State policies drive cancer burden


Recent media reports highlight how a lack of state policy on cigarette taxes can drive a state to have high cancer rates. Missouri is a fine US example which now has the lowest tax on cigarettes in the nation (17 cents per pack).

State level policy impacting cancer is not limited to just cigarettes and increased burden from smoking-related cancers, however. With reductions in resources available to the state, Missouri cut back funding for the Breast and Cervical Cancer Screening Program (in Missouri called Show Me Healthy Women). This added t to the existing language in qualifying for treatment after diagnosis among women without health insurance leads poor rural areas to have low breast cancer incidence (lack of screening) and high mortality. This morality is driven by late stage at diagnosis and limited access to current standard quality of care for breast cancer.  Maps at the county level show rural Missouri dominates the state with high cancer mortality.

If we are to overcome disparities in access to detection and care for cancer patients, then state policies must foster access for all. Access has to be not only for detection methods (breast, cervix, and colon cancer screening) but also to effective programs to aid cessation from smoking.  Programs must also seamlessly link those diagnosed with cancer to effective care.

cancers list keywords

1     breast cancer     4,390            
2     prostate cancer     2,346            
3     skin cancer     2,112            
4     pancreatic cancer     2,044            
5     american cancer society     1,925            
6     aspirin vs cancer     1,795            
7     lung cancer     1,652            
8     cancer cure from india bill clinton eats     1,617            
9     breast cancer awareness     1,479            
10     tropic of cancer     1,478            
11     colon cancer     1,247            
12     inflammatory breast cancer     1,194            
13     batman vs cancer     1,088            
14     ovarian cancer     1,081            
15     cancer awareness     1,033            
16     maple syrup baking soda vs cancer     995            
17     breakthrough breast cancer     974            
18     colon cancer symptoms     956            
19     coaches vs cancer     951            
20     cervical cancer     924            
21     pancreatic cancer symptoms     880            
22     breast cancer ribbon     841            
23     lung cancer symptoms     839            
24     scorpio and cancer compatibility     830            
25     cancer horoscope     825            
26     cancer treatment centers of america     752            
27     aspiri vs cancer     743            
28     ovarian cancer symptoms     733            
29     liver cancer     727            
30     aspirin cancer     713            
31     cancer awareness months     713            
32     testicular cancer     712            
33     cancer daily horoscope     666            
34     libra and cancer relationship     625            
35     tropic of cancer capricorn     609            
36     bladder cancer     608            
37     cancer awareness ribbons     601            
38     steve jobs cancer     594            
39     leo vs cancer     593            
40     types of cancer     591            
41     stomach cancer symptoms     583            
42     baking soda cancer cure     562            
43     thyroid cancer     552            
44     colon cancer warning signs     535            
45     bone cancer     532            
46     capricorn and cancer compatibility     523            
47     uterine cancer     518            
48     stomach cancer     517            
49     canadian drug touted for advanced breast cancer     510            
50     esophageal cancer     503            
51     signs of colon cancer     493            
52     brain cancer     492            
53     cancer pisces relationship     489            
54     cancer research     481            
55     asparagus and cancer     479            
56     national cancer institute     461            
57     tropic of cancer map     461            
58     edd vs cancer     458            
59     gemini cancer relationship     447            
60     tratamiento del cancer     440            
61     endometrial cancer     435            
62     matching aries gemini cancer tattoos     433            
63     scorpio and cancer relationship     427            
64     cancer symptoms     425            
65     cancer ribbon     424            
66     baking soda and cancer     420            
67     prostrate cancer     413            
68     cervical cancer symptoms     410            
69     cancer man     407            
70     national breast cancer awareness month     404            
71     nosh aspirin colon cancer     402            
72     cancer ribbons     399            
73     13 yr old cancer patient     393            
74     best relationship match for cancer male     393            
75     aries and cancer relationship     390            
76     aspirin preventing cancer     386            
77     confirmed baking soda cancer cure     384            
78     lance armstrong cancer     383            
79     tongue cancer     376            
80     acai vs cancer     369            
81     hydrocortisone vs decadron brain cancer     369            
82     virgo cancer compatibility     362            
83     cancer drug     361            
84     colon cancer early symptoms     355            
85     cancer 2013 horoscope money     348            
86     liver cancer symptoms     347            
87     bladder cancer symptoms     346            
88     kidney cancer     341            
89     cancer patients     340            
90     cancer stages     340            
91     cancer ribbon tattoo     337            
92     md anderson cancer center     337            
93     aspirin a cure for cancer     331            
94     pink cancer ribbon     328            
95     symptoms of colon cancer     328            
96     cancer centers of america     326            
97     asprin vs cancer     325            
98     free cancer awareness crochet patterns     323            
99     when a cancer man is in love     315            
100     types of breast cancer     312            
1     breast cancer     4,390            
2     prostate cancer     2,346            
3     skin cancer     2,112            
4     pancreatic cancer     2,044            
5     american cancer society     1,925            
6     aspirin vs cancer     1,795            
7     lung cancer     1,652            
8     cancer cure from india bill clinton eats     1,617            
9     breast cancer awareness     1,479            
10     tropic of cancer     1,478            
11     colon cancer     1,247            
12     inflammatory breast cancer     1,194            
13     batman vs cancer     1,088            
14     ovarian cancer     1,081            
15     cancer awareness     1,033            
16     maple syrup baking soda vs cancer     995            
17     breakthrough breast cancer     974            
18     colon cancer symptoms     956            
19     coaches vs cancer     951            
20     cervical cancer     924            
21     pancreatic cancer symptoms     880            
22     breast cancer ribbon     841            
23     lung cancer symptoms     839            
24     scorpio and cancer compatibility     830            
25     cancer horoscope     825            
26     cancer treatment centers of america     752            
27     aspiri vs cancer     743            
28     ovarian cancer symptoms     733            
29     liver cancer     727            
30     aspirin cancer     713            
31     cancer awareness months     713            
32     testicular cancer     712            
33     cancer daily horoscope     666            
34     libra and cancer relationship     625            
35     tropic of cancer capricorn     609            
36     bladder cancer     608            
