Cancer- Should Money Be Spent on Prevention or Therapy?

[haha]

Everyone in my family is or was t2 diabetic, except me. And none of us were fat. I have dropped my A1C levels to levels that my Doc says are not even pre-diabetic. But all I would have to do is eat a "mixed reasonable diet" instead of a fairly strict low carb diet and I would see my A1Cs climb to at least pre-diabetic and possibly diabetic levels. It seems like in matters of health, the easy assumption of stochastic processes tends to get thrown out, while in finance most of us implicitly accept that nothing is always, things are always stochastic.

A favorite technique of attacking a post here is to reduce it ad absurdum, then to attack that absurdity. No educated person is simple minded enough to imagine the things that get assumed as the meaning of his post. I will quit trying.

Now I agree with some others, obesity and smoking have nothing to do with anything. In fact, we should perhaps encourage more people to eat more and exercise less. Who knows, it may save them from a fatal case of anorexia nervosa, a real enough but perhaps somewhat less common affliction than obesity.


Ha

 

[Alan]

People I know who have had lung cancer the past several years were not heavy--one a long-time ex-smoker thirty years since her last cigarette, a current smoker, and two who never smoked. Several others who had other forms of cancer (brain, myeloma, primary bone, leukemia) were not at all heavy and would have fit right on those Seattle streets, to continue anecdotal instances. My own mother exactly fit M Paquette's profile of healthy behavior and was gone at 50 of her third relapse. So I guess I am just saying I am firmly on the side of funding therapy and letting the education and prevention efforts continue on their own, and I will let this go now as I think I am a little too emotionally invested in it (and I have the holidays to depress me instead ).

I also know a number of close friends and relatives, including my mother, a grandfather and my FIL, who were not overweight, and walked a lot. In fact my FIL and grandfather were super thin and very fit and healthy, and neither had ever smoked, but suddenly got ill, had aggressive cancer and were dead in 6 weeks.

While I am in favor of prevention rather than cure I don't think the level of investment for a cure to cancer should be curtailed. I also don't think big pharma will slow their search for a cure as the potential rewards are too high. There was an interesting documentary a few weeks back (Frontline?) looking into why we appear to be losing the battle against bacteria with fewer and fewer effective anti-biotic drugs available. Turns out that the last of the big Pharma companies has stopped researching new anti-biotics. Like the rest of the Pharma companies they have decided that new anti-biotics have too short a lifetime too be big profit makers.

 

[Bestwifeever]

Everyone in my family is or was t2 diabetic, except me. And none of us were fat. I have dropped my A1C levels to levels that my Doc says are not even pre-diabetic. But all I would have to do is eat a "mixed reasonable diet" instead of a fairly strict low carb diet and I would see my A1Cs climb to at least pre-diabetic and possibly diabetic levels. It seems like in matters of health, the easy assumption of stochastic processes tends to get thrown out, while in finance most of us implicitly accept that nothing is always, things are always stochastic. A favorite technique of attacking a post here is to reduce it ad absurdum, then to attack that absurdity. No educated person is simple minded enough to imagine the things that get assumed as the meaning of his post. I will quit trying. Now I agree with some others, obesity and smoking have nothing to do with anything. In fact, we should perhaps encourage more people to eat more and exercise less. Who knows, it may save them from a fatal case of anorexia nervosa, a real enough but perhaps somewhat less common affliction than obesity. Ha

I'm sorry, I thought you were asking if money should be spent on prevention or therapy. We just gave our opinions.

 

[haha]

Several others who had other forms of cancer (brain, myeloma, primary bone, leukemia) were not at all heavy and would have fit right on those Seattle streets, to continue anecdotal instances. My own mother exactly fit M Paquette's profile of healthy behavior and was gone at 50 of her third relapse.

Well of course when you look out the window and report what you see, it is necessarily an anecdote. Most of us structure our map of reality by just such anecdotes, and as the saying goes, who do you trust-your lying eyes or what someone says?

Also of course, one's sidewalk observations have nothing whatsoever to do with cancer. Every thin person I see may have cancer for all I know. It is well known that cancer makes you thin. I was commenting only in favor of the well supported epidemiologic observation that urban populations where people walk are more likely to be normal weight than populations where one necessarily has to get around by private automobile. And of course I say urban populations, not every individual.

