Primary Prevention of Cancer

Abstract

Primary prevention has enormous potential to reduce the human, social, and economic costs of cancer worldwide. The following sections discuss the development and application of preventive interventions in six broad areas of public health: tobacco control, the prevention of obesity and physical inactivity, prevention of infection-related cancers, protection against excessive exposure to ultraviolet light, preventive drug therapies (chemoprevention), and the regulation of carcinogenic exposures. All of these areas affect multiple types of cancer and massive numbers of people. Different interventions are at varying stages of development. For example, effective, evidence-based approaches have been developed over several decades to reduce tobacco use, prevent chronic infection with hepatitis B virus, protect children from excessive sun exposure, regulate exposures in high-income countries, and reduce breast cancer incidence and recurrence in high-risk women. More recent efforts are seeking to identify upstream measures to prevent excessive weight gain, reduce caloric intake, and increase physical activity.

Lung Cancer Incidence in Nonmetropolitan and Metropolitan Counties — United States, 2007–2016

“…Lung cancer prevention and control is a comprehensive approach and includes strategies such as screening for tobacco dependence, promoting tobacco cessation, implementing comprehensive smoke-free laws, testing all homes for radon and using proven methods to lower high radon levels, and reducing exposure to lung carcinogens such as asbestos ( 1 ). The U.S. Preventive Services Task Force recommends that clinicians screen all adults for tobacco use at each office visit and refer or provide behavioral and pharmacotherapy smoking cessation interventions as indicated †† .…”

“…Lung and bronchus (lung) cancer is the leading cause of cancer death in the United States ( 1 ). In 2016, 148,869 lung cancer deaths were reported *.…”

“…In 2016, 148,869 lung cancer deaths were reported *. Most lung cancers can be attributed to modifiable exposures, such as tobacco use, secondhand smoke, radon, and asbestos ( 1 ). Exposure to lung cancer risk factors vary over time and by characteristics such as sex, age, and nonmetropolitan or metropolitan residence that might affect lung cancer rates ( 1 , 2 ).…”

“…Most lung cancers can be attributed to modifiable exposures, such as tobacco use, secondhand smoke, radon, and asbestos ( 1 ). Exposure to lung cancer risk factors vary over time and by characteristics such as sex, age, and nonmetropolitan or metropolitan residence that might affect lung cancer rates ( 1 , 2 ). A recent report found that lung cancer incidence rates were higher and decreased more slowly in nonmetropolitan counties than in metropolitan counties ( 3 ).…”

“…Overall, among males, lung cancer incidence rates decreased from 99 to 82 per 100,000 in nonmetropolitan areas and from 83 to 63 in metropolitan areas; among females, lung cancer incidence rates decreased from 61 to 58 in nonmetropolitan areas and from 57 to 50 in metropolitan areas. A comprehensive approach to lung cancer prevention and control includes such population-based strategies as screening for tobacco dependence, promoting tobacco cessation, implementing comprehensive smoke-free laws, testing all homes for radon and using proven methods to lower high radon levels, and reducing exposure to lung carcinogens such as asbestos ( 1 ). Increasing the implementation of these strategies, particularly among persons living in nonmetropolitan counties, might help to reduce disparities in the decline of lung cancer incidence.…”