15 ms·
Smoking, alcohol and high BMI are leading risk factors for global cancer deaths
- yamrzou 4y agoThe study in question: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01438-6/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
- francisofascii 4y agoSmall nit. Smoking, alcohol, and high BMI are the big risk factors, but not causes. The interesting question is why these risk factors are associated with cancer.
- yamrzou 4y agoTrue, I edited the title to reflect that.
- ctrlmeta 4y agoWhy not preserve the original title? "Smoking and other risk factors cause almost half of cancer deaths, study finds" Accurate or not, that's the original title of the article.
- deleted 4y ago[deleted]
- bena 4y agoReal broad strokes here. Cancer isn't a disease. It's a class of diseases. It's a class of diseases characterized by the inability of your cells to regulate reproduction. Typically caused by cells that had errors in reproduction. Caused by various mutations. Those mutations are more likely with the introduction of certain things. All of those things, smoking, alcohol, high BMI, are things that cause more mutations. Either through more reproduction or affecting that reproduction. We kind of "get" cancer all the time. You could have cancer right now. But usually our body is good at getting rid of it by itself. It's when it can't that it becomes a problem.
- Rury 4y agoRight, and for some more detail, recent studies on cellular energy metabolism and epigenetics suggests that DNA damage may happen more often when you're eating or metabolizing. This is because, your cells tend to reproduce when it has available food, and in order to reproduce, they need to make a copy of your DNA, and so it must open up structures and read your DNA to make a copy of the DNA. However, DNA is at greater risk of being damaged/corrupted (from chemicals like those in smoking, or food itself) when this process is occurring because the DNA is open for access, rather than being in an otherwise mostly packaged/protected state.
- porknubbins 4y agoI’m not clear what the takeaway from this is as a human on the macro scale. Is this just support for time restricted eating? Presumably most adult humans have, all else equal, roughly the same number of cells that live on average X days and then must copy themselves at some point during their lifespan. If I space my eating out to small amounts over the whole day but don’t increase calories am I going to get more DNA damage without more net cell growth in numbers?
- ehnto 4y agoI'm sure there's causal effects in there, but I also wonder if it's not similar to how riding an unregistered motorcycle puts you in a much higher risk cohort. Of course, riding an unregistered bike is not going to cause an accident, but it's a behavior of people with very high risk profiles. As a motorcyclist, if you have a license, and your bike is registered, you become part of a behavior cohort that's barely represented in crash statistics when compared to the other cohort. Someone who's likely to smoke, is potentially the type of person who doesn't take care of themselves in a number of dimensions, putting them in a higher risk behavior cohort.
- ReptileMan 4y agoConstant inflammation at least for BMI and smoking.
- bregma 4y agoCorrelation is causation, at least at the 6th-grade reading level.
- potatoman22 4y agoI'm pretty sure scientists agreed 60 years ago that smoking causes lung cancer. They are not only correlated, one causes the other.
- deleted 4y ago[deleted]
- RubyRidgeRandy 4y agoAll of these are well known carcinogens but it is crazy the lengths people will go to defend alcohol especially in this regard. Alcohol, in any amount, is a poison and is treated as so by the body. It breaks down into acetaldehyde and damages DNA. I'm all for people making informed decisions on what they want to put into their bodies but informed is the operative word. There's a reason people don't associate drinking or being fat with cancer the way they do with cigarettes.
- Test0129 4y ago> There's a reason people don't associate drinking or being fat with cancer the way they do with cigarettes. To be fair people are also inundated with X increases cancer risk by Y (typically marginal) amount. So much so the noise just gets tuned out. Cigarettes are one of the few things that dramatically increase cancer risk. Enough that just about everyone knows someone who caught a deadly disease from smoking.
- cgb223 4y agoWhat are the relative risk increases for each?
