Asymmetry – the shape of one half doesn't match the other
  2. Border-edges are ragged or blurred
  3. Color-uneven shades of brown, black, tan, red, white or blue may be present
  4. Diameter – a change in size occurs (greater than 6mm)
Early Detection of Skin Cancer

Early detection involves regularly and thoroughly inspecting your body for any skin changes. Any new or changes moles, sores or discolorations should be evaluated by a physician as soon as you notice them.

To find out more about skin cancer and skin cancer prevention, go to The Cleveland Clinic Department of Dermatology Skin Cancer Questions & Answers.

Cancer Answers & Appointments

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This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

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