HOW TO PREVENT CANCERS

A new study in this month's Archives of Dermatology suggests that indoor tanning can be addicting in young adults (study) (1).  While the study was relatively small, with just over 400 participants surveyed, the results seem to bolster the need for moves toward greater regulation of the indoor tanning industry, especially through policies that curtail use by youth (related post).

The release of the study seems particularly well timed with the signing of the new health care reform bill, which institutes a 10 percent tax on all indoor UV tanning services (related post).  Raising the price point of risky items has proved a particularly effective approach in limiting certain high risk behaviors in youth.  The classic example of this is tobacco (study) (2).  As excise taxes on - and therefore the prices of - cigarettes go up, the use of cigarettes by youth go down.  Keeping smoking rates low in youth means fewer will go on to develop lifelong smoking habits.

Though tanning bed use is not as destructive, nor likely as addictive, as tobacco use, it is an activity that can have serious lifelong consequences.  Much of the melanoma (and other skin cancer) risk related to UV exposure comes  from unprotected exposure in youth and young adulthood.  Taking a cue from the tobacco control playbook and raising the cost of tanning should help a good percentage of young people decide that it's just not worth it.  And they'd be right.

Related CNiC posts
Health Care Reform and Prevention of Cancer - April 7, 2008
More Blistering Truths About Tanning Bed Use by Youths - April 5, 2008 


Related media
Washington Post: Tanning beds may get closer scrutiny based on findings about skin cancer risk - April 20, 2010


Literature cited

1. Mosher, C., Addiction to Indoor Tanning: Relation to Anxiety, Depression, and Substance Abuse. Arch Dermatol, 2010. 146(4): p. 412-417.
2. Liang, L., et al., Prices, policies and youth smoking, May 2001. Addiction, 2003. 98 Suppl 1: p. 105-22.

Lately, with health care reform being the health topic de rigueur, much of the talk about technology in health has been related to electronic medical records. But, as the presentations at the 2010 Society of Behavioral Medicine (SBM) Annual Meeting demonstrate, there is a lot more to using technology to improve health than just electronic medical records. Many of these technologies focus on cancer risk factors like physical activity, diet and diabetes.

Pedometers
Pedometers (or step counters) have been around for decades, but lately thanks to some key technological advances, pedometers have gotten a big boost. Now you can seamlessly upload your pedometer data to the web and track your progress. The declines in the cost of some technologies has also meant that more sophisticated devices that measure both the amount and intensity of exercise (called accelerometers) are more affordable. These devices track both your total steps as well as the number of those steps that are aerobic, or more vigorous. This means those dilly-dallying steps I take when slowly walking my dog in the morning don’t count toward my aerobic goal, but the faster ones I take when I’m running late to a meeting do! The latest devices update seamlessly online and allow you to both track and share your progress.

Phone-based tracking
Smart phone applications (“apps”) to allow individuals to track and monitor health behaviors are getting lots of buzz these days. Unfortunately, there aren’t a lot of data on their effectiveness yet, but expect to see that coming soon. These applications allow you to track your food intake in a real time diary (evidence does show that people who keep food diaries do better at losing weight and maintaining a healthy weight). There are also programs in the works to allow you to use the camera in your phone to track your food and caloric intake! Similar programs for physical activity diaries are also available, and we expect to see more and more advances that will link smart phones with pedometers. There are even apps (many of which are free) that let you use your iPhone as a pedometer or a GPS tracking device that can show you how far you’ve gone, how fast, and even how much up and down you’ve traveled! Most of these applications haven’t been evaluated in a research setting, but the principles that underlie them have been.

Web tools
One of the most intriguing things presented at SBM last week was on the use of social networking websites to build support in young adult populations for improving health. In particular, some promising results were presented from a team at Vanderbilt on their use of a website for adolescents with diabetes to improve management of symptoms and improving health behaviors. Expect to see more and more of these sites for kids and adults going forward. Not only do they provide a place to track your progress, but you can get tips and support from others in a similar situation. And of course, if you want a personalized risk assessment, Your Disease Risk is a powerful validated tool that gives you YOUR risk for a host of cancers, heart disease, stroke, diabetes and osteoporosis.

In results widely reported this week, a new study has found strong links between the drinking behavior of young women and adolescent girls and their later risk of developing benign breast disease, a marker of future risk for breast cancer (study link) (1).

The study, published early online in the journal Pediatrics, surveyed close to 7,000 girls and young women aged 16 - 23 years in 2003 about their drinking behavior, then followed them through 2007, tracking health outcomes.  The researchers (which included CNiC's Dr. Graham Colditz) found strong links between regular drinking and a diagnosis of benign breast disease over that period.  Drinking once or more each week significantly increased the risk of benign breast disease compared to those who drank rarely or not at all.  Drinking 3 - 5 days each week was linked to three times the risk.  Drinking 6 - 7 days each week was linked to five times the risk.

Alcohol is a well established cause of breast cancer (2).  So while the link between alcohol use and a possible increased risk of cancer later in life isn't necessarily surprising, these findings are important because they show that  behaviors in the youth and young adult years likely play very key roles in the pathways that lead to cancer. Studies of soy and fiber intake early in life show similar results (related post) (3, 4) . This growing body of evidence points to the need to boost disease prevention efforts in youth while at the same time further explore the science behind early life choices and the impact this can have on later cancer risk. 

It's been long known that youth is a key time for laying the foundation for a healthy lifestyle.  Avoiding smoking, keeping weight in a healthy range, being regularly active, and eating a healthy diet are all behaviors that, when started in youth, are more likely to carry through to adult life as well.  Now, with the results of this and other studies, the importance of fostering healthy choices in youth and young adulthood are even more compelling and something we shouldn't wait to act upon.

Related Web links
8 Ways to Stay Healthy and Prevent Disease (includes tips for parents & grandparents) 
American Academy of Pediatrics - Policy Statement--Alcohol Use by Youth and Adolescents: A Pediatric Concern (free full text)

Related CNiC posts
Despite New Results - Keep Eating Your Fruits and Vegetables - April 8, 2010  
More Blistering Truths About Tanning Bed Use by Youths - April 5, 2008 
Adolescent diet prevents breast cancer - March 18, 2010


Literature cited

1. Berkey, C.S., et al., Prospective Study of Adolescent Alcohol Consumption and Risk of Benign Breast Disease in Young Women. Pediatrics, 2010.
2. Hamajima, N., et al., Alcohol, tobacco and breast cancer--collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95,067 women without the disease. Br J Cancer, 2002. 87(11): p. 1234-45.
3. Wu, A.H., et al., Epidemiology of soy exposures and breast cancer risk. Br J Cancer, 2008. 98(1): p. 9-14.
4. Su, X., et al., Intake of fiber and nuts during adolescence and incidence of proliferative benign breast disease. Cancer Causes Control.