Ha

 

[ERhoosier]

Perhaps semantics, but IMHO prevention and treatment are both critical in the "war" on any disease. It would be silly to attack a cholera outbreak by spending all your resources on antibiotics while ignoring the contaminated water supply.
BTW- cases of thin, athletic folks getting diabetes or cancer is entirely consistent with obesity being an important risk factor. Just because there's a few obese centenarians who smoked like chimneys & drank like fishes doesn't mean public health officials should be promoting gluttony, chain smoking, and alcoholism as keys to longevity

 

[M Paquette]

Well of course when you look out the window and report what you see, it is necessarily an anecdote. Most of us structure our map of reality by just such anecdotes, and as the saying goes, who do you trust-your lying eyes or what someone says? Also of course, one's sidewalk observations have nothing whatsoever to do with cancer. Every thin person I see may have cancer for all I know. It is well known that cancer makes you thin. I was commenting only in favor of the well supported epidemiologic observation that urban populations where people walk are more likely to be normal weight than populations where one necessarily has to get around by private automobile. And of course I say urban populations, not every individual. Ha

Statistics are good. Big fan here.

Unfortunately, we hairless plains apes tend to be anecdote-driven. Ever since we saw Thag get eaten by that big cat at the sunset watering hole we've avoided it and gone thirsty at night...

I'm a big fan of the science stuff. (Physics degree, but a couple year detour into organic and biochemistry.) I tend to look closer than many folks are comfortable with, including the various diet fads and cures. So, when someone tells me that their diet works because 'cancer cells can only ferment glucose' and the diet deprives them, I just have to ask if they really believe that just cutting carbohydrates removes all glucose from the cell's environment. What happens to other cells when one drops the level of glucose in the extracellular fluid to the point where the cancer cells stop replication? (Hint: It ain't pretty, especially for cells in the central nervous system.).

 

[nash031]

Interesting topic. Cancer seems to be a stochastic occurrence: everyone's got cancerous cells in their body, it's impossible not to. Not everyone forms a malignant tumor. Not everyone who smokes gets lung cancer. Not every lung cancer patient smoked. There are lots of things that increase your chances of getting certain forms of cancer, but I don't think there's a way to 100% prevent any form of it.

What we CAN do is detect it earlier and, therefore, treat it earlier. That's been key in reducing the lethality of both breast and prostate cancers to the point where they were extremely deadly in the 70s, and now the 5-year survival rate is near 100% for prostate and over 90% for breast cancer.

Meanwhile, pancreatic cancer has gone from about 2% in the 70s to just about 6% now for 5-year survival. Why? Because by the time it's detected, it's usually spread to the liver or stomach or other organ, or gone stage IV.

My dad was diagnosed with pancreatic cancer in January, and so far seems to be one of the very lucky few. 4 in 5 are dead within a year.

He did smoke, and that might be part of it. But there is also evidence that it could be linked to genetics, and now we think his mom may have died from PC because her symptoms were consistent. Of course, I am very interested in the study of pancreatic cancer, particularly detection methods, and there is hope out there.

But to say we need to stop looking for a cure might be fine... not sure there IS a cure for cancer, considering its nature... and I agree we should continue to fight obesity even if it's not a cancer issue.

But there are plenty of ways to make cancers like pancreatic much more in line with prostate cancer - in other words, let's figure out ways to detect them so we can treat them. Treatments can be effective, but only if caught in time.

 

[NW-Bound]

Maybe we should call a truce in the War on Cancer and concentrate on prevention. Besides smoking, the most preventable cause of cancer seems to be obesity. It is generally thought that obesity may account for about a third of many cancer types, particularly breast, colon, uterus, kidney and esophagus. Obesity is a risk factor for type II diabetes and these patients are not only more likely to get cancer, but to have poor outcomes...

The National Cancer Institute has this to say about obesity as it relates to cancer risks: Obesity and Cancer Risk - National Cancer Institute.

Of course, the exact causes for cancer are not known. Besides genetic factors, many other environmental factors may also contribute, perhaps in synergism. For example, exposure to asbestos greatly amplifies the risk of lung cancer to cigarette smokers.

And speaking of smoking whose association with lung cancer is the highest, compared to any other personal factors with respect to any other cancer, this association of cause and effect is still not 1 to 1.

I saw somewhere that the risk of an individual getting lung cancer in his/her lifetime is 1 in 13. This includes both smokers and non-smokers. Yet, only about 1 in 8 smokers dies of lung cancer. If it were not for the other 7 out of 8 that we see live to a long life with no ill-effects from smoking, smokers would all quit. And out of all lung cancer patients, about 10-15% never smoke. Life just is not fair.

