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Cancer Risk
What is Cancer?
Cancer occurs through a process called carcinogenesis, when a normal cell becomes a malignant
(cancer) cell. Each cell in the body contains genes that guide how the body grows, develops and repairs
itself. Changes in genes are called mutations. When a mutation occurs, the way the cell works is
changed so that the cells don’t die when they should and new cells are produced when they aren’t
needed. The buildup of extra cells may cause a mass or tumor to form.
Tumors can be benign or malignant. Malignant tumor cells invade (grow into) nearby tissues and can
spread to other parts of the body. The process of spreading to other parts of the body is called
metastasis.
Benign tumors are not cancer. Benign tumor cells do not invade other tissues or spread to other parts of
the body, but they can cause problems when they grow large and press on healthy organs and tissues.
Cancer is not one disease. There are more than 100 different diseases that are considered cancer. All
types of cancer start when abnormal cells grow out of control, potentially causing serious illness or
death. Each type of cancer is different and requires different treatment. Many cancers are caused by our
lifestyle choices (things we do, such as smoking) or things we’re exposed to in the environment (such as
radiation or asbestos). However, it’s often impossible to know why and how the cancer started.
Your Risk of Getting Cancer
At this point in time, about half of all men and about one in three women will be diagnosed with
some kind of cancer. Not all these cancers are life-threatening or even require treatment. For example,
many kinds of skin cancer can be treated and cured. For men, prostate cancer is often diagnosed late in
life and may not require treatment.
You can do many things to reduce the risk of developing cancer. If you have a history of cancer in your
family, it may mean that you have an increased risk of developing cancer. But since cancer is so
common, a family history doesn’t necessarily mean that you are at higher risk. Family members
sometimes have certain risk factors in common, such as smoking, which can cause many types of cancer.
In other cases, the cancer is caused by an abnormal gene that is passed along from generation to
generation. Although this is often referred to as inherited cancer, what is inherited is the abnormal gene
that can lead to cancer, not the cancer itself. In fact, only about 5%-10% of all cancers are inherited.
If you have a family history of a specific type of cancer, you may want to talk with your doctor about
whether genetic testing might be useful. For cancers that are known to sometimes be caused by an
inherited abnormal gene (including some types of breast, ovarian, pancreatic, endometrial and colon
cancer), genetic testing and counseling can help you understand your risk and whether there is anything
you can do to reduce your likelihood of developing that type of cancer. For more information, see the
section below about genetic testing.
How You Can Reduce Your Risk of Cancer
There are many things you can do to reduce the risk of developing certain kinds of cancer. This includes
staying healthy and getting recommended cancer screenings.
Below are several risk reduction actions you can take:
 Don’t use tobacco products: Tobacco use, cigarette smoking in particular, is the leading
preventable cause of death in the United States. The link between tobacco use and cancer is
clear and proven with research. All types of tobacco use increase the risk of developing cancers
such as lung cancer, cancers of the head and neck and several other kinds of cancer. If you
smoke (cigarettes, cigars or pipes) or use smokeless tobacco, talk with your doctor about how
you can quit. There are medications that can help you quit tobacco use. It is difficult for many
people to quit smoking on their own, so consider joining a support group. The American Lung
Association, the American Cancer Society and other organizations offer support programs to
help you stop smoking.
 Avoid being around people who smoke: If you live with someone who smokes, exposure to
smoke increases the risk of developing lung cancer as well as a number of other cancers.
Whenever possible, avoid being in enclosed spaces where others are smoking by leaving the
room or asking the smoker to go outside.
 If you drink alcohol, drink only in moderation: Consumption of large amounts of alcohol can lead
to liver cancer and other medical problems. Moderate alcohol consumption is defined as having
up to one drink per day and no more than four drinks per week for women and up to two drinks
per day for men. A drink is one 12-ounce beer, one 5-ounce glass of wine, or 1-1/2 ounces of 80proof liquor. Women who are at increased risk of developing breast cancer should avoid
alcohol.1
 Infections: Certain viruses and bacteria are associated with an increased risk of cancer. Vaccines
are available to reduce the risk of developing human papilloma virus (HPV) and hepatitis B.