- khuey 4y agoThe American Cancer Society claims that smoking accounts for 30% of cancer deaths in the United States (https://www.cancer.org/healthy/stay-away-from-tobacco/health-risks-of-tobacco/health-risks-of-smoking-tobacco.html https://www.cancer.org/healthy/stay-away-from-tobacco/health...) while alcohol accounts for 4% (https://www.cancer.org/healthy/cancer-causes/diet-physical-activity/alcohol-use-and-cancer.html https://www.cancer.org/healthy/cancer-causes/diet-physical-a...)
- hooverd 4y agoI wonder how that aligns with the percentage of people are heavy drinkers.
- 4y ago
- Test0129 4y agoI suppose this comes as no surprise. It almost feels like a conspiracy that With the exception of a few illegal drugs such as meth, heroin and cocaine, the only legal drugs are the ones that arguably carry fairly high risks. Though I suppose the damage from smoking comes mostly from combustion and not the nicotine. High BMI is such a problem in the west and so trivially preventable. I have family in both medicine and the school system and the number of children who are morbidly obese seems to get higher every year. One thing I've done to pass the time is to count the number of obese people where ever I am. It's relatively shocking that within some margin of error the vast majority of people appear to be obese. Pairing this with the social contagion of "Healthy at Any Size" and we quite possibly have an epidemic worse than anything we have ever seen before. More than just cancer, obesity is expected to surpass heavy alcohol abuse as the #1 cause of severe liver damage. I am surprised however that chemicals in food weren't studied as a sub-group of the BMI study. Endocrine disrupters are basically everywhere now. A standard western diet is so loaded with garbage.
- newaccount2021 4y ago
- 11235813213455 4y agoWhen I think about it, being low BMI is sort of a FIFO food queue, you wait to use all you stored fat before making some again; being overweight is more a LIFO mode, you carry with you constantly a concentrate of food in you (fat), but still eat more external food. But food is just like any other addiction, possible but hard to reason about
- bena 4y agoIt's also the one addiction where you cannot resolve it by quitting. People with unhealthy relationships with food actually have to do the work to resolve that. Alcoholics, gamblers, smokers, addicts of all stripes, etc, can just not partake. They never have to confront why they're addicted.
- 4y ago
- dukeofdoom 4y agoPresumably at least half of those people would still get Cancer just later.
- User23 4y ago"Everyone who doesn't first die of something else will die of cancer" is trivially true and doesn't offer any real insight. The particular timing and circumstances of death is often salient.
- patkai 4y agoCorrect! Worth checking the work of Gabor Mate on this. He claims that trauma is the key.
- nradov 4y agoDr. Gabor Maté appears to be a quack trying to sell some dubious books and courses. His hypotheses are not supported on an evidence-based medicine basis.
- patkai 4y agoI thought that the emotional life-history pattern of cancer patients is quite well researched and linking trauma, anxiety and stress to cancer is not his hypothesis, he is just popularizing it.
- jcims 4y agoMany of these studies and related conversations seem to presuppose that everyone wants to live to a ripe old age, or that the society with the highest life expectancy wins. Clearly there is value to being fit and healthy throughout life, but there's also value to living in the moment. I've been enjoying cigars quite a bit recently, I'm not particularly interested in cutting that out of my life to weight the die a bit more in favor of a few more years on the planet. And I'm saying that as someone who was holding my wife as she took her last breaths after a ruthless and painful battle with cancer.
- csours 4y agoSmoking, alcohol, and high BMI are among the easiest things to track on a population level study. Smoking introduces large amounts of carcinogens into the body, I would expect these results to hold up even when you drill down to the finest level. Alcohol and high BMI are surely direct factors for many cancers as well, but they may also be correlated to other risk factors that are harder to track on population level studies.
