The invitation that comes from young Italian oncologists is addressed to women and is to ‘get a move on’ because the numbers show a female population dangerously attached to lifestyles that increase not only the risk of breast cancer, but also that of other pathologies starting from cardiovascular ones. For this reason, the news of the launch of a national campaign for the defense of women’s health at 360° comes from Perugia, where the Aiom Giovani national congress is taking place.
The bad habits of women
Healthy lifestyles can reduce the risk of developing breast cancer by 27%. In Italy, however, 36.9% of women are sedentary, 26.8% are overweight and 11.1% obese, 15.3% smoke and 8.7% consume alcohol in health risk. These behaviors increase the likelihood of developing not only breast cancer, but also other neoplasms and serious diseases, such as cardiovascular, metabolic and neurodegenerative diseases. Furthermore, the frequency of incorrect lifestyles increases with age, precisely when the risk of developing breast cancer is also higher due to hormonal changes associated with menopause. A sedentary lifestyle increases from 30.2% of 45-54 year-olds to 31.9% of 55-59 year-olds up to 36% of 60-64 year-olds, overweight increases from 25.6% of 45-54 year-olds to 30% of 55-64 year-olds, risky alcohol consumption increases from 7.5% of 45-64 year olds to 9.3% of 65-74 year olds.
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The campaign for prevention
For this reason, the Italian Association of Medical Oncology (AIOM) is launching the first national campaign aimed at women aged 20 and over, to encourage correct lifestyles at all ages, with the aim of reducing the incidence and mortality of breast cancer. A campaign, created with the non-conditioning contribution of AstraZeneca, aimed at the female population with direct messages, which focuses above all on modifiable risk factors to prevent breast cancer and, in cascade, all pathologies influenced by lifestyles. An all-round campaign that, starting from breast cancer, preserves women’s health at 360 degrees. “We will produce brochures on healthy lifestyles to be distributed in pharmacies and general practitioners,” he says Saverio Cinieri, president Aiom. “Each booklet will have a specific message linked to a single lifestyle: fight against smoking, incorrect diet, excessive alcohol consumption, sedentary lifestyle and overweight. Excess weight, especially after menopause, can increase the risk of breast cancer because adipose tissue is the main source of circulating estrogen hormone synthesis, with consequent excessive hormonal stimulation on the mammary gland. The Mediterranean diet, which has extra virgin olive oil as its cornerstone, has demonstrated an effective protective action”.
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Too much alcohol for 9% of women
Particular attention will also be paid to alcohol, a true enemy of breast health. “50 grams of alcohol a day, equal to just over 3 glasses, are enough to determine a 50% increase in the risk of breast cancer compared to those who do not drink”, underlines Cinieri. In Italy, in 2022, 55,700 new cases were estimated and 834,200 women live after diagnosis. The 5-year survival is 88% and exceeds 90% when the disease is identified in the early stages.
Self-examination education
“The prevention of this neoplasm – he underlines – also includes breast self-examination, a non-invasive practice that does not involve the presence of a doctor and that every woman, after adolescence, can experiment on herself with great results in terms of early diagnosis . “It should be done every month from the age of 20, preferably in the first or second week after the end of the menstrual cycle. Any abnormalities should be reported to your doctor immediately. Self-examination is a first prevention tool, but it is not enough by itself. It must be combined, starting from the age of 50, with more precise instrumental tests such as mammography”, explains the President of Aiom. “This screening exam – he adds Lorraine IncorvaiaCoordinator of the AIOM Youth Working Group – overall coverage in our country reaches 46%, but it needs to be implemented above all in some areas, because it goes from 63% in the North to 48% in the Center and drops to 23% in the South”.
Involve general practitioners and family doctors
The project also includes the organization of training courses for general practitioners, but the aim is also to promote public health action towards the other members of the family: children, parents and husbands. “The project – he continues Corvaia – also includes a survey to photograph the level of awareness of the female population on healthy lifestyles and the activation of a dedicated portal, a point of reference for all women with practical advice, interviews, best practices, case histories, direct testimonies of the patients. All the activity will be widely disseminated on AIOM’s social channels”.
L’Healthy Lifestyle Index
A study, published in the scientific journal Breast Cancer involved 1319 patients with breast cancer, enrolled in the ‘Long Island Breast Cancer Study Project’, and 1310 women not affected by the disease. Both groups were followed up for an average of almost 18 years. “In the studio – he says Matthew Lambertini, member of the AIOM National Executive and Associate Professor of Medical Oncology at the IRCCS San Martino Policlinico Hospital, University of Genoa – the Healthy Lifestyle Index was used, calculated in relation to the body mass index, the physical activity practiced, to the consumption of animal and vegetable foods, alcohol, breastfeeding and the habit of smoking. Higher scores corresponded to healthier lifestyles. Women with medium to high scores on the Healthy Lifestyle Index had a 22-27% lower risk of developing breast cancer and about 30% lower risk of dying from all causes after a cancer diagnosis than women with high scores lower. These data highlight the role of healthy lifestyles not only in reducing the risk of breast cancer, but also in improving survival after cancer diagnosis, especially among postmenopausal women.
The study on the role of diet
The results of this study are in line with previous experiments. A work presented at the Congress of the American Society of Clinical Oncology (ASCO) showed that diet influences the risk of dying from breast cancer. It surveyed nearly 49,000 postmenopausal women, ages 50 to 79, with no prior history of breast cancer, to figure out whether or not a dietary intervention made a difference. “The researchers – explains Lambertini – divided the women into two groups: the first had to continue to follow their diet in which fat represented 32% or more of the daily calories. The second group, on the other hand, had to adopt a diet that aimed to reduce fat consumption – until it reached 20% or less of the caloric intake – and included at least one portion of vegetables, fruit and cereals a day. Overall, women who followed the balanced low-fat diet showed health benefits, with a 21% reduction in the risk of dying from breast cancer.
The role of physical activity
A study, published in the ‘British Journal of Sports Medicine’, demonstrated the cause-effect link between increased physical activity and reduced risk of breast cancer. “The latter was 41%. The beneficial effects of movement are more evident after menopause, but practicing physical activity from adolescence can decrease the incidence of neoplasms which would then develop at the end of the childbearing age”, continues Incorvaia. “Constant movement and a balanced diet are the most important tools in the primary prevention of the disease – concludes Saverio Cinieri -. Visceral fat helps create an inflammatory state, high insulin and glucose levels. A diet rich in whole grains, vegetables and legumes reduces, for example, the risk of metabolic syndrome, one of the risk factors. Unrefined foods should be preferred and animal fats should be limited because they tend to slow down the action of insulin and keep blood sugar high, factors associated with a greater probability of developing the disease. With this campaign we want to reach the largest number of citizens so that they can adopt the tools of prevention”.