37     cancer awareness ribbons     601            
38     steve jobs cancer     594            
39     leo vs cancer     593            
40     types of cancer     591            
41     stomach cancer symptoms     583            
42     baking soda cancer cure     562            
43     thyroid cancer     552            
44     colon cancer warning signs     535            
45     bone cancer     532            
46     capricorn and cancer compatibility     523            
47     uterine cancer     518            
48     stomach cancer     517            
49     canadian drug touted for advanced breast cancer     510            
50     esophageal cancer     503            
51     signs of colon cancer     493            
52     brain cancer     492            
53     cancer pisces relationship     489            
54     cancer research     481            
55     asparagus and cancer     479            
56     national cancer institute     461            
57     tropic of cancer map     461            
58     edd vs cancer     458            
59     gemini cancer relationship     447            
60     tratamiento del cancer     440            
61     endometrial cancer     435            
62     matching aries gemini cancer tattoos     433            
63     scorpio and cancer relationship     427            
64     cancer symptoms     425            
65     cancer ribbon     424            
66     baking soda and cancer     420            
67     prostrate cancer     413            
68     cervical cancer symptoms     410            
69     cancer man     407            
70     national breast cancer awareness month     404            
71     nosh aspirin colon cancer     402            
72     cancer ribbons     399            
73     13 yr old cancer patient     393            
74     best relationship match for cancer male     393            
75     aries and cancer relationship     390            
76     aspirin preventing cancer     386            
77     confirmed baking soda cancer cure     384            
78     lance armstrong cancer     383            
79     tongue cancer     376            
80     acai vs cancer     369            
81     hydrocortisone vs decadron brain cancer     369            
82     virgo cancer compatibility     362            
83     cancer drug     361            
84     colon cancer early symptoms     355            
85     cancer 2013 horoscope money     348            
86     liver cancer symptoms     347            
87     bladder cancer symptoms     346            
88     kidney cancer     341            
89     cancer patients     340            
90     cancer stages     340            
91     cancer ribbon tattoo     337            
92     md anderson cancer center     337            
93     aspirin a cure for cancer     331            
94     pink cancer ribbon     328            
95     symptoms of colon cancer     328            
96     cancer centers of america     326            
97     asprin vs cancer     325            
98     free cancer awareness crochet patterns     323            
99     when a cancer man is in love     315            
100     types of breast cancer     312            
1     breast cancer     4,390            
2     prostate cancer     2,346            
3     skin cancer     2,112            
4     pancreatic cancer     2,044            
5     american cancer society     1,925            
6     aspirin vs cancer     1,795            
7     lung cancer     1,652            
8     cancer cure from india bill clinton eats     1,617            
9     breast cancer awareness     1,479            
10     tropic of cancer     1,478            
11     colon cancer     1,247            
12     inflammatory breast cancer     1,194            
13     batman vs cancer     1,088            
14     ovarian cancer     1,081            
15     cancer awareness     1,033            
16     maple syrup baking soda vs cancer     995            
17     breakthrough breast cancer     974            
18     colon cancer symptoms     956            
19     coaches vs cancer     951            
20     cervical cancer     924            
21     pancreatic cancer symptoms     880            
22     breast cancer ribbon     841            
23     lung cancer symptoms     839            
24     scorpio and cancer compatibility     830            
25     cancer horoscope     825            
26     cancer treatment centers of america     752            
27     aspiri vs cancer     743            
28     ovarian cancer symptoms     733            
29     liver cancer     727            
30     aspirin cancer     713            
31     cancer awareness months     713            
32     testicular cancer     712            
33     cancer daily horoscope     666            
34     libra and cancer relationship     625            
35     tropic of cancer capricorn     609            
36     bladder cancer     608            
37     cancer awareness ribbons     601            
38     steve jobs cancer     594            
39     leo vs cancer     593            
40     types of cancer     591            
41     stomach cancer symptoms     583            
42     baking soda cancer cure     562            
43     thyroid cancer     552            
44     colon cancer warning signs     535            
45     bone cancer     532            
46     capricorn and cancer compatibility     523            
47     uterine cancer     518            
48     stomach cancer     517            
49     canadian drug touted for advanced breast cancer     510            
50     esophageal cancer     503            
51     signs of colon cancer     493            
52     brain cancer     492            
53     cancer pisces relationship     489            
54     cancer research     481            
55     asparagus and cancer     479            
56     national cancer institute     461            
57     tropic of cancer map     461            
58     edd vs cancer     458            
59     gemini cancer relationship     447            
60     tratamiento del cancer     440            
61     endometrial cancer     435            
62     matching aries gemini cancer tattoos     433            
63     scorpio and cancer relationship     427            
64     cancer symptoms     425            
65     cancer ribbon     424            
66     baking soda and cancer     420            
67     prostrate cancer     413            
68     cervical cancer symptoms     410            
69     cancer man     407            
70     national breast cancer awareness month     404            
71     nosh aspirin colon cancer     402            
72     cancer ribbons     399            
73     13 yr old cancer patient     393            
74     best relationship match for cancer male     393            
75     aries and cancer relationship     390            
76     aspirin preventing cancer     386            
77     confirmed baking soda cancer cure     384            
78     lance armstrong cancer     383            
79     tongue cancer     376            
80     acai vs cancer     369            
81     hydrocortisone vs decadron brain cancer     369            
82     virgo cancer compatibility     362            
83     cancer drug     361            
84     colon cancer early symptoms     355            
85     cancer 2013 horoscope money     348            
86     liver cancer symptoms     347            
87     bladder cancer symptoms     346            
88     kidney cancer     341            
89     cancer patients     340            
90     cancer stages     340            
91     cancer ribbon tattoo     337            
92     md anderson cancer center     337            
93     aspirin a cure for cancer     331            
94     pink cancer ribbon     328            
95     symptoms of colon cancer     328            
96     cancer centers of america     326            
97     asprin vs cancer     325            
98     free cancer awareness crochet patterns     323            
99     when a cancer man is in love     315            
100     types of breast cancer     312            

