Читать книгу Textbook of Lifestyle Medicine - Labros S. Sidossis - Страница 36

The major risk factors for cancer onset include use of tobacco products, excessive alcohol intake, unhealthy body weight, physical inactivity, and certain infections and occupational/environmental chemical exposures.

Tobacco use accounts for approximately six million deaths on an annual basis. At least 50 of the chemicals contained in tobacco have a well‐established causal effect on cancer development. Tobacco smoking causes malignancies in lung, esophagus, larynx, mouth, throat, kidney, bladder, pancreas, stomach, and cervix. Second‐hand smoking can also cause lung cancer. Additionally, smokeless tobacco products, such as oral or chewing tobacco, have been shown to cause oral, esophageal, and pancreatic neoplasms. Interestingly, the majority of smokers globally (i.e., 80% of 1 billion) live in regions of low or middle income.

Other lifestyle‐related factors associated with cancer onset include unhealthy dietary habits, being physically inactive, and obesity. Obesity has been linked to esophageal, colorectal, breast, endometrial, and kidney malignancies. Excess alcohol intake increases the risk of malignancies developed in the oral cavity, pharynx, larynx, esophagus, liver, colorectum, and breast.

There is a dose–response relationship between alcohol intake and cancer development, and the risk of several cancer types is further exacerbated when increased alcohol consumption is combined with smoking. Alcohol use accounted for about 6% of all cancers and 4% of all cancer deaths in the United States in 2020.

Infection‐related factors, exposure to carcinogens derived from occupational environment or environmental pollution, and ultraviolet and ionized radiation can also increase the risk for developing cancer. Infectious agents such as helicobacter pylori, human papilloma virus (HPV), hepatitis B and C, and Epstein–Barr virus accounted for 20% of cancer cases in 2020, and their prevalence was substantially greater in developing countries. Air, water, and soil contamination with carcinogens plays a role in the total burden of the disease. Contamination of foods with carcinogenic chemicals, such as aflatoxins and dioxins, is another means by which humans are exposed to carcinogens. Exposure to occupational carcinogens mainly affects specific population groups whose working environment incurs exposure to carcinogenic chemicals, such as asbestos. Exposure to ionized and ultraviolet radiation can also aggravate the risk of developing certain types of neoplasms. There is a dose–response relationship between the extent to radiation exposure and risk of carcinogenesis, and a greater risk of cancer onset when the exposure occurs at a young age.

More than 80% of US health‐care costs are spent in the treatment of preventable chronic diseases and conditions, such as T2DM, obesity, osteoporosis, heart disease, hypertension, stroke, and many types of cancer. Preventing even a small fraction of chronic disease cases could significantly improve people's health and alleviate the pressure on health‐care systems around the world.