The Centers for Disease Control and Prevention (CDC) reported last week that in 2002 and 2003, the proportion of smokers between 18 and 24 years old had reached its lowest point since 1991. Overall, the agency reported, smoking rates are continuing to decline. This promising news comes on the heels of other recent research findings that are shedding further light on the extent to which lifestyle factors and choices affect cancer risk and outcomes.

A study published last week in the Journal of the American Medical Association showed, for instance, that women with breast cancer who engaged in moderate exercise - anywhere from 3 to 5 hours a week - reduced their risk of death by half compared with women who did little or no exercise. A similar study presented at the recent ASCO annual meeting reached a similar conclusion: a 40- to 50-percent reduction in the recurrence of stage III colon cancer in those who engaged in regular exercise after treatment.

In an analogous finding earlier this year, data from the Lung Health Study showed that intensive smoking cessation counseling translated into a striking improvement in both overall and lung cancer survival among those who quit. The progress achieved in cancer prevention is an excellent example of the success possible when evidence-based interventions are adopted in the community.

In cancer research today, we are devoting a lot of attention and resources to the development of new targeted therapies and the use of cutting-edge tools such as proteomics and nanotechnology to advance research across the entire cancer prevention-diagnosis-treatment spectrum. But we haven't lost sight of the fact that basic interventions like managing lifestyle factors such as diet, exercise, and tobacco use are critical components of our efforts to eliminate the suffering and death due to cancer.

At NCI, we are supporting innovative research in these areas, much of which falls under the umbrella of "energy balance." We are, for example, funding the first National Institutes of Health (NIH)-wide program to improve the methodology by which researchers assess diet and physical activity. And we are partnering with CDC to collect data on diet, weight, physical activity, and neighborhood environment to determine whether there is a relationship between those factors and disease risk.

That latter example is important because it illustrates that this is not something the cancer community can or should do on its own. We must continue to form public- and private-sector partnerships, such as the strong collaboration between NCI and the American Cancer Society (ACS) and organizations such as C-Change, and educate legislators and policy makers at all levels about the perils of smoking, inactivity, and poor nutrition.

Along with sophisticated tools such as gene microarrays and advanced imaging systems, understanding and influencing environmental and lifestyle choices that affect cancer risk and outcomes is an integral component of achieving the 2015 goal.

Dr. Andrew C. von Eschenbach
Director, National Cancer Institute