Why tobacco is so uniquely harmful

Tobacco smoke contains roughly 7,000 chemicals — about 70 of which are known to cause cancer. These chemicals damage DNA throughout the body, not just the lungs. Tobacco is causally linked to cancers of the lung, mouth, throat, voice box, esophagus, stomach, pancreas, kidney, bladder, cervix, colon and rectum, and to a form of leukemia.

Risk is dose-dependent: how much you smoke, how long, and how deeply you inhale all matter. Secondhand smoke causes lung cancer in non-smokers. Smokeless tobacco (chew, snuff) causes mouth, esophageal, and pancreatic cancers. E-cigarettes are not a safe alternative — long-term cancer risk is still under study, but lung injury is well-documented.

The encouraging news: the body begins repairing itself almost immediately after quitting. Within 20 minutes, heart rate drops. Within a year, heart disease risk halves. Within 10 years, lung cancer death risk drops by about half compared to continuing smokers.

What to do

• Set a quit date — within the next 2 weeks.Tell people who'll support you. Remove tobacco, ashtrays, and lighters from your space the day before.
• Use cessation aids — they double your chance of success.Nicotine replacement (patch, gum, lozenge), prescription meds (varenicline, bupropion), or both. Talk to a doctor or pharmacist.
• Call a free quit line.Washington State Quitline: 1-800-QUIT-NOW (1-800-784-8669). Free coaching, free nicotine patches, available in many languages.
• Avoid your triggers for the first 4 weeks.Coffee, alcohol, the morning routine spot — anything tied to smoking. Replace with a walk, water, or a piece of fruit.
• If you slip, don't quit quitting.Most successful quitters take several attempts. A single cigarette is not failure — it's data. Reset the next day.

Common myths, busted

Screening that applies here

If you are 50–80 years old, have a 20+ pack-year smoking history, and currently smoke or quit within the last 15 years, the USPSTF recommends annual low-dose CT screening for lung cancer. Ask your primary care doctor or call the WACC Navigation Hub — we'll help you get connected.

What 40+ years of nutrition research actually tells us

Single foods rarely cause or prevent cancer. Patterns of eating, sustained over decades, are what move the needle. The strongest evidence supports a plant-forward, fiber-rich, minimally processed diet — think Mediterranean or DASH patterns — with limited processed meat, red meat, and sugary drinks.

Processed meats (bacon, hot dogs, deli meat, sausage) are classified by the WHO as Group 1 carcinogens — the same category as tobacco, though the absolute risk increase is much smaller. Each 50g/day of processed meat raises colorectal cancer risk by about 18%. Red meat (beef, pork, lamb) is Group 2A — probably carcinogenic — with risk concentrated at higher intakes.

Fiber (whole grains, beans, fruits, vegetables) is consistently linked to lower colorectal cancer risk. Dairy may modestly reduce colorectal cancer risk but slightly raises prostate cancer risk at very high intakes. Sugar-sweetened beverages drive weight gain and obesity, which itself causes 13+ cancers.

What to do

• Make half your plate vegetables and fruit.Aim for variety and color. Cruciferous (broccoli, kale, cabbage) and leafy greens are especially well-studied.
• Switch refined grains for whole grains.Brown rice, oats, whole-wheat bread, barley, quinoa. Aim for at least 30g of fiber per day.
• Eat beans, lentils, or other legumes at least 3x per week.High in fiber, protein, and protective phytochemicals. A cheap, accessible substitute for processed meat.
• Limit processed meat as much as possible.Cut bacon, hot dogs, deli meats, sausage to occasional — not daily. The evidence here is among the strongest in nutrition.
• Cap red meat at about 12–18 oz (350–500g) cooked per week.Choose fish, poultry, beans, or tofu more often. When you do eat red meat, smaller portions and gentler cooking (not charred) are better.
• Drink mostly water.Limit sugary drinks (soda, sweetened coffee/tea, juice). They drive weight gain, which itself raises cancer risk.

Why your body's movement and size shape cancer risk

Excess body fat — particularly around the waist — is a chronic inflammatory state. It raises insulin, growth factors (IGF-1), and estrogens, all of which can promote cancer cell growth. The International Agency for Research on Cancer (IARC) has linked obesity to cancers of the breast (postmenopausal), colon and rectum, endometrium (uterine lining), esophagus, gallbladder, kidney, liver, ovary, pancreas, stomach, thyroid, plus multiple myeloma and meningioma.