Anyway, it's not to say that obesity and smoking should not be avoided. There are other health risks beside cancer that these bring.

 

[M Paquette]

The National Cancer Institute has this to say about obesity as it relates to cancer risks: Obesity and Cancer Risk - National Cancer Institute.

Excellent link. Thanks.

One study, using NCI Surveillance, Epidemiology, and End Results (SEER) data, estimated that in 2007 in the United States, about 34,000 new cases of cancer in men (4 percent) and 50,500 in women (7 percent) were due to obesity. The percentage of cases attributed to obesity varied widely for different cancer types but was as high as 40 percent for some cancers, particularly endometrial cancer and esophageal adenocarcinoma.

The article gives lots and lots of details on specific types of cancer after that quoted bit, so it's well worth looking at.

Also, please note that the statistics are pretty clear on obesity NOT being the primary cause of most cancer. It is a significant factor for colon, breast, endometrial, and gallbladder cancers. Also also, please note that this doesn't mean obesity is not a health problem. It causes a significant physical stress on the body mechanics, with the stress on the circulatory system leading to heart disease and stroke, and the load on knees, hips, and back promoting osteoarthritis. There are also some bad metabolic effects as others have noted.

If everyone has a near ideal weight, diet, and exercise plan in effect, we don't prevent cancer. There are a bit fewer cases in a given population. We also don't cure cancer. Maintenance of weight, proper diet, and exercise improve the likelihood of being able to receive and recover from some treatment (e.g., tolerate surgery, chemo, or radiation treatment), and might contribute to survival time.

So, yes. Money should be spent on prevention AND therapy.

 

[NW-Bound]

Also, please note that the statistics are pretty clear on obesity NOT being the primary cause of most cancer. It is a significant factor for colon, breast, endometrial, and gallbladder cancers...

Regarding the diet factor, I recently saw quite a few articles on high-carb diets increasing the risk of recurrence of some types of cancer among patients in remission. This effect is strongest if the patient is also obese.

 

[kyounge1956]

Maybe we should call a truce in the War on Cancer and concentrate on prevention. Besides smoking, the most preventable cause of cancer seems to be obesity. It is generally thought that obesity may account for about a third of many cancer types, particularly breast, colon, uterus, kidney and esophagus. (snip)

Ha

Let's assume that obesity does account for one-third of cancer risk. What about the other two-thirds? Obesity is a recognized factor in breast cancer risk, but there are many others. Just to mention a few that I personally could point the finger of blame at, unless there is some way of preventing dense breast tissue, late menopause, and failure to breast-feed (due to childlessness in my case) as well as obesity, I don't know how much prevention can be counted on to reduce the incidence of breast cancer. My mother, sister, and one of my aunts have all been well over "healthy body weight" for decades, and none of them got cancer. I was underweight for a good deal of my childhood, and overweight for only five or six of the nearly fifty-eight years I've been on this planet. The fact that I'm the only one of us who did get breast cancer, suggests at least that other risk factors are have a greater influence than weight on overall breast cancer risk.

I wish you had found some other way to pose this question. As someone who already has the disease, "calling a truce in the war on cancer" in favor of prevention sounds uncomfortably close to "don't bother to treat people with cancer more than minimally and don't bother with research into new treatments--they're going to die anyway and it's probably their own fault they got sick in the first place". Prevention alone isn't enough. Obesity, breast density, alcohol consumption etc etc are risk factors. Reducing them doesn't make you immune to cancer the way a vaccine makes you immune to smallpox or tetanus. I frequent an online breast cancer forum, and many, many, of the women there "did everything right"--they maintained healthy weight, didn't overindulge in alcohol, exercised regularly, breastfed their children etcetera, etcetera, etcetera--and they got got breast cancer anyway. Even if everyone perfectly followed every preventive measure, people would still get cancer. It will take both prevention and treatment to eliminate cancer.

 

[timo2]

Rant alert: I find that much of the attempted correlation in this thread of various individual bodily types or lifestyle characteristics to be based upon a subtext of 'blame the victim' In ancient days, if someone became ill, it was because someone sinned somehow, meaning it was their fault. Now, it is because they did this or didn't do that - still blaming the victim. The truth is life is a risk factor, and no one gets out alive. So enjoy it while you got it!

 

[Amethyst]

Except for citing reputable medical studies, we may need to consider avoiding all attempts to correlate disease with body type. There have been a number of such discussions, which end up as political discussions do: nobody is convinced, and most people are annoyed.

