Preventing Future Cancers

Cancer develops gradually over many years as a result of a complex mix of factors related to behaviors, genetics (heredity) and environment. Each type of cancer is caused by a different set of factors, some well established (such as cigarette smoking causing lung cancer), some uncertain and some unknown.

Many cancers are thought to result from more than one risk factor. A risk factor for cancer is a condition or an activity that increases a person’s chance of developing a particular type of cancer. There is a wide range of risk factors associated with different types of cancers. Behavioral choices like over-exposure to ultraviolet light, tobacco use, alcohol consumption, poor diet, and lack of physical activity can increase a person’s chance of getting cancer.

One of the primary ways to reduce the impact of cancer on Vermonters is to reduce the risk factors that can lead to cancer among Vermonters. Another is through regular screening tests. Cancers of the colon (large intestine) and cervix can actually be prevented by screening, since abnormal tissue can be found and removed before becoming cancerous.

Although not all types of cancers are preventable many can be prevented by stopping smoking, increasing physical activity, and eating a healthy diet that is low in fat, moderate in calories and high in fiber. These healthy lifestyle choices also significantly reduce the risk of other chronic diseases, such as heart disease and diabetes.

The following includes VTAAC’s goals and objectives toward preventing future cancers by reducing known risk factors. Many of these goals, objectives and strategies come directly from other statewide planning efforts relating to tobacco control, obesity prevention and other health issues. References and links to these plans and coalitions have been provided where appropriate.

Tobacco Use Prevention and Cessation

Using tobacco is the leading cause of all preventable deaths in the US and Vermont. Exposure to carcinogens (cancer-causing substances) in tobacco products accounts for about one-third of all cancer deaths in the United States each year. More than 820 Vermonters die each year from tobacco-related illnesses, including cancers of the lung, mouth and throat, cervix and bladder.

Lung cancer is the leading cancer killer among men and women, accounting for nearly 30 percent of all cancer deaths in Vermont. Smoking tobacco is a leading cause of lung cancer, and exposure to second-hand smoke is also dangerous, especially to children. Prohibiting smoking in cars and homes is one way to protect children and adults from second-hand smoke. Reduce tobacco usage and exposure to second hand smoke.

Objectives: Reduce prevalence of smoking in the past month among youth in grades 8-12 from 20% in 2003 to 16% by 2010. Reduce prevalence of adult smoking from 20% in 2004 to 12% by 2010. Increase the percentage of Vermont smokers with children who prohibit smoking in their homes from 58% in 2004 to 65% in 2010.

For more information about the Tobacco Control Program, go to: www.HealthVermont.gov

Healthy Eating Habits

Poor nutrition is the second leading actual cause of death in the US. One-third of the cancer deaths in the U.S. are due to poor nutrition and lack of physical activity. A poor diet can lead to obesity, which is known to increase a person’s risk for cancers of the breast, colon, endometrium, esophagus, and kidneys. Diets high in saturated fats and low in fiber have been linked to various cancers, including breast and colon.

Poor nutrition habits started in youth often continue into adulthood and increase a person’s risk for malnutrition, obesity, cancer, diabetes, heart disease, and other chronic health conditions.

It is recommended that people eat at least two servings of fruit daily and at least three servings of vegetables daily. In Vermont, only about half of Vermont adults eat the recommended servings of fruit and vegetables each day.

Body mass index (BMI) is an indicator of appropriate weight compared to height. A BMI higher than 25 indicates overweight, and a BMI higher than 30 indicates obesity. Over half (55%) of Vermonters age 18 and older were overweight or obese in 2003; up from 44 percent in 1992.

Goal: Reduce the risk of various cancers through healthful eating habits.

Objectives: Reduce the prevalence of obesity (BMI >30) among Vermont adults from 20% in 2003 to 15% in 2010. Increase the proportion of adults who consume at least 3 daily servings of vegetables from 41% in 1998 to 50% in 2010. Increase proportion of adults who consume at least 2 daily servings of fruit from 50% in 1998 to 75% in 2010. Reduce the prevalence of overweight Vermont youth (> 95th percentile of BMI) from 11% in 2003 to 5% in 2010. Increase the proportion of youth in grades 8-12 who consume at least 3 daily servings of vegetables from 16% in 2003 to 50% in 2010.