Physical activity helps even independently of weight loss. It lowers insulin resistance, reduces inflammation, improves immune surveillance, and helps regulate sex hormones. People who meet activity guidelines have measurably lower risk of colon, breast, endometrial, and several other cancers.

Strength training has been understudied historically but is now firmly part of guidance — it preserves muscle and supports metabolic health, especially as we age. You do not need a gym, special clothes, or to "love" exercise. The goal is consistent, sustainable movement.

What to do

• Aim for 150 minutes of moderate activity per week.That's about 22 minutes a day — a brisk walk, dancing, cycling on flat ground, gardening that gets your heart up. Or 75 minutes of vigorous activity (running, swimming laps, hiking hills).
• Add muscle-strengthening 2 days a week.Bodyweight (squats, push-ups, planks), resistance bands, or weights. Hit all major muscle groups.
• Sit less. Move more often.Sedentary time itself raises risk, even in people who exercise. Stand or walk a few minutes every 30–60 minutes during long sitting periods.
• If you want to lose weight, start small and sustainable.5–10% of body weight loss already meaningfully reduces cancer-related risk markers. Crash diets rarely last; small daily changes do.
• Sleep 7–9 hours per night.Poor sleep raises cortisol, drives weight gain, and impairs immune function. It is part of the prevention picture.

Common myths, busted

What we now know — and what's changed

For years, moderate drinking was thought to be heart-protective. The latest, more rigorous studies suggest this benefit was largely an artifact of how studies were designed. The WHO now states: "When it comes to alcohol consumption, there is no safe amount that does not affect health."

Alcohol — specifically, its metabolite acetaldehyde — directly damages DNA and impairs the body's ability to repair it. Alcohol is causally linked to cancers of the mouth, throat (pharynx), voice box (larynx), esophagus, liver, colon and rectum, and breast (in women). The risk rises with every drink, but is meaningful even at low levels — about 1 drink per day raises a woman's breast cancer risk by about 7–10%.

Risk is multiplied when alcohol is combined with smoking, especially for cancers of the mouth, throat, and esophagus.

What to do

• If you don't drink, don't start.The health benefits attributed to moderate drinking are now considered minimal at best — and they don't apply to cancer risk.
• If you do drink, less is better — and any reduction helps.If you currently have 3 drinks a night, cutting to 1 is a meaningful risk reduction. Going to 0 is more.
• Aim below CDC moderate-drinking limits if you continue.≤1 drink/day for women, ≤2 drinks/day for men. A "drink" = 12 oz beer (5%), 5 oz wine (12%), or 1.5 oz spirits (40%).
• Pair alcohol with food, and alternate with water.This slows absorption but does not eliminate cancer risk — just helps manage overall intake.
• Take alcohol-free days every week.Regular alcohol-free days reduce total weekly intake and help break habitual drinking patterns.

Common myths, busted

UV light is the main driver

Ultraviolet (UV) radiation damages skin cell DNA. Most damage accumulates from a lifetime of incidental exposure — walking, driving, gardening — not just beach days. The three main types of skin cancer are basal cell carcinoma and squamous cell carcinoma (very common, rarely fatal), and melanoma (less common, but the cause of most skin-cancer deaths).

UV comes in two relevant forms: UVB (causes most sunburns and skin cancer) and UVA (penetrates deeper, contributes to aging and cancer). "Broad-spectrum" sunscreen blocks both.

People with darker skin tones have a lower lifetime risk of skin cancer but are more likely to be diagnosed at later, more dangerous stages — partly because symptoms can look different and screening is less aggressive. Everyone, regardless of skin color, benefits from sun protection and skin self-checks.

What to do

• Daily sunscreen, SPF 30+ broad-spectrum.Apply to face, ears, neck, and any exposed skin — even on overcast days, even in winter. UV penetrates clouds.
• Reapply every 2 hours outdoors, sooner if swimming or sweating."Water-resistant" buys 40–80 minutes, not all day. One application is not enough for prolonged exposure.
• Seek shade, especially 10am–4pm.This is when UV is most intense. A hat, sleeves, and shade reduce exposure dramatically.
• Cover up: wide-brim hat, long sleeves, UPF-rated clothing.Clothing is the most reliable sun protection. A tight-weave fabric blocks more UV than the average sunscreen.
• Skip tanning beds.Tanning beds are a Group 1 carcinogen (same category as tobacco). Use of indoor tanning before age 35 raises melanoma risk by ~75%.
• Do a monthly skin self-check.Look for new spots, changes to existing moles, or sores that don't heal. Use the ABCDE rule below.

