Cancer Prevention and Early Detection Strategies

Cancer is a growing public health concern in India. Approximately 14.6 lakh new cancer cases were estimated in India in 2022. Common cancers include breast, lung, oral cavity, cervical, and tongue cancer. Many cancers in India are diagnosed at locally advanced or advanced stages, making awareness, prevention, screening, and early detection especially important.

According to Dr Anshul Agarwal, adopting healthy lifestyle habits, undergoing appropriate screening, receiving recommended vaccinations, and understanding family history can help reduce cancer risks and support early diagnosis.

Lifestyle Measures to Help Reduce Cancer Risk

Here are some important lifestyle measures recommended by Dr Anshul Agarwal to help reduce the risk of developing certain types of cancer.

1. Do Not Use Tobacco: Tobacco contains harmful chemicals that can cause cancer. Both smoking and smokeless tobacco use are associated with several types of cancer, including cancers of the lungs, mouth, throat, voice box, pancreas, bladder, cervix, and kidneys. Avoiding tobacco in all forms is one of the most effective ways to reduce cancer risk.
2. Adopt a Balanced Diet: Eat a balanced diet rich in fruits, vegetables, whole grains, and lean protein sources. A nutritious diet supports overall health and may help reduce the risk of certain cancers. Choose a variety of foods and limit highly processed food products.
3. Limit Processed Meat: Reduce consumption of processed meats such as bacon, sausages, ham, and salami. Frequent consumption of processed meat is associated with an increased risk of colorectal cancer.
4. Avoid or Minimise Alcohol Consumption: Alcohol consumption increases the risk of several cancers, including cancers of the mouth, throat, oesophagus, liver, breast, and colorectum. Avoiding alcohol can help reduce these risks.
5. Maintain a Healthy Weight and Stay Physically Active: Maintaining a healthy body weight and exercising regularly can help reduce the risk of certain cancers, including breast and colorectal cancer. Adults should generally aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity each week, along with muscle-strengthening activities on two or more days, as appropriate.
6. Minimise Exposure to Harmful Substances: Take appropriate precautions to reduce exposure to carcinogens such as asbestos, certain pesticides, and harmful chemicals. Protect your skin from excessive ultraviolet radiation by using sunscreen, wearing protective clothing, and seeking shade.
7. Practise Safe Sex: Practising safer sex and following recommended vaccination guidelines can help reduce the risk of infections such as human papillomavirus (HPV) and hepatitis B, which are associated with certain cancers. HIV infection can also increase the risk of some cancers, partly because it weakens the immune system. Use appropriate protection and seek medical advice regarding testing and prevention.

Importance of Regular Cancer Screening and Early Detection

Regular screening and early detection can help identify certain cancers or precancerous changes before symptoms develop. Early diagnosis may provide more treatment options and improve outcomes. Screening recommendations depend on factors such as age, sex, personal medical history, family history, and individual risk.

Dr Anshul Agarwal highlights the importance of discussing appropriate screening options with a healthcare professional.

1. Breast Cancer Screening: Mammography is an important screening method for breast cancer. Women should discuss when to begin screening with their healthcare provider. The appropriate starting age and screening interval depend on individual risk and the guidelines followed; some recommendations begin routine screening at age 40, while others use different age thresholds.
2. Cervical Cancer Screening: Cervical cancer screening may involve a Pap test, an HPV test, or both, depending on the applicable guidelines and the individual's medical history. Screening generally begins in adulthood, with the recommended starting age varying by guideline and test method. Consult a healthcare professional to determine the appropriate schedule.
3. Report Bleeding After Menopause: Any vaginal bleeding or spotting after menopause should be evaluated promptly by a doctor. Although it does not always indicate cancer, it can be a warning sign of endometrial or other gynaecological conditions that require investigation.
4. Lung Cancer Screening for Long-Term Smokers: People with a significant smoking history may benefit from low-dose computed tomography (LDCT) screening. Eligibility depends on age, smoking history, and the applicable clinical guidelines. In some guidelines, screening is recommended for eligible adults aged 50–80 years with at least a 20 pack-year smoking history who currently smoke or quit within the past 15 years. A doctor can determine whether screening is appropriate.
5. Prostate Cancer Screening: Men with a father or brother who has had prostate cancer, particularly at a younger age, may have an increased risk. They should discuss the potential benefits and limitations of prostate-specific antigen (PSA) testing with their doctor. Screening decisions should be made after considering individual risk and preferences.