Superbad? The Problem with "Superfood" Lists

Today I hopped over to Forbes.com to review their "most stressful cities" list (and was relieved that St Louis wasn't topping another "bad" place to live list -- I think topping the syphilis list is enough). While I was there, a link to a list of "10 foods you should be eating" caught my eye. I'm always wary of such lists, and this one provided a nice reminder of why:

The list starts out with three great foods - cherries, blueberries and kiwi. All three are great choices because they are fruit and eating a lot of fruits and vegetables have been shown to decrease risk of several diseases, including cancer. The problem, to me, is that most Americans don't come anywhere near to eating enough fruit, regardless of the type. Also, the three fruits are in season for a pretty short period of time, making their cost pretty high the rest of the year. Add to that, the fact that berries tend to top lists of fruits that absorb the most pesticides, so other lists are telling you to only buy organic and you've got a major cost issue on your hands. For most people, just starting to eat 2-3 servings of fruit a day, of ANY fruit, is going to be a big step.

The list then moves on to proteins -- grass-fed beef, wild salmon, flax seed and whey protein powder. While I certainly see the merit of choosing grass-fed beef over industrial beef for the reasons listed (omega-3 content being a big one, environmental impact being another), the context is missing here. Grass-fed beef is expensive and most Americans eat too much red meat of all kinds and certainly don't need beef appearing on a list of things they need more of. If you want to up your omega-3 intake, replace your meat intake with other sources of protein rich in omega-3, like fish and flax seed and aim to reduce your meat intake in general.

The list ends with dark chocolate. With overweight and obesity rates topping 60% in the US, I don't think anyone needs encouragement to eat more chocolate. Granted, the fine print suggests looking for chocolate with at least 60% cocoa content (ruling out most candy bars in the checkout aisle), but portion size and frequency of intake are big issues here and neither is mentioned.

Also overlooked in the discussion is that much of the data supporting the "superfood" concept don't come from studies of people eating those foods. The data come from studies of human cell lines or of extracts of a single component/nutrient that the food is high in. The problem with these studies is 1) that flesh and blood humans are very different from a collection of cells in a petri dish and 2) that the volume of intake needed to reach the dose given to the cells or extracted and given to humans is difficult to achieve through consumption of the food itself.

So, the cold reality is that there are no real "superfoods," just like there are no magic bullets.  It's simply a title dreamed up by magazine editors or folks who don't have a good understanding of the science linking diet and human health.

Of course, overall diet can have a large impact on chronic disease, and making simple, largely inexpensive, changes to what we eat can have big benefits.  Eating a diet rich in fruits, vegetables, whole grains, and healthy fats (like poly and monounsaturated fats); and low in red meat and unhealthy fats (like saturated and trans) will trump any collection of "superfoods" when it comes to health benefits, and it'll likely save you a lot of money along the way.

I wonder if by suggesting that people need to go spend $30 on organic blueberries and eat chocolate to be healthy we actually encourage the status quo as so few people have the ability to spend at this level and so few read the fine print of the message? What do you think? Do these lists help you make healthy choices or confirm that you are/aren't healthy already?