The ABCDEs of mole self-check

A — Asymmetry: One half doesn't match the other.
B — Border: Edges are ragged, blurred, or irregular.
C — Color: Multiple colors, or uneven color.
D — Diameter: Larger than 6mm (about the size of a pencil eraser) — though melanomas can be smaller.
E — Evolving: Changing in size, shape, color, or symptoms (itching, bleeding).

Common myths, busted

Cancer-causing infections you can prevent or treat

HPV (Human Papillomavirus)

HPV causes nearly all cervical cancers, the majority of anal, vaginal, vulvar, and penile cancers, and a growing share of throat/oropharyngeal cancers — particularly in men. The HPV vaccine (Gardasil 9) prevents infection by the highest-risk strains and is one of the most effective cancer-prevention tools we have. In countries with high vaccination coverage, cervical cancer rates are plummeting.

Recommended: Routine vaccination at ages 11–12 (can start at 9). Catch-up vaccination through age 26. Shared decision-making between ages 27–45.

Hepatitis B (HBV)

Chronic Hep B infection is a leading cause of liver cancer worldwide. The Hep B vaccine — given to all U.S. infants since 1991 — has dramatically reduced liver cancer rates. Adults who weren't vaccinated as infants and have risk factors (healthcare work, sexual or household contact with HBV, certain countries of origin) should ask their doctor.

Hepatitis C (HCV)

There is no Hep C vaccine yet, but HCV is now curable with 8–12 weeks of oral antiviral medication. Treating HCV before cirrhosis dramatically lowers liver cancer risk. The CDC recommends one-time HCV screening for all adults age 18+.

H. pylori

This common stomach bacterium causes most stomach (gastric) cancers and lymphomas of the stomach. A simple breath, stool, or blood test diagnoses it; a 10–14 day antibiotic course treats it. If you have persistent stomach pain or a family history of stomach cancer, ask about testing.

HIV

HIV itself doesn't cause cancer, but immunosuppression from untreated HIV raises risk for several cancers (Kaposi sarcoma, certain lymphomas, anal cancer, cervical cancer). Effective antiretroviral therapy keeps the immune system strong and dramatically reduces these risks.

EBV (Epstein-Barr)

EBV is linked to certain lymphomas and nasopharyngeal cancer. There is no vaccine yet, but vaccines are in development. Awareness matters most for high-risk groups.

What to do

• Get the HPV vaccine — and make sure your kids do too.If you're under 26 and unvaccinated, ask your doctor. If you have children, the routine age is 11–12 (can start at 9). Both girls and boys.
• Confirm your Hep B vaccination status.Most people born after 1991 in the U.S. are vaccinated. If you're not sure, ask for a blood test or talk to your doctor about catch-up vaccination.
• Get screened for Hepatitis C at least once as an adult.One-time HCV screening recommended for all adults 18+. If positive, treatment is now short, oral, and curative.
• If you have persistent stomach symptoms, ask about H. pylori testing.Especially if there is a family history of stomach cancer or you come from a region with high gastric cancer rates.
• Practice safer sex and consistent condom use.Reduces HPV, HIV, Hep B, and Hep C transmission.

Common myths, busted

Why showing up matters so much

Most cancers are far more treatable — often curable — when caught early. Screening tests are designed to find cancer or precancer before symptoms appear, in people without obvious risk. They work because evidence has shown that finding and treating these cancers early saves lives in the screened population overall.

Below are the screenings with the strongest evidence, with the most recent U.S. Preventive Services Task Force (USPSTF) and American Cancer Society (ACS) guidance. Your personal start age may differ if you have family history, a known genetic risk, or other factors — talk to your doctor.

🩺 Breast cancer (mammography)

USPSTF (2024): Biennial screening for women age 40–74. ACS: Annual age 45–54, then biennial. Earlier or more frequent screening if family history, BRCA mutations, or other risk factors. Talk to your doctor about supplemental MRI if you have dense breasts.

🩺 Colorectal cancer

Start age: 45 for average-risk adults (USPSTF, ACS). Options: colonoscopy every 10 years (gold standard — detects and removes precancers), FIT stool test annually, or Cologuard every 3 years. Earlier if family history of colorectal cancer or polyps, inflammatory bowel disease, or Lynch syndrome.

🩺 Cervical cancer

Ages 21–29: Pap test every 3 years. Ages 30–65: Pap + HPV co-test every 5 years, or HPV alone every 5 years, or Pap alone every 3 years. After 65: Stop if adequate prior screening was normal. Vaccination doesn't replace screening.