 Avoid ultraviolet exposure from sunlight and tanning booths: Stay out of the sun as much as
possible, and use adequate amounts of sunscreen (look for SPF 30 or higher) when in the sun.2
Stay out of tanning booths. Skin damage from tanning is especially harmful for children and
teens.
 Avoid exposure to harmful substances in your environment: These include radon in your home,
asbestos and pollutants in air and water.
 Maintain a healthy diet and weight: Evidence about the effect of diet on reducing cancer risk is
mixed. However, there are many health benefits to eating a healthy diet and getting regular
exercise to help you maintain a normal weight. Being overweight or obese is associated with a
higher risk of developing several types of cancer and has other undesirable health effects.
 Get recommended cancer screenings: Most medical health insurance plans covers 100% of the
cost of screening services that are recommended by the U.S. Preventive Services Task Force.
They are listed here.
For more information on reducing your cancer risk and the topics listed above, check these websites:
American Cancer Society: http://www.cancer.org/healthy/
American Institute for Cancer Research: http://www.aicr.org/reduce-your-cancer-risk/
National Cancer Institute: http://www.cancer.gov/cancertopics/prevention-genetics-causes. This
site provides information on many topics related to cancer prevention.
Information on environmental risks and radon exposure is available at the Environmental Protection
Agency (EPA) website: http://www.epa.gov/radon/pubs/citguide.html
Information on smoking and quitting tobacco use:
American Cancer Society: http://www.cancer.org/healthy/stayawayfromtobacco/index
American Lung Association: http://www.lung.org/stop-smoking/how-to-quit/getting-help/ or by
calling 1-800-LUNGUSA (1-800-586-4872).
Centers for Disease Control and Prevention:
http://www.cdc.gov/tobacco/quit_smoking/how_to_quit/resources/
When is Genetic Testing Appropriate?
Genetic testing can be useful for people who have a history of
certain types of cancer in their family. Genetic testing is not
recommended for most people. Cancers that are inherited are
often associated with mutations that result in a higher than
normal risk of developing cancer. Examples are BRCA1 and BRCA2
mutations that are associated with a much higher risk of
developing breast and ovarian cancer.
If you have a family history of a type
of cancer that is genetically linked
(which includes some types of breast,
ovarian, pancreatic, endometrial and
colon cancers), genetic testing may be
useful for you.
Assessment of an individual’s risk of hereditary cancer is based on a thorough evaluation of the family
history. You should talk with your doctor about your concerns. Through a series of questions, your
doctor can determine if genetic testing is appropriate for you.
If you are a candidate for genetic testing, you should be referred to a genetic counselor or other clinician
with expertise in cancer genetics who can explain the process and describe the pros and cons of testing.
If you go ahead with testing, the counselor will help you understand the results and decide what to do
next.
Genetic counseling is a critical part of the cancer risk assessment process. The genetic counselor will
help you view your genetic risk with other risk factors you may have and provide information that
relates to your specific situation. This will help you make an informed decision about testing, screening
and prevention options. Not all health plans cover genetic testing and counseling, so it will be important
to check with your health plan to find out if you have coverage for this and whether there are certain
providers that are covered.
Resources
American Cancer Society:
http://www.cancer.org/cancer/cancercauses/geneticsandcancer/genetictesting
National Cancer Institute: http://www.cancer.gov/cancertopics/genetics
References
1.
2.
American Institute for Cancer Research (AICR). The Facts about Alcohol.
http://www.aicr.org/assets/docs/pdf/brochures/facts-about-alcohol.pdf. Accessed April 22,
2013.
American Cancer Society. Cancer prevention & early detection facts & figures 2013.
http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/
acspc-037535.pdf. Accessed May 31, 2013.