Primary prevention of cancer attempts to limit exposure to carcinogens in order to prevent the initiation or promotion of cancer. Cancer prevention strategies to modify cancer risk factors involve lifestyle interventions and medical interventions which include chemoprevention and vaccines.22
Key areas of primary prevention addressing modifiable risk factors through lifestyle interventions in Australia are focused on:13
- Tobacco smoking
- Sun exposure
- Physical activity, body mass and nutrition
- Alcohol
- Occupational exposure
- Viral and bacterial infections.
There is strong evidence of the association between viruses such as human papillomavirus (HPV) and hepatitis B virus (HBV) and the development of malignancies. The administration of prophylactic vaccines to protect against cancer-causing viruses is appropriate if:22
- A microorganism is the known etiologic source of cancer.
- Vaccination can effectively prevent infection from the microorganism.
- Prevention of infection by the microorganism can prevent cancer from developing.
Key initiatives in Australia include the universal infant hepatitis B vaccination program and HPV vaccination program.13 The American Society of Clinical Oncologists has recently released their statement on Human Papillomavirus Vaccination for Cancer Prevention (April 2016, PDF 593KB). The Statement outlines the role of vaccination in the primary prevention of cervical and other cancers, and includes recommendations for increasing vaccination rates among adolescents.
Chemoprevention is an emerging area of primary prevention undergoing rigorous research through clinical trials. Chemoprevention refers to the use of natural or synthetic agents to interrupt the carcinogenic process, preventing progression to invasive cancer. In comparison to population-based lifestyle interventions, chemoprevention focuses more narrowly on individuals or subpopulations known to be at increased risk for developing a malignancy.22 Aspirin is one agent which has shown promise in decreasing colon cancer.22, 23
Learning activities
Access the National Cancer Prevention Policy14 and for one modifiable risk factor:
- Summarise the evidence regarding the need to modify risk.
- Outline the cancer prevention initiatives in Australia to address this risk factor.