🩺 Lung cancer (low-dose CT)

Annual low-dose CT recommended for adults age 50–80 with a 20+ pack-year smoking history who currently smoke or quit within the last 15 years. This is underused — if you qualify, ask your doctor.

🩺 Prostate cancer (PSA)

Shared decision-making with your doctor starting at age 50 (or 45 if Black or family history; 40 if multiple first-degree relatives or BRCA). PSA screening has trade-offs — not every doctor will recommend it for every patient. Discuss benefits and risks.

🩺 Skin cancer

No national guideline recommends routine population-wide skin checks, but self-checks monthly (see Sun & Skin page for ABCDEs) and a full-body dermatologist check annually are reasonable for higher-risk people: lots of moles, family history of melanoma, fair skin, prior heavy sun exposure.

What to do

• Write down your screening calendar — and don't skip.Set yearly reminders for the screens that apply to your age and sex. A missed mammogram is the easiest preventable cause of a late-stage diagnosis.
• Talk to your doctor about your family history.Even at the first visit. Earlier screening, additional screening, or genetic counseling may apply if relatives had cancer — especially before age 50.
• Know that most screenings are free under the ACA.Most insurance plans cover age-appropriate cancer screening with $0 copay as preventive care. If you're uninsured, WA state has free or sliding-scale programs.
• If you can't afford screening, contact the Navigation Hub.WA Cancer Connect can match you with low-cost or no-cost screening programs in your county.
• Don't wait for symptoms.The whole point of screening is finding cancer before symptoms. By the time you feel something, the cancer is often more advanced.

Common myths, busted

When cancer runs in families

Most cancer is not strongly inherited — it arises from a lifetime of cell-division errors plus environment. But some people are born with a gene change that meaningfully raises their lifetime risk. Knowing this changes prevention dramatically: screening starts earlier, more intensively, sometimes with risk-reducing surgery as an option.

The most common hereditary cancer syndromes include:

BRCA1 and BRCA2 mutations — raise lifetime breast cancer risk to 45–72% (vs. ~13% baseline), ovarian cancer to 17–44%, and also raise pancreatic, prostate, and male breast cancer risk. More common in people of Ashkenazi Jewish ancestry, but found in every population.

Lynch syndrome — raises lifetime colorectal cancer risk to 50–80%, endometrial cancer to 40–60%, and also raises ovarian, stomach, urinary tract, and small bowel cancer risk. The most common hereditary colorectal cancer syndrome.

Familial adenomatous polyposis (FAP), Li-Fraumeni, Cowden, von Hippel-Lindau, and others — rarer but profound risk-raisers.

Should you consider genetic counseling?

Genetic counselors are master's-level health professionals who specialize in inherited disease. They take a detailed family history, explain what testing can and can't tell you, help you decide whether to test, and interpret results in context. Most people benefit from counseling before testing — not the other way around.

Consider asking about genetic counseling if you have:

• Multiple close relatives with the same cancer.Especially breast, ovarian, colorectal, endometrial, prostate, or pancreatic. Same side of the family, multiple generations.
• A relative diagnosed under age 50.Especially with breast, colon, or endometrial cancer.
• A relative with more than one cancer.For example, breast + ovarian, or colon + endometrial — even in the same person.
• Ashkenazi Jewish ancestry plus any breast, ovarian, prostate, or pancreatic cancer in the family.BRCA founder mutations are more common in this group.
• A rare cancer in the family.Male breast cancer, sarcoma in a child, medullary thyroid cancer, etc.
• A known mutation already identified in a relative.Testing for the specific known mutation is usually straightforward.

What to do

• Build a family cancer history list.Who had what cancer, at what age, on which side of the family. Include grandparents, parents, siblings, aunts, uncles, cousins. Bring it to your next doctor's visit.
• Tell your primary care doctor.Family history can change screening recommendations even without genetic testing. Your doctor can refer you to genetic counseling if criteria are met.
• Know that genetic testing has changed.It's faster, cheaper, and more accurate than 10 years ago. Most insurance covers it when there is a medical indication. Some at-risk groups qualify for free testing.
• Decide who to share results with — and when.If you test positive, family members may want to know so they can be tested too. A genetic counselor can help with these conversations.
• Be aware of GINA — the Genetic Information Nondiscrimination Act.Federal law prevents most health insurers and employers from using genetic information against you. It does not cover life, disability, or long-term care insurance — discuss timing of any application with a counselor.

Common myths, busted