There is no question at this point in our medical knowledge that health behaviors play a prominent role in morbidity and mortality from cancer and other diseases. The seminal paper by McGinnis and Foege Actual causes of death in the United States in 1993 did a great deal to put health behaviors on the map as significant public health problems. In their analysis, the authors concluded that approximately half of all deaths are due to health behaviors. The three most prominent behaviors in their analysis, tobacco (19%), diet and physical activity patterns (14%), and alcohol (5%), could be linked to more than one-third of all deaths in 1990.1 A reanalysis of the same question reached basically the same conclusions using data from the year 2000.2 This chapter takes a similar examination of the available evidence for the most common health behaviors that are implicated as contributing to cancer. We focus the analysis on tobacco use, diet, physical activity, being overweight, and sun exposure, as each is quite common and has been the subject of significant study. For each behavior, this chapter discusses one or more cancers with which the behavior is purported to be associated, yet the discussion focuses on behaviors, rather than cancers. For each behavior, this chapter examines (1) the evidence linking changes in the health behaviors to reducing cancer morbidity and mortality, (2) the effectiveness of physician counseling as a commonly used method of behavior modification, (3) the recommendations of professional groups regarding what individuals can do to improve these health behaviors, and (4) methods for improving the quality of physician counseling for behavior modification.
All Science Journal Classification (ASJC) codes