Fostering Multiple Healthy Lifestyle Behaviors for Primary Prevention of Cancer
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AbstractThe odds of developing cancer are increased by specific lifestyle behaviors (tobacco use, excess energy and alcohol intakes, low fruit and vegetable intake, physical inactivity, risky sexual behaviors, and inadequate sun protection). These behaviors are largely absent in childhood, emerge and tend to cluster over the lifespan, and show an increased prevalence among those disadvantaged by low education or income or minority status. Even though risk behaviors are modifiable, few are diminishing in the population over time. We review the prevalence and population distribution of these behaviors and apply an ecological model to describe effective or promising healthy lifestyle interventions targeted to the individual, the sociocultural context, or environmental and policy influences. We suggest that implementing multiple health behavior change interventions across several ecological levels could substantially reduce the prevalence of cancer and the burden it places on the public and the health care system. We note important still unresolved questions about which behaviors can be intervened upon simultaneously in order to maximize positive behavioral synergies, minimize negative ones, and effectively engage underserved populations. We conclude that interprofessional collaboration is needed to appropriately evaluate and convey the value of primary prevention of cancer and other chronic diseases.