Last year in January a study came out that was widely reported as, “cancer is totally bad luck and has almost nothing to do with your lifestyle choices!” That wasn’t what it said, as we reported, but they did make the case for a lot of cancer being pure bad luck.
A new study1 used a mix of stem cell research and statistical analysis to find the exact opposite: according to these researchers, 70 to 90% of cancer risk is due either to your terrible life choices or environmental exposures.
That makes for some super dramatic headlines, but I noticed that the coverage mentions a list of lifestyle-related cancer triggers that includes smoking (fair enough; smoking causes basically everything), diet (fair enough, I guess; the fact that we’re constantly changing our minds about overall dietary guidelines doesn’t mean that the food you eat doesn’t effect your risks of pretty much everything) and sun exposure.
And that latter one brought me to a screeching halt. Does that mean that their statistics include basal cell carcinoma?
Because it sure appears that way from their charts.
Basal cell carcinoma is the most common kind of skin cancer; there are 2.8 million cases of it per year according to the Skin Cancer Foundation, which also notes that it is the most frequently occurring form of cancer, to the point that more than 1/3 of all new cancers is a skin cancer and the vast majority of those are basal cell carcinoma. But it also almost never spreads, doesn’t require treatment beyond removal, and it’s almost never fatal. It’s cancer, technically, but it’s not a cancer anyone needs to actually worry about.
Note: I found conflicting statistics on deaths from the non-melanoma skin cancers. It’s between 2,000 and 9,000 per year and those might all be squamous cell carcinomas, or maybe not. I can say, though, with a lot of confidence, that although you’re more likely to get basal cell carcinoma than any other cancer, you’re more likely to die from almost any other cancer than basal cell carcinoma.
Basal cell carcinoma is so common and so unremarkable that there are sets of cancer statistics that just exclude the non-melanoma skin cancers entirely because including them is just confusing. If you’re trying to prove that cancer cases are mostly environmental, though, you can totally throw them back into the mix, because so many cases of basal cell carcinoma are environmental.
This was already an apples-to-oranges statistical set: last year’s study was actually making its claim about types of cancer, which is kind of a ridiculous way to frame it anyway since most people are more concerned about the types of cancer that they’re most likely to get. Lung, breast, colorectal, and prostate (the four cancers that kill the most people) were all “deterministic,” i.e., they had causes that weren’t just bad luck. (Note – that study included genetics as a deterministic factor, and your genetic hand is totally outside of your control.)
This study is making its claim about cases of cancer, which is a much more reasonable way to frame it … unless you include the cases of basal cell carcinoma, because there are 2.8 million cases per year and almost no deaths.
From a lay perspective, the actual take-home, what-should-I-do-with-this information has not changed even slightly. Don’t smoke! Eat lots of fruits and vegetables! Support the Clean Air Act (and don’t move to Beijing)! Wear a brimmed hat in the summer! But also recognize that genetics and many environmental exposures are totally outside your control; sometimes we don’t know about dangers until it’s too late, and life isn’t fair.
Do you actually need to believe that cancer is bad luck in order to feel compassion for people who get cancer? Maybe, in that case, focus on all the stuff that’s outside our control. Because there are lots.
Do you actually need to believe that cancer is totally deterministic in order to feel motivated not to smoke? Maybe, in that case, read up on lung cancer statistics (or COPD or heart disease statistics), because “coffin nails” really is an apt nickname for cigarettes.
Feature photo via [Shutterstock]