Important: Screening recommendations vary across countries and medical organisations. These examples are general guidance and should not replace an individual assessment by a qualified healthcare professional.

Vaccination Strategies for Cancer Prevention

Vaccination plays an important role in preventing infections associated with certain cancers. The hepatitis B and human papillomavirus vaccines are two important examples.

1. Hepatitis B Vaccine: Chronic hepatitis B infection can cause liver inflammation, cirrhosis, and liver cancer. Hepatitis B vaccination helps prevent infection and reduces the long-term risk of hepatitis B-related liver cancer. Vaccination is particularly important for infants and people who have not previously been immunised.
2. Human Papillomavirus (HPV) Vaccine: HPV vaccination helps prevent infections caused by HPV types responsible for most cervical cancers and a substantial proportion of several other cancers, including anal, vaginal, vulvar, penile, and oropharyngeal cancers. Vaccination is routinely recommended before exposure to HPV, ideally during adolescence. Depending on national guidelines and individual circumstances, vaccination may also be recommended for older adolescents and adults. In many guidelines, catch-up vaccination is recommended through age 26.

HPV vaccination can substantially reduce the risk of HPV-related cancers, but it does not eliminate every risk. Vaccinated individuals who are eligible for cervical cancer screening should continue to follow the recommended screening schedule.

Understanding Genetic Risk and Family History

Approximately 5% to 10% of cancers are thought to be associated with inherited genetic changes passed down through families. Having an inherited genetic mutation does not mean that a person will definitely develop cancer; it means the risk of developing certain cancers may be higher.

People with a significant family history of cancer may benefit from consulting a genetic counsellor to discuss their risk and whether genetic testing is appropriate. You may consider seeking genetic counselling if any of the following apply to you:

• You have several first-degree relatives, such as your mother, father, sisters, brothers, or children, who have had cancer.
• Several relatives on the same side of your family have had the same type of cancer.
• Multiple cancers in your family may be associated with an inherited genetic mutation, such as certain forms of breast, ovarian, colorectal, or pancreatic cancer.
• A family member has had more than one type of cancer.
• Family members developed cancer at a younger age than is typical for that cancer.
• Close relatives have cancers associated with recognised hereditary cancer syndromes.
• A family member has a rare cancer, such as male breast cancer or retinoblastoma, a type of eye cancer.
• You or a family member has a physical finding associated with inherited cancer risk, such as numerous colorectal polyps.
• One or more family members have undergone genetic testing that identified a potentially inherited cancer-associated mutation.

Genetic counselling can help you understand your inherited risk, the possible benefits and limitations of testing, and the preventive measures or screening strategies that may be appropriate for you.

For more information about inherited cancer risk, visit the American Cancer Society's guide to cancer genetics.

The Importance of Awareness and Early Action

Detecting cancer early can allow timely medical intervention, expand treatment options, and improve the chances of successful treatment. However, not every cancer can be prevented or detected through routine screening, making awareness of symptoms and timely medical evaluation equally important.

By adopting healthier behaviours, avoiding tobacco, maintaining a balanced diet, staying physically active, receiving recommended vaccinations, understanding family history, and following appropriate screening guidelines, individuals can take meaningful steps towards reducing their cancer risk.

Increasing public awareness, encouraging regular medical consultations, and supporting accessible cancer prevention and screening programmes can help reduce the burden of cancer and contribute to a healthier future for generations to come.