Increase the proportion of youth in grades 8-12 who consume at least 2 daily servings of fruit from 40% in 2003 to 75% in 2010.

For more information on the Obesity Plan go to: www.HealthVermont.gov

Physical Activity

Regular, moderate physical activity is essential to healthy living, as it not only helps to maintain a person’s weight but influences hormone levels. Lack of regular physical activity is the 3rd leading cause of actual death in the US, and increases the risk of cancer of the colon and breast.

The recommendation for exercise is 30 minutes a day, five days a week or more for adults. It has been found that more exercise is beneficial in reducing risk of breast and colon cancer. Only 55 percent of Vermonters engage in regular, moderate physical activity.

While Vermont has met some of the goals for physical activity among all adults Vermont, several sub-populations have not met these goals.

Goal: Reduce the risk of various cancers through increased regular physical activity.

Objectives:

Increase the percentage of adults (age 18+) who engage in regular, moderate physical activity (30+ minutes per day, 5 days per week) from 55% in 2003 to 63% in 2010. Increase the percentage of adolescents who engage in moderate physical activity (30+ minutes per day, 5 or more days of the previous 7 days) from 26% in 2003 to 31% in 2010.

For more information on the Physical Activity Plan, go to: www.HealthVermont.gov

Environmental Exposure

Exposure to naturally occurring and man-made carcinogens (cancer-causing substances) in the environment, home or workplace increases the risk of developing various cancers. These include second-hand tobacco smoke, radon gas, asbestos fibers, ultra-violet radiation from the sun, and household and industrial chemicals.

Lung cancer is the leading cancer killer for both men and women in Vermont, accounting for nearly 30 percent of all cancer deaths. Smoking tobacco is a leading cause of lung cancer, followed by exposure to radon gas and asbestos fibers. Second-hand smoke is also a major risk factor for cancer, especially among children.

Radon gas is widespread in Vermont and the risk of exposure can easily be reduced through air testing and proper ventilation. Vermont has met its Healthy Vermonters goal of 20 percent of homes being tested for radon. However, the U.S. Environmental Protection Agency recommends that all households be tested for radon gas.

Ultraviolet radiation from the sun is the most significant risk for skin cancer. Exposure to ultraviolet radiation, either from the sun, tanning beds, or sunlamps causes premature skin aging and DNA damage. This can lead to melanoma and other forms of skin cancer.

Goal: Reduce environmental exposures including second-hand tobacco smoke,
radon gas in homes, and ultraviolet radiation.

Objectives: Increase the proportion of Vermont smokers with children that prohibit smoking in their homes from an average of 58% in 2004 to 65% in 2010. Increase the number of all Vermont adults reporting using at least one sun protection method when out in the sun from 76% in 2001 to 75% among all subpopulations in 2010. Continue to increase the number of Vermont households tested for radon gas beyond 20% by 2010.

Breastfeeding

Some studies suggest that breastfeeding may slightly lower breast cancer risk, especially among women who breastfeed for a cumulative total of 1.5 to 2 years or more. Of Vermont women over age 40 (regardless of the number of children they have had), only 14.9 percent have breastfed for a period of greater than 1.5 years over their lifetime. Breastfeeding also increases healthy nutrition among infants and decreases risk of obesity among children.

Data from the 2004 Behavioral Risk Factor Surveillance System, a statewide telephone survey of adults, show that of Vermont women who have ever given birth, more than one-third (34.5%) have never breastfed an infant. More information on breast cancer risk can be found at www.cancer.org

Goal: Increase breastfeeding rates among Vermont mothers to increase health
of children and decrease breast cancer risks.

Objective: Increase the percentage of Vermont mothers who report ever breastfeeding from 66% in 2004 to 75% in 2010.

For more information on breastfeeding resources in Vermont, go to: www.HealthVermont.gov