Amethyst

 

[NW-Bound]

Regarding treatment vs. prevention, I think both areas are being worked on. As I understand, the prevention researches are mostly epidemiology studies that collect data from many individuals and to attempt to identify causes and effects. We cannot do direct experiments on people habits and lifestyles like we do with mice.

A book that I just finished may be of interest to people reading this thread. See http://www.early-retirement.org/forums/f27/what-have-you-read-recently-43066-17.html#post1383946.

 

[haha]

I have a question-did any of you rather outspoken critics read any of the article? It isn't at all clear that you did. It's not my thesis, I have no clear opinion, BECAUSE I DON'T KNOW ENOUGH ABOUT THE ISSUES. Also it is not the thesis of Peter Attia, who just wonders if perhaps our LIMITED resources might go further if a larger % were spent on basic research. As he clearly points out, operative therapies tend to work very well. But (according to Dr. Abrass) not much progress has been made in the treatment of metastatic cancer in a very long time. It might be that this is saying that another pathway might be worth trying.

Hey, but feel free to ignore what this expert says, just don't blame me, since I only posted what I mistakenly thought might interest the group. I should have known better.

Dr Abrass' final statement:"Maybe we should call a truce in the War on Cancer and concentrate on prevention. Besides smoking, the most preventable cause of cancer seems to be obesity. It is generally thought that obesity may account for about a third of many cancer types, particularly breast, colon, uterus, kidney and esophagus."

As I read this, he doesn't seem to be saying that you have to be obese to get cancer. Only that the most preventable cause of cancer, after smoking, seems to be obesity. Then he names cancers for which this seems to be noticed. But you know, he may well be wrong. Why not write him and point out his errors, 'cause I don't know him and I cannot carry the messages and I am not sure I would be comfortable with this anyway.

But whatever.

 

[NW-Bound]

... But (according to Dr. Abrass) not much progress has been made in the treatment of metastatic cancer in a very long time. It might be that this is saying that another pathway might be worth trying.

This is very true! People should also read the book that I reference in another thread as described in my earlier post, which describes how cancer cells can mutate very quickly to get around new drugs.

However, researchers will keep on trying, out of professional prestige and financial rewards. If it is from private funding, they can do whatever they like. They may make some breakthroughs, and we cannot rule that out.

...
Dr Abrass' final statement:Maybe we should call a truce in the War on Cancer and concentrate on prevention. Besides smoking, the most preventable cause of cancer seems to be obesity. It is generally thought that obesity may account for about a third of many cancer types, particularly breast, colon, uterus, kidney and esophagus.

Yes, but why call a truce on treatment? And every bit in prevention helps. It is not about blaming. It's about an individual doing what he/she can to help him/herself. A lot of time, they just do not know.

And if they know, but ignore the risks like smokers do, what is left to do?

 

[NW-Bound]

About cancer prevention, the common wisdom that a diet high in fruits and veggies can prevent some cancer types has been retracted. It made no difference in several studies.

 

[Bestwifeever]

I read all of the article that you linked to before I posted, ha.

 

[haha]

Yes, but why call a truce on treatment? And every bit in prevention helps. It is not about blaming. It's about an individual doing what he/she can to help him/herself. A lot of time, they just do not know.

And if they know, but ignore the risks like smokers do, what is left to do?

Again, write him and ask him why he choose those words. Anyone will know that treatment is never going to be slighted, because that is where the real $$$ are, and also that is where the political pressure is. I used a variation of Dr Abrass' title to introduce he thread, only because the management insists on a title and a description.

I would appreciate knowing from where the blame thread comes.
I guess I never could have guessed the problems members have found here.

 

[Katsmeow]

As someone who has struggled with weight, bouncing up and down between normal weight, overweight, and obese during most of my adult life, I am very interested in the issue of obesity. (And, no, I'm not obese because I drink sugary drinks. I haven't those types of drinks in over 30 years).

I think smoking and obesity should be fairly amenable to modification, and likely very worthwhile to do that for the individual and the society.

Let me first say that I think the treating obesity is something that is worthwhile to do for many reasons.

That said, I think the above statement is fundamentally not true at this time. That is, obesity is in fact extremely difficult to successfully treat, if you consider successful treatment to be persistence of lost weight. In fact, it is so difficult that many experts feel that it is basically a waste of time to try to treat obesity and that virtually all efforts should be directed to obesity prevention.


