20 oktober 2016: ik heb enkele links gecorrigeerd in onderstaand artikel.

24 november 2005: Bron: The Guardian and The Lancet

In een groot artikel in The Lancet worden de resultaten van een grote nieuwe epidemologische studie gepubliceerd welke aangeeft dat een bepaald voedingspatroon en een bepaalde leefstijl verantwoordelijk zijn wereldwijd voor minimaal 1/3 van alle jaarlijks voorkomende gevallen van kanker. De auteurs stellen ook dat een verandering van voedingswijze en verandering van leefstijl een veel groter effect zal hebben dan betere en vroegtijdiger diagnoses en geavanceerdere opsporingstechnieken en bewezen reguliere behandelingen. Een aanpassing van de voedingwijze en leefstijl - niet roken, veel groenten en fruit eten, goede beweging, sporten op z'n tijd, vaccin tegen HPV virus, terugdringing van luchtvervuiling enz. zou maar liefst 2 miljoen minder gevallen van kanker wereldwijd kunnen betekenen op een jaarlijks aantal gevallen van kanker van 7 miljoen wereldwijd. Lees een groot artikel uit The Guardian over deze studie en daaronder hebben een samenvatting geplaatst van het artikel uit The Lancet met deeplink naar het volledige artikel met grafieken enz.

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Lifestyle changes could stop a third of cancers, says study

· Behaviour more critical than screening and drugs
· Smoking a factor in 21% of the 7 million deaths a year

James Meikle, health correspondent
Friday November 18, 2005
The Guardian

More than a third of cancer deaths worldwide have preventable causes that could be tackled by changing people's behaviour and their environment, according to a study published today. The impact of smoking on several cancers is well known, but alcohol use, unsafe sex, low fruit and vegetable intake, obesity, lack of exercise, contaminated injections and indoor smoke from fuels are also risks that could be reduced.

Majid Ezzati of the Harvard School of Public Health in Boston and colleagues suggest in the Lancet medical journal that health interventions could prevent a "substantial proportion" of the 7 million cancer deaths a year, and be more effective in reducing mortality than screening and ever-improving treatments.

Smoking is a factor in 21% of all cancer deaths, especially in men, they say, with alcohol and low fruit and vegetable intake accounting for 5% each. Sexual transmission of the human papilloma virus is a leading risk factor for cervical cancer in low- and middle-income countries, especially where screening is limited, although there are hopes that vaccines will soon be widely available. The researchers say smoking is linked to 856,000 deaths a year from lung, bronchial and tracheal cancers, 184,000 oesophageal cancers and 131,000 oral cancers. About 116,000 oesophageal cancer deaths and 51,000 oral cancer deaths are linked to alcohol. They based their figures on a review of published studies, government reports and international databases, as well as a reanalysis of primary data. Problems with missing information meant they did not include other factors such as occupational risk or exposure to ultraviolet light and passive smoking.

Meanwhile, Karol Sikora from Imperial College and Hammersmith hospital in London predicted that in 20 years "we will be talking about controlling cancer in the long term, not eradicating it but making cancer like diabetes". Improving technology allowed more personalised and targeted treatments. For instance, improvements in imaging equipment provided better pictures of the location of tumours to direct radiotherapy.

Globally, however, health services would struggle to pay for new treatments and prevention programmes as the number of people diagnosed with cancer continued to grow. "We will not eliminate cancer in the next 25 to 50 years," said Professor Sikora. "That is not possible. Even if everyone stopped smoking tomorrow there would still be cancer in 2025."

He said a blood test to predict a person's risk of developing cancer may be possible in a decade. That could help to make people more motivated to make lifestyle changes, he told a conference organised by the charity Canceractive.

Mike Richards, the government's cancer tsar, said the incidence of the disease was continuing to rise because the population was growing older. "One in four people are dying of cancer and that is likely to go on for some while longer. If you look at the death rate for cancer, it is going down, but not fast enough."

He said he had wanted a total ban on smoking in enclosed public places in England, rather than the planned exemptions for pubs that do not sell food and private members' clubs. He said it remained "a tricky point" but he was "absolutely convinced that over time we will get a full ban because it makes sense".

En hier de samenvatting van het artikel uit The Lancet:

The Lancet 2005; 366:1784-1793 DOI:10.1016/S0140-6736(05)67725-2

Causes of cancer in the world: comparative risk assessment of nine behavioural and environmental risk factors
Goodarz Danaei a, Stephen Vander Hoorn b, Alan D Lopez c, Christopher JL Murray a and Majid Ezzati a , The Comparative Risk Assessment collaborating group (Cancers)

Summary
Introduction
With respect to reducing mortality, advances in cancer treatment have not been as effective as those for other chronic diseases; effective screening methods are available for only a few cancers. Primary prevention through lifestyle and environmental interventions remains the main way to reduce the burden of cancers. In this report, we estimate mortality from 12 types of cancer attributable to nine risk factors in seven World Bank regions for 2001

. Methods
We analysed data from the Comparative Risk Assessment project and from new sources to assess exposure to risk factors and relative risk by age, sex, and region. We applied population attributable fractions for individual and multiple risk factors to site-specific cancer mortality from WHO.

Findings
Of the 7 million deaths from cancer worldwide in 2001, an estimated 2·43 million (35%) were attributable to nine potentially modifiable risk factors. Of these, 0·76 million deaths were in high-income countries and 1·67 million in low-and-middle-income nations. Among low-and-middle-income regions, Europe and Central Asia had the highest proportion (39%) of deaths from cancer attributable to the risk factors studied. 1·6 million of the deaths attributable to these risk factors were in men and 0·83 million in women. Smoking, alcohol use, and low fruit and vegetable intake were the leading risk factors for death from cancer worldwide and in low-and-middle-income countries. In high-income countries, smoking, alcohol use, and overweight and obesity were the most important causes of cancer. Sexual transmission of human papilloma virus is a leading risk factor for cervical cancer in women in low-and-middle-income countries.

Interpretation
Reduction of exposure to key behavioural and environmental risk factors would prevent a substantial proportion of deaths from cancer.

Read the entire article including grafics and tables from The Lancet at: The Lancet - full text


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