- aaron695 4y ago
- elil17 4y agoThe actual study said that almost half (44.4%) of cancer deaths were attributable to any risk factor, not just those. Smoking is by far the biggest risk fctor, coming in at over twice the attributable deaths than alcohol and high BMI combined. Cervical cancer from STIs, high blood glucose, and air pollution were almost as high as alcohol and BMI. Of these, one has a very low effort solution on the personal level: get the HPV vaccine (Gardasil). Have your kids get it too. HPV causes many cancers in both men and women, but by far the most significant in terms of number of attributable cases is cervical cancer. Almost half of people have HPV, but it's never tested for and you won't know you have it until you get cancer. Gardasil may either save your life, save the life of your partner, or save the life of a stranger (by preventing the spread of HPV in general). Quitting smoking, alcohol, or junk food can be hard, but getting Gardasil is easy.
- photochemsyn 4y agoFar better coverage here, including links to the original study and a deeper dive into the statistics: https://www.healthdata.org/news-release/lancet-almost-half-global-cancer-deaths-are-due-risk-factors-smoking-alcohol-use-and https://www.healthdata.org/news-release/lancet-almost-half-g... Some other facts left out of the Guardian version: > "When examining environmental and occupational risks, researchers found that the cancer attributable DALYs were three-fold higher among males (3.9%) than females (1.3%), suggesting that males may be more likely than females to work in places that have higher risk of being exposed to carcinogens." There's this rather unfortunate trend in corporate media reporting on cancer to bury any discussion of carcinogen exposure due to industrial activities, contamination of processed foods, agricultural use of pesticides and herbicides, etc. and instead focus on 'personal choice' issues like smoking tobacco and drinking alcohol and not maintaining personal health (i.e. obesity). While the latter are indeed significant, ignoring the former isn't justified. This does somewhat mirror an academic trend over the past few decades in which cancer research turned towards 'inherited genetic' causes of cancer while also neglecting industrial and agricultural exposure to carcinogens. It's not hard to see a link between the corporatization of American universities, i.e. the spread of public-private partnerships between agribusiness and petrochemical corporations and academic institutions, and this trend.
- pigtailgirl 4y ago-- meanwhile japan is trying to figure out how to get young people to drink more -- https://www.npr.org/2022/08/18/1118163173/japans-tax-alcohol-young-people-campaign https://www.npr.org/2022/08/18/1118163173/japans-tax-alcohol...
- symlinkk 4y agoI’m so sick of these articles, this is another useless correlations study that tells me nothing. I’m going to continue to drink until someone can tell my clearly and succinctly how much of a risk it is.
- jkereako 4y agoI agree. These studies view life on strict biological terms, which, in their defense, is the only way to quantify life. While some folks here believe that any amount of alcohol is poison, it's also true that red wine and fatty beef are an excellent pairing. And drinking a cocktail with friends is time well spent.
- calvinmorrison 4y agoThere's a book that dives into the FDA and Tobacco Industry beef, and one of the big points is that, neither was a good source for consumers. Big Tobacco wouldn't admit smoking was bad in any way, and the FDA wouldn't admit that any level of smoking was negligibly bad. Instead of allowing consumers to make informed choices, the government treated everyone like idiots and said no amount is safe. The fact is - smoking cigars, less than 5 full sized cigars per day, is basically a negligent contributor to any risk. A long term study of pipe smokers found they lived longer. Nicotine itself isn't much worse than caffiene in many ways. Instead of promoting studies into safer smoking, they didn't allow Big Tobacco to make any health claims. Now we know that certain filters (primarily those Charcoal ones popular in Japan) may have a big impact on reducing carcinogens. Snuff (nasal) and snus (cured tobacco from scandinavia) are both basically negligent in any side effect. Give consumers useful information. Let them make choices. The lying on both sides helped nobody at all. Big tobacco couldnt admit cigarettes caused cancer, and the FDA wouldn't admit a small amount probably wouldn't - leaving consumers wondering "how safe is it if I smoke 1 cigarette a day, 5 cigarettes a day, or once a month" the actual useful bits for people.
- Havoc 4y agoAnnoying how its always the fun stuff.
