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Cancer Prevention is Better Than Early Detection

In 1971, then President Richard Nixon declared a war on cancer with the aim of eliminating the disease in time for the bicentenary in 1976. A measure of how we are doing can be seen in projections that by 2050 there will be over double the number of cancer deaths and new cases each year than there were in 2007.

Part of the reason, in my opinion, that the incidence of cancer continues to rise is the confusion between prevention and early detection. It is certainly much better to detect cancers early (in most instances) but surely it is better not to get it at all. There has recently been a renewed call for screening for bowel cancer to be funded by the Federal Government. The Cancer Council claims that screening with fecal occult blood testing is the best way to reduce deaths from bowel cancer. A major UK study has shown that this form of screening would reduce deaths by around 15%. However there was a way to reduce deaths by around 25% and this required no funding or government action.

All that was required was for people to exercise regularly, eat more fruits and vegetables, moderate their intakes of red meat and alcohol and maintain a healthy body weight. Doing this would not lead to earlier detection of cancer but actually reduce the incidence of bowel cancer. Why this does not get as much publicity as screening is a mystery.

Another cancer controversy is with prostate cancer. Debate has been reignited about the value of PSA screening with the launch of a new book. The inventor of the test went on the public record with an Op-ed piece in The New York Times earlier this year to describe the test as like the flip of a coin.

For every man whose life is “saved ” by the test there are 48 men who have unnecessary surgery and many suffer complications like impotence and incontinence. In this debate it is interesting to see that the main supporters of testing are those who are actively involved in either testing or treatment. One could also argue they have a vested interest.

With breast cancer, for every 1600 women who have a mammogram one woman will have a cancer detected and treated who would not otherwise have done so. These are heavily promoted. Yet when it has been shown that the chances of getting breast cancer could be reduced by one third if women ate more fruits and vegetables, did regular exercise and had moderate alcohol intake cancer groups were reluctant to promote it.

To be honest I am getting a little questioning of some disease support groups. Many are well meaning but is there an inherent conflict between needing people to have a disease to stay in business and being dedicated to reducing the prevalence of a disease?

Early detection and treatment is better than late in most instances but not all. Some people with early cancers may never have problems but have treatments they do not need. Genuine prevention is clearly the best option. This is where the focus needs to be. The fact that prevention is not guaranteed does not change that.

There are no guarantees in life. However there are ways of increasing the odds in your favor. You can (according to the World Cancer Research Fund) reduce your chances of getting cancer by one third. This is achieved by doing regular exercise and, you guessed it, eating a healthy diet.

Health is a lot easier than you are led to believe.

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