Of course, there are people who are obese who successfully lose weight and keep it off. However, they are outliers and aren't the norm. Over 95% of people who successfully lose weight regain within 5 years (I am one of them).


On another board, an obesity researcher posted about this issue awhile back:

http://boards.fool.com/to-preface-my-post-i-have-never-been-overweight-27721294.aspx

Basically one of the major problems with obesity is that a once obese person who reduces weight to a normal weight will have a lower metabolism and burn fewer calories than a never obese person.

See this article:

MMS: Error

Basically it is showing that formerly overweight people burn about 15% less calories than expected.

That may not sound like much but the thing most people don't understand is that the difference between staying weight stable and gaining weight is a very small one.

In order to be overweight it doesn't require eating a lot of fast food (I don't, some but not a lot), or sugary drinks (I don't), or lots of sugary sweets (I don't). If you eat an extra 100 calories a day, you would gain about 10 pounds in a year.

Now imagine that a never obese person at a certain weight and activity level would be weight stable at 2000 calories a day. Let's imagine she has a friend of the same weight and activity level, who was once obese. That person also eats 2000 calories a day. But, in her case, she isn't weight stable at 2000 calories. She is eating 300 calories too much and at the end of year, she has gained 30 pounds even though she ate the same amount as her weight stable friend. She would be weight stable at 1700 calories a day, but that is very, very difficult to maintain on a permanent basis. And, if she instead says she will eat 1900 calories a day, then she is back to gaining 10 pounds every year.

By and large most of the people (not saying all) who are able to maintain weight loss after being obese either restrict calories to a point well beyond that of other never obese people or exercises a great deal - far more than the average person who was never obese.

Anyway - the main point I am making is that for whatever reason, obesity is very, very difficult to treat. It is not just that obese people don't want to lose weight. I know many people who are highly motivated to lose weight, try very hard and still don't permanently succeed. (Yes, there are exceptions. Some people don't try hard and some people lose weight easily and keep it off easily. But when 95% of people who actually did lose weight, can't keep it off there is more going on than lack of willpower or people just being lazy. The best explanation I've seen that makes sense is the change in metabolism.

 

[kyounge1956]

I have a question-did any of you rather outspoken critics read any of the article? It isn't at all clear that you did. It's not my thesis, I have no clear opinion, BECAUSE I DON'T KNOW ENOUGH ABOUT THE ISSUES. It is not the thesis of Peter Attia, who just wonders if perhaps our LIMITED resources might go further if a larger % were spent on basic research. As he clearly points out, operative therapies tend to work very well. But (according to Dr. Abrass) not much progress has been made in the treatment of metastatic cancer in a very long time. It might be that this is saying that another pathway might be worth trying.

The first time I saw this thread I mistakenly thought the link was to a TED talk, which had been linked on an earlier thread and which I had already listened to when it was originally posted. I have now read the article linked on this thread, but it doesn't change my reaction. It is one thing to suggest that another pathway--prevention--might be worth trying, and another thing to suggest "calling a truce". A truce is an agreement between adversaries to stop fighting each other, either temporarily or permanently. A disease isn't capable of making such an agreement.

I do not see any call for more "basic research" in the article. Basic research is what revealed the complexities of cancer described in the first and largest part of the article, but the author doesn't call for more of such research, but for a greater concentration on prevention, and specifically prevention focused on obesity.

I have stage IV cancer, and it is no news to me that not much progress has been made in treatment of metastatic disease over the last several decades. That does not strike me as a good reason to divert resources away from development of more effective treatments for the aspect of the disease which actually kills people.

Hey, but feel free to ignore what this expert says, just don't blame me, since I only posted what I mistakenly thought might interest the group. I should have known better. (snip)

Yes, you should have known better than to suppose that leading off your thread with a quote advocating a "truce" with cancer would not raise hackles. What were you expecting?

 

[Amethyst]

Yes, I read the article, and a number of the following comments, until they inevitably degenerated into the familiar religious war over "carbs."

Amethyst

 

[NW-Bound]

Again, write him and ask him why he choose those words. Anyone will know that treatment is never going to be slighted, because that is where the real $$$ are, and also that is where the political pressure is. I used a variation of Dr Abrass' title to introduce he thread, only because the management insists on a title and a description.

I would appreciate knowing from where the blame thread comes.
I guess I never could have guessed the problems members have found here.

