HOW TO PREVENT CANCERS

There is lots of talk in the news right now about scanning - mostly about the kind in airports and whether it is too great an invasion of privacy. But medical scanning has also been making headlines - specifically, whether we do too much of it unnecessarily, as CT and X-ray scans expose the body to radiation, which has risks. Recent reports indicated that CT scans of smokers may reduce their risk of mortality by 20%, which may suggest the exposure to radiation is worth the risk. However, as Laura Gottleib points out in the San Francisco Chronicle, prevention is a cheaper and lower risk option. 87% of lung cancer is caused by smoking and CT scans aren't going to eliminate that - they are simply going to help us catch and treat the lung cancer earlier. Preventing people from starting smoking, minimizing (or eliminating) exposure to secondhand smoke and helping people quit prevent lung cancer from developing.

What about the cost? According to Gottleib, the cost of scanning all former and current smokers in the United States is roughly $30 billion per year. In contrast, California's Tobacco Control Program decreased adult tobacco use by 35 percent, saving $86 billion in health care costs. How does she get at that HUGE savings? For every $1 California spends, it reduces statewide health care costs by $3.60, according to research done by Tobacco Free Kids.

Advances in early detection and treatment are great, but let's not forget the value of prevention!

Read more: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2010/11/21/EDKC1GEUHP.DTL#ixzz161rYIMli

This morning, I had the extreme pleasure of hearing Dr. Bill Dietz of the CDC's Division of Nutrition and Physical Activity in the Center for Chronic Disease Prevention and Health Promotion speak about Policy and Environmental Changes to Prevent and Control Obesity at the Washington University School of Medicine Grand Rounds. Dr. Dietz touched on many topics, but one that stood out to me was the focus CDC has on its list of priority strategies to address important health behaviors: increasing access to fruits and vegetables through retail stores.

I'm sure many of my fellow news junkies saw the NY Times Magazine story about Walgreens' new program to eliminate food deserts. A food desert the NY Times describes as "urban neighborhoods where there are few grocers selling fresh produce, but a cornucopia of fast-food places and convenience stores selling salty snacks (though, strictly speaking, the term can be applied to rural or suburban areas, too). Often the problem afflicts low-income areas abandoned or shunned by food businesses that focus on better-off consumers"

Food deserts are a problem that numerous non-profit and community groups have worked to tackle. Most notable is probably the Food Trust based in Pennsylvania. The Food Trust work has expanded to other states and has had some notable successes in encouraging supermarket development and expanded farmers' market programs. Perhaps it shouldn't be surprising then that when the US government announced the $400+ million Healthy Food Financing Initiative to bring grocery stores to underserved communities, it did so in Philadelphia.

Do big intiatives like this work? The general consensus is cautious optimism. Certainly having the White House behind programs like this is a big deal. But, as Marion Nestle noted, voluntary programs such as these don't always move us very far in the path to healthier communities. That businesses are seeing an opportunity here, perhaps points to some real movement (even if the cynic in me points out that this is about the bottom line for any business). I'm looking forward to seeing Walgreens provide some data on the successes (or not) of their program, something the Times article notes it has been unwilling to do so far. I'm also curious to see more data on whether these programs change fruit and vegetable intake, and ultimately rates of associated comorbidities, like obesity. Economic disparities have a big effect on food choices and the economic challenges facing families will be a big driver of our success in food access and numerous other health challenges.

I've been pretty reluctant to pick up best seller books about cancer and the history of cancer since I bought one a few years ago that I found so terrible I finally decided my time was being terribly misspent. So this morning's Morning Edition interview with Siddhartha Mukherjee, the author of The Emperor of All Maladies: A Biography of Cancer was intriguing to me. The NY Times Book Review gave it a positive endorsement as well. Dr. Mukherjee had a great perspective on how we're doing in the "War on Cancer" and at the end of the interview, I decided to add his book to my Kindle.

Do you read books of this kind? Or do you find they don't add much to your knowledge base? How do you choose which ones to read given the boom in "health" books?