@Middle-aged and young people: Don’t step on the cancer “minefield”

Author: Ni Chenxu, Shanghai Tenth People's Hospital

Reviewer: Yuan Min, deputy chief physician, Shanghai Tenth People's Hospital

After the age of 50, the risk of cancer usually increases significantly, so many doctors recommend that people undergo regular cancer screening after the age of 50. However, although cancer is an old age disease, the trend of younger people becoming more and more prominent, and even in some countries, the proportion of cancer cases in people under 30 is increasing. The younger age of cancer cannot be ignored.

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For young and middle-aged people, cancer prevention requires appropriate "preparation for a rainy day", so what can we do in our daily lives? Today I will mainly introduce the following 4 points.

1. Preventing Chronic Diseases from Affecting Young People

Recently, a study of over 5 million Asians published in the top international journal Clinical Oncology[1] showed that fatty liver disease in people aged 20 to 39 is associated with an increased risk of developing digestive system cancer in the later stages of life. Fatty liver disease is becoming younger, which is closely related to the fact that young people today like to eat cakes, fried chicken, drink beer, and drink milk tea. In addition, it is closely related to the three common bad habits of young people: long-term sitting, staying up late, and lack of exercise. However, we need to clearly realize that chronic diseases such as fatty liver disease are relatively preventable and treatable diseases, and the difficulty of treatment is much lower than that of cancer. As long as we develop good living habits, such as regular work and rest, moderate exercise, and dietary moderation, it is possible to prevent or effectively manage these chronic diseases. This study also sounded the alarm for our young and middle-aged people: "control your mouth, move your legs, sleep well, and stay away from chronic diseases" is crucial to preventing and treating early-onset cancer.

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2. Stay away from cigarettes

The harm of smoking is well known, but many smokers still refuse to quit, and even say: "xxx has smoked all his life and nothing happened." So, are those long-term "old smokers" really less likely to get lung cancer? Epidemiological statistics do show that only 10% to 20% of lifelong smokers will develop lung cancer, but this is not a reason to continue smoking. A study published in the journal Nature Genetics[2] revealed the secret behind the saying that "smokers are less likely to get lung cancer" - some heavy smokers (>23 packs of cigarettes/year) may have evolved "special functions", that is, they have stronger DNA repair capabilities, thereby restoring accumulated mutations and protecting themselves from lung cancer. However, this phenomenon has significant individual differences, and it is impossible to predict whether you are the "chosen one". Therefore, we urge the majority of young and middle-aged people not to take chances. The safest way to prevent lung cancer is to "avoid active smoking."

In addition, passive smoking, that is, being in a tobacco smoke environment for a long time, which is what we often call "second-hand smoke", is more harmful to human health. Second-hand smoke contains more than 40 carcinogens, which can be inhaled into the body. In the long run, it will greatly increase the incidence of lung cancer and have a direct harmful effect on the human cardiovascular system. Therefore, young and middle-aged people should also "stay away from second-hand smoke."

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3. Get enough sunlight and eat a moderate amount of vitamin D

Since they rarely get sun in their daily lives, many office workers will find that their vitamin D levels are insufficient during physical examinations. Does this have any impact on health? A study published in the international journal "Gastroenterology" in 2021 [3] showed that higher vitamin D intake was associated with a reduced risk of early-onset colorectal cancer and colorectal precancerous lesions. The study also found that daily intake of vitamin D ≥ 450 IU (roughly equivalent to eating 100 g salmon, 300 g sardines, and 750 g yogurt) was associated with a 50% reduction in the risk of colorectal cancer. In addition, dietary intake of vitamin D is more strongly associated with a reduced risk of disease than supplements.

Sunbathing is the most convenient and economical way to supplement vitamin D. It is recommended that young and middle-aged people go out to sunbathe 2-3 times a week, and each time the sun is at an appropriate intensity for 15-30 minutes. It is recommended to expose your limbs when sunbathing, not to apply sunscreen, and avoid sunbathing behind glass or with an umbrella. In addition, remember to wear sunglasses when sunbathing outdoors to prevent eye injuries and avoid exposure to strong sunlight.

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4. Maintain a good mood

Long-term negative emotions, such as depression and anxiety, are one of the risk factors for cancer. Chinese medicine believes that "uncontrolled joy and anger will damage the internal organs", that is, excessive emotional fluctuations will cause harm to the body. Young and middle-aged people are inevitably young and energetic at this age, so they must learn to regulate their emotions and stay in a good mood. When we face troubles in life, we can find someone we trust to chat with, adjust our mentality, face the problem positively, and seek solutions. This will not only keep us in a good mental state, but also improve our quality of life and sense of happiness.

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The World Health Organization (WHO) emphasizes that nearly half of cancers are preventable. With the accelerated pace of life, young and middle-aged people are generally under great work pressure. In this case, more attention should be paid to the early prevention and detection of cancer, and good living habits should be developed. Cancer prevention should be integrated into daily life. The "China Youth and Middle-aged Cancer Prevention Science Report" introduces the ten basic principles of cancer prevention for young and middle-aged people in China: ① Stay away from tobacco; ② Block chronic infection; ③ Eat a healthy diet; ④ Control weight; ⑤ Exercise; ⑥ Don't stay up late; ⑦ Limit drinking; ⑧ Screening and early diagnosis and treatment; ⑨ Psychological balance; ⑩ Young people prevent cancer for your reference. For your own health and family happiness, young and middle-aged people, start now and don't step on the "minefield" of cancer!

References:

[1] Park JH, Hong JY, Shen JJ, et al. Increased Risk of Young-Onset Digestive Tract Cancers Among Young Adults Age 20-39 Years With Nonalcoholic Fatty Liver Disease: A Nationwide Cohort Study. J Clin Oncol, 2023, 41(18): 3363-3373. JCO2201740. doi: 10.1200/JCO.22.01740.

[2] Huang Z, Sun S, Lee M, et al. Single-cell analysis of somatic mutations in human bronchial epithelial cells in relation to aging and smoking. Nat Genet, 2022, 54: 492-498. doi:10.1038/s41588-022-01035-w.

[3]Kim H, Lipsyc-Sharf M, Zong