- josephcsible 4y agoIsn't this just Berkson's paradox? Nobody would ever do anything that's harmful and not fun.
- dr_ 4y agoHow does this correlate with research that looks into the very old - populations where people live the longest lives - and find that wine consumption seems to be rather high? I believe there was a link to such research on HN a month or so ago. I’m not denying the risks associated with alcohol - just wondering if all alcohol should be looked at in the same way.
- cpncrunch 4y agoThere are quite a lot of factors that affect lifespan. From what I understand from reading those studies, factors such as lack of stress, strong social contacts, exercise, sunlight exposure and good diet all likely play a large part in reducing mortality in these populations. Perhaps they would live even longer if they drank alcohol free wine? And how much wine do they actually drink?
- nonameiguess 4y agoI don't think this means anything at all. It's similar to the people with genetics such that they'll have low LDL no matter what posting their blood panels to social media after trying the carnivore diet. It doesn't mean the general population can draw any conclusions from it. It doesn't mean the risks of drinking in moderation outweigh whatever benefits you think you're getting from it, but living past 100 is unlikely to be one of those benefits for any particular person.
- ugjka 4y agoQuitting smoking was the best decision I've done after smoking pack a day for 12 years.
- antiverse 4y agoThis thread is seriously bonkers. When we were children, our elders were well aware of a link between alcohol and cancer (among other failures like cirrhosis) because their elderly friends would pass away from one or more of these. It was, albeit unscientifically, established that there does exist a strong enough correlation to warrant warning children about it. To this day, none of us needed a study for any of this. What happened? To see HN stand up for Big Alcohol and twist this study with whataboutism and other nonsensical detractions is just plain morbid.
- acuozzo 4y ago> To this day, none of us needed a study for any of this. I guess this means I should stop cracking my knuckles then since my elders told me doing so would give me arthritis in my hands. I mean, shit, by this logic I should wear a 3M respirator 24/7 since the elders of my elders (of my elders…) believed "bad air" and "foul smells" were the cause of The Black Death. No. Studies. Needed. Right?
- stoneglyph 4y ago[flagged]
- tedchs 4y agoBMI is accepted as a poor indicator of health or fitness. It's common for objectively healthy people, such as muscular athletes, to have a high BMI. https://www.npr.org/templates/story/story.php?storyId=106268439 https://www.npr.org/templates/story/story.php?storyId=106268...
- recursive 4y agoThat's all true. But none of that stops it from being significantly positively correlated with incidence of cancer.
- rob137 4y agoWhat about when you control for bodyfat percentage? Genuinely curious. I've heard that waist circumference is associated with lots of negative outcomes even when you control for physical fitness, but I don't actually know this is true.
- missedthecue 4y agoA lot of body builders (even clean ones) are not healthy at all. 270 pounds is 270 pounds, whether it's fat or muscle. And 270 pounds of muscle is harder on the heart. Many professional athletes shrink down to a healthy size after retirement because being so big is just bad for you.
- ishjoh 4y agoI agree, it doesn't work for extremely muscular athletes but for the vast majority of people it works very well because the number of extremely muscular athletes in any country is small. So in this case it still serves its purpose very well.
- hinkley 4y agoI have been trying to get more exercise lately and been frustrated by how my smart watch is telling me that some of my biometrics are dead flat while other things like duration and intensity have been going up. Recently, but well after I started to make changes, I heard someone say in passing that a sedentary lifestyle is as big of a risk factor as smoking. Initially I had a histamine reaction to that, but it actually isn't that surprising, once you get over the strong emotional response (like feeling attacked).
- mcguire 4y agoI'm assuming they have already factored out age.
- sizzle 4y agoI’m a habitual coffee drinker (3+ double shots a day pulled from my machine), what’s the increased cancer risk of coffee?
- stjohnswarts 4y agoI don't think this has changed in the past 30 years has it?
- alexklarjr 4y agoIf you live unhealthy, you gonna have bad time!