What I meant about "blaming" was that if a researcher found that any lifestyle or obesity was linked to a disease and reported it, he would risk offending people. However, the fact has to be told, else we cannot reduce the rate of cancer. Obesity is a risk factor, and some obese people may still die of old age, but being thin gives you an edge. It's just like non-smokers who can still get lung cancer, but smoking increases your risk.

The book that I referenced talks about a study in Europe called EPIC (European Prospective Investigation into Cancer and Nutrition) that found a strong link between obesity and cancer. This is a study of 520,000 people over more than a decade. It is also the study that finds a diet high in veggie and fruits does not offer protection as previously thought. What they have found is that obesity itself is the problem. How you get there with different diets do not matter that much. Here's an excerpt.

"Moving beyond culinary issues, EPIC has strengthened the case against obesity. One study found that older women who had gained 15 to 20 kilograms, or roughly 40 pounds, since they were twenty had an increased breast cancer risk of 50 percent. As in the old animal experiments, fatness itself, whatever its cause, appeared to be the driving force. Along with lack of exercise, it may account for as much as 25 percent of cancer, with dietary specifics falling to as little as 5 percent."​

The above means that 1 out of 4 cancer cases is due to obesity and can be avoided, and 3 out of 4 cases have unknown other causes.

So what if obesity itself is a medical problem? Let's try to understand it. People were not obese in the old days. What changed? Was it carb, meat, processed food or whatever? In Europe, the per capita consumption of sugar has increased from 2 to 3 kilos per year in the 1800s to 50 to 60 kilos today. EPIC researchers think that is a contributing factor.

PS. By the way, I searched the Web and found that the US per capita consumption of sugar is 77 lbs per year. That is a lot less than European consumption, and I find that very surprising. Europeans are thinner than US citizens by far.

 

[Katsmeow]

PS. By the way, I searched the Web and found that the US per capita consumption of sugar is 77 lbs per year. That is a lot less than European consumption, and I find that very surprising. Europeans are thinner than US citizens by far.

You have to be sure what you are comparing. According to the below in 2008, American per capita consumptiom of refined sugar was 65.4 lbs per year, but there was also consumption of 68.3 lbs of corn-derived sweeteners per person.

Sugar - Wikipedia, the free encyclopedia

Here is a nice graph which shows intake by country but is apparently just the actual amount, and not per capita so hard to use to compare. The notable thing is that high fructose corn syrup on this is about half of all sweeteners in the US and it is apparently only a significant (but well under half) contributor in Japan, Canada, Mexico and Argentina (with what looks like a tiny amount in Australia).

CONVERSABLE ECONOMIST: The Global Sugar Market and US Sugar Consumption

The biggest source of sweeteners in the US is from soft drinks. Basically about 43% of added sugar in the US comes from soft drinks or fruit drinks (fruitades and punch).

As an aside looking down the list of added sugar I rarely have any of it. No sweetened drinks at all, rare candy (maybe once or twice a year), occasional cakes and cookies (maybe once or twice a month and even then a small serving), occasional ice cream, no sweetened cereals. I track my nutrition online and I am routinely very low on sugar. So getting rid of sugar is undoubtedly important to preventing obesity but it hardly explains all of it.

 

[NW-Bound]

Thanks. The number you cited makes more sense.

The number I quoted was from the USDA, which does not include fructose. When all sweeterners are added together, the US per capita consumption is about the same as that of Europeans. I still find that surprising, becase we all know Americans are soda guzzlers, while Europeans rarely drink that. So, in what form do Europeans consume their sugar? It's a mystery, and I will need longer trips to Europe to learn more about their culinary habits for myself.

But, another statistic worth mentioning is that the US does not lead the world in cancer rate, and in fact ties in #6 with France, despite having a higher obesity rate.

Nation	Cases per 100,000
Denmark	326
Ireland	317
Australia	314
New Zealand	309
Belgium	307
France	300
US	300
Norway	299
Canada	297
Czech Rep.	295

If we look at continental aggregates, then Australia is highest, followed by Western Europe, then North America. Poor countries have the lowest cancer rates which are 1/10 or less of the above numbers.

The Web sources were never clear, or perhaps I miss something, but I think the above numbers are newly diagnosed cases each year. As many cancer patients survive more than 1 year, then the number of cumulative patients will be higher.

Regarding cancer prevention, I found the fact that fruit and vegetable consumption not helping ward off cancer disheartening. I am an omnivore and will continue to consume a lot of fruit and vegetable as I love them, and they still help with diabetes, cholesterol, high blood pressure, and weight control.