In the hypothetical scenario where overweight and obesity levels in European countries increased during the period 2009 at the same rate as has been observed in the US, the projected increase in rates of colon cancer ranged between 1.7 (UK) and 2.8 more (Spain) cases for 100,000 person-years for males. Increases for females ranged from 0.1 (Czech Republic) and 0.6 more cases (The Netherlands) per 100,000 person-years. These rates would translate to increases in numbers of new colon cancer cases of between 0.7 and 3.8%, the researchers say.

If a whole population obtained a mean BMI of 21, between 0.6 (Czech Republic, females) and 11 (Spain, males) per 100,000 new colon cancer cases would be avoided by 2040, translating into a population avoidable fraction (PAF) of overweight and BMI for colon cancer of 2/3% to 18%. PAFs for excess weight were much higher for males (between 13.5% and 18.2%) than for females 2.3% to 4.6%), and highest for British males (18%), the researchers say.

In the physical activity scenario, if all countries adopt the physical activity levels as observed for The Netherlands, which had the highest levels observed overall, between 0.5 (Czech Republic, males) and 5.1 (Spain; females) per 100,000 colon cancer cases per 100,000 person-years, or up to 17.5% of new colon cancer cases might be prevented in 2040. The highest PAF for physical activity was projected to be 21% for Spanish females.

"We found interesting patterns in these models," said Dr. Renehan. "Preventing weight gain and encouraging weight reduction would seem to be most beneficial in men, but for women a strategy with a great emphasis on increasing physical activity would be more effective."

Throughout the various papers in the special issue, the authors understand that modifying lifestyle is difficult. "We can safely say increasing physical activity across Europe to the level already achieved in The Netherlands, where everyone cycles, would be of substantial benefit," said Professor Jan-Willem Coebergh, from Erasmus University, The Netherlands, and one of the co-editors. "But we will always need sound evidence before prevention strategies can be implemented," he added.

Professor Michael Baumann, from the University Hospital and Medical Faculty, Dresden, Germany, and ECCO President, said: "Cancer prevention may not be foremost in the policy-makers' minds at present, but right now it is more relevant than it has ever been before. The recession confronts them with a clear choice - either to introduce short-term cost-containment strategies, which will simply increase long-term costs, or to use the financial crisis as an opportunity to strengthen evidence-based prevention policies. We hope that the evidence so amply provided in this special issue of the EJC will help make them decide to follow the right road and take a major step towards reducing the incidence of cancer in Europe over the years to come."

Source: ECCO-the European CanCer Organisation