The Cooper Institute

Founded in 1970 by the "Father of Aerobics"
Kenneth H. Cooper MD, MPH


Cancer: A Frequently Preventable Cause of Illness and Death?

Posted in

Monday, May 03, 2021

Cancer is the second-leading cause of death among U.S. men and women, accounting for approximately 600,000 deaths each year as well as ~$160 billion in annual health care costs.

The current top 5 leading causes of cancer death for U.S. men and women are shown below in Table 1. Data source: American Cancer Society (

Table 1. Leading causes of cancer death in U.S. men and women.

Men Annual number of deaths Women Annual number of deaths

Lung cancer


Lung cancer


Prostate cancer


Breast cancer


Colorectal cancer


Colorectal cancer


Pancreatic cancer


Pancreatic cancer


Liver cancer


Ovarian cancer


A common statement that is heard is ‘everything causes cancer, there’s nothing that you can do.’ While it is true that genetics cannot be controlled and exposure to environmental carcinogens cannot always be controlled, there are a number of lifestyle factors that have a very significant effect on cancer risk. In 2020, the American Cancer Society published updated Guidelines for Diet and Physical Activity for Cancer Prevention. These guidelines are summarized below.

  Tobacco Use | Alcohol Intake | Obesity | Sedentary Lifestyle | Diet  


Tobacco Use: 

The use of tobacco accounts for 30% of all cancer deaths and nearly 90% of all lung cancer deaths in the U.S. Exposure to environmental radon gas, genetics, and poor diet are thought to account for the remaining 10% of lung cancer deaths. Smokers are 25 times more likely to develop lung cancer than non-smokers. Tobacco use also increases the risk for developing cancers of the nose, mouth, esophagus, larynx, pharynx, stomach, pancreas, kidney, bladder, uterus, cervix, colon, and ovary.  All forms of tobacco should be avoided, including second-hand smoke and chewing tobacco.

Alcohol Intake: 

While it is true that a light to moderate alcohol intake can significantly decrease the risk of cardiovascular disease, many people are surprised to learn that alcohol is a major risk factor for cancers of the mouth, esophagus, larynx, pharynx, breast, colon, and liver. For the goal of cancer prevention, it is best not to drink at all. Adults who consume alcohol are advised to limit their intake to no more than 2 drinks per day for men and no more than 1 drink per day for women. A drink is defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of hard liquor. Women who are pregnant should not consume alcohol, and adults who are currently non-drinkers are advised to remain non-drinkers.


40% of American adults are now classified as obese. Two of the best measures of obesity are body mass index (BMI) and waist circumference (WC). For adults, a BMI value of >30 kg/m2 is the criterion for obesity, while a WC of >35 inches in women or >40 inches in men is the criterion. Obesity is a cause of breast, colorectal, esophageal, endometrial, kidney, stomach, liver, gall bladder, ovarian, thyroid, multiple myeloma, and pancreatic cancers. Individuals should try to maintain a body weight within the healthy range, and adults should try to avoid weight gain. Of interest, research published by The Cooper Institute showed that the risk of cancer death in obese individuals was much lower in those with a moderate to high level of cardiorespiratory fitness than in obese individuals with a low level of cardiorespiratory fitness.

Sedentary Lifestyle:

Only ~20% of American adults meet the minimal current public health guidelines for physical activity. The ACS recommends 150-300 minutes per week of moderate intensity exercise or 75-150 minutes per week of vigorous intensity exercise. Children and adolescents should get one hour of moderate or vigorous activity each day. All individuals should limit sedentary behaviors such as sitting, lying down, watching television and other forms of screen-based entertainment. Physical activity may reduce the risk of several types of cancer including breast, colon, endometrial, esophageal, stomach, liver, and lung. The Cooper Institute data has shown a marked reduction in cancer mortality among men and women with moderate to high levels of cardiorespiratory fitness compared to those with low levels of fitness, even after controlling for age, BMI, and smoking.


There are a number of myths and misconceptions regarding diet and cancer risk. What we do know about diet, and cancer are summarized by the recent ACS Guidelines: Processed meat (bacon, sausage, hot dogs, lunch meat) and red meat (beef, pork, and lamb) should be limited or not consumed in the diet. Individuals are advised to choose fish, poultry, or beans instead of red meat. Farm-raised fish, as well as shark, swordfish, tilefish, and king mackerel may contain high levels of mercury, dioxins and other pollutants. Young children, as well as women who are pregnant or breast feeding should not consume these fish. Intake of fruits, vegetables, and whole grains should be increased, while refined grain products (pastry, sugar-sweetened cereals) should be limited in the diet. When choosing fruits and vegetables, it is recommended to choose a variety of colors. Sugar sweetened beverages such as soft drinks should be limited or not consumed in the diet. Irradiated foods are not a cancer risk since radiation does not remain in these foods. The US Food and Drug Administration has evaluated the safety of irradiated food for >30 years and has found the process to be safe.

Despite public perception, it is largely unknown whether or not organic foods carry a lower risk of cancer because they are less likely to be contaminated by compounds that might cause cancer. Plant-based, fiber-rich foods such as vegetables, fruits, legumes, and whole grains should form the central part of a person’s diet, regardless of whether they are grown conventionally or organically. The ACS also states that although genetically modified foods (GMO’s) should continue to be assessed for safety, there is no evidence that consumption of GMO’s such as corn or soy would either increase or decrease cancer risk. Finally, there is no evidence that sugar substitutes such as aspartame and saccharin cause cancer in humans.  More detailed information from the ACS on diet and cancer risk can be found at:

So there you have it. Following the above recommendations is associated with a marked reduction in the risk of developing several types of cancer. The ACS has long-stated that “for individuals who do not use tobacco, diet and physical activity remain the most modifiable determinants of cancer risk.”


Farrell, S.W., Cortese, G.M., LaMonte, M.J., and Blair, S.N. (2007). Cardiorespiratory fitness, different measures of adiposity, and cancer mortality in men. Obesity. 15(2):3140-3148.

Farrell, S.W., Finley, C.E., McAuley, P.A., and Frierson, G.M. Cardiorespiratory fitness, different measures of adiposity, and total cancer mortality in women.  (2011). Obesity. 19(11):2261-2267.

Rock, C.L., et al. American Cancer Society guidelines on diet and physical activity for cancer prevention. (2020). CA: A cancer journal for clinicians. 70:245-271.