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Comment & Response
September 2016

Self-Responsibility for Our Good Health—Reply

Author Affiliations
  • 1Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
  • 2Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
  • 3Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
  • 4Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Boston, Massachusetts
JAMA Oncol. 2016;2(9):1242-1243. doi:10.1001/jamaoncol.2016.3074

In Reply We thank Gasparri and colleagues for their interest in our recent publication1 and share in their enthusiasm for “[r]edirecting economic resources into education and awareness of lifestyle risk factors” to promote adoption of healthy lifestyles in the general population. The benefit of such primary prevention measure goes well beyond control of the increasing cancer burden and can extend to a wide spectrum of health problems, such as cardiovascular diseases and diabetes, which are also heavily influenced by the 4 lifestyle factors considered in our study (ie, smoking, heavy alcohol drinking, obesity, and physical inactivity). Compelling data have established the cost-effectiveness of most lifestyle modification strategies that include individual-based behavioral interventions, communitywide lifestyle programs, physician counseling, mass media campaigns for health promotion, and policy change (eg, tax increase and advertisement regulation).25 As Colditz and Sutcliffe6 commented in their editorial, “[i]t is these efforts that will be our fastest return on past investments in cancer research over the coming decades.”

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