To the Editor we read with great interest the article by Song and Giovannucci1 showing that a healthy lifestyle reduced cancer incidence by 20% to 40% and cancer mortality by 50%. This effect was even more pronounced when compared with the broader US population, which has a worse lifestyle than that of the study participants. In this study, a healthy lifestyle was defined as the control of 4 major risk factors by not smoking, consuming only moderate amounts of alcohol, maintaining a BMI lower than 27.5, and engaging in regular physical activity. Smoking, heavy alcohol consumption, high BMI, and sedentary life habits are also risk factors for diseases other than cancer (eg, cardiovascular and respiratory diseases, diabetes, osteoporosis) and thus account for a significant burden of morbidity and costs to the health care system and to society. Interestingly, only 20.8% of the patients in this study fulfilled the criteria for a healthy lifestyle, and this proportion is believed to be even lower in the general population.
Gasparri ML, Mueller MD, Papadia A. Self-responsibility for Our Good Health. JAMA Oncol. 2016;2(9):1242. doi:10.1001/jamaoncol.2016.3079