and Cancer Control
Advances in identifying what causes cancer have enabled behavioral
researchers to bring forward a spectrum of approaches to capitalize
on this knowledge. Their goals are to implement behavior change that
will reduce cancer incidence and mortality, and improve the quality of
life for cancer survivors.
Behavioral research encompasses both qualitative (interviews, focus
groups, observation) and quantitative (measurement of attitudes,
knowledge, cancer worry or concerns) approaches, which range from
describing behavioral patterns to testing strategies that can lead to
cost-effective interventions. Behavioral researchers make important
inferences from studies involving a few people to studies of entire
communities. These inferences enable the testing of appropriately
targeted behavioral and educational interventions or policy changes.
The role of behavioral research in reducing tobacco use cannot be
overestimated. Reduction of tobacco smoking in the U.S. has
benefited from behavioral science findings, particularly at the
individual level where a model 4-stage model facilitates interventions
for smokers to successfully change their behavior and quit smoking.
Also, educational programs, strategies that utilize networks of family
and community, nicotine replacement therapy, and policy changes,
such as increasing taxes on tobacco products, banning tobacco use in
public spaces, and restrictions on tobacco product marketing and
advertising, have all been successful in reducing the number of
tobacco users in America.
Behavioral research has also helped improve early detection of
cancer through the identification of barriers, motivators, and means to
increase adherence. For example, increased education and
awareness have contributed to increased rates of mammography. In
addition, the role of the health care provider in recommending colon
cancer screening has been a crucial motivator.
With the introduction in the mid-1990s of cancer genetic testing for
susceptibility to breast and colorectal cancers, behavioral researchers
have had an important opportunity to study the diffusion of new
discoveries and use new technologies to educate cancer patients,
family members, and the population at large about risk and lifestyle
factors associated with cancer. Key insights have led to development
of novel educational programs, genetic counseling services, and the
use of genetic test results, as well as policy innovations such as the
Genetic Information Nondiscrimination Act.
Since many behaviors are associated with an increased risk of
cancer, behavior modification stands to make a significant impact on
the reduction of cancer. Continued research in how to maximize
behavior modification is an essential component of our cancer
Tobacco Use and Cancer
The causal relationship between cigarette smoking and lung
cancer was first brought to the public’s attention in 1964 by
the U.S. Surgeon General’s Report on Smoking and Health.
The Report marked the beginning of major U.S. policy
changes, media campaigns, and other measures to combat
cigarette smoking, all of which have helped to reduce the
percentage of Americans who smoke to about 20% of the
population, down from 42% in 19654, 5.
Since that landmark Report, research has shown that tobacco
use is a cause of 18 different cancers6, including lung, head
and neck, stomach, pancreas, and cervical cancers, among
others, and accounts for 30% of all cancer deaths in the U.S. 1
A substantial evidence base also proves that exposure to
secondhand smoke, or environmental tobacco smoke, also
causes cancer, a finding that has led to important policies
restricting smoking in public places. In recent decades, there
has been a steady decline in lung cancer death rates among
men, which is directly attributable to the decrease in smoking
prevalence. This success is representative of how scientific
progress can inform public policy and educational efforts to
measurably reduce cancer rates.
The Surgeon General’s 31st report on tobacco, released in
2010, concludes that there is no safe level of exposure to
tobacco smoke. Yet, every day 4,000 American youths
smoke their first cigarette14, and 1,000 join the 71 million
Americans, aged 12 and older, who regularly use tobacco15.
Clearly, countless lives can be saved in the future through
continued research to develop and implement effective
tobacco control strategies.
Exposure to Radiation and Environmental
and Occupational Toxins and Cancer
Epidemiological research has determined that even low
levels of radiation exposure increase cancer risk, and that
efforts to limit diagnostic X-ray exposure should be made.