The 12 European commandments for reducing your risk of cancer

It's less well known than the Erasmus program, thanks to which students travel all over Europe. But it has saved thousands of lives and deserves at least as much attention in 2017, when, like Erasmus, it celebrates its ^30th anniversary. Henri Pujol, University of Montpellier

1. Don't smoke.
2. Make your home and car a smoke-free environment.
3. Limit your alcohol intake.
4. Eat a healthy diet rich in fruit, vegetables and wholegrain cereals. Limit red meat, foods high in fat, salt or sugar, and avoid cold meats.
5. Maintain a healthy weight.
6. Be physically active in your daily life.
7. Avoid excessive sun exposure, especially for children. Use sun protection. Do not use tanning equipment.
8. Take steps to reduce your risk of radon exposure at home.
9. Follow safety instructions in the workplace, to protect yourself from carcinogenic substances.
10. For women: If possible, breast-feed your children. Limit menopausal hormone treatments.
11. Have your children vaccinated against hepatitis B (newborns) and HPV (young girls).
12. Participate in screening programs for colorectal cancer (men and women), breast cancer and cervical cancer (women).

In France, 18,300 lives saved in 2000

Today, research is making it possible to estimate the number of lives saved thanks to the Code. Assuming unchanged behaviour on the part of citizens and public authorities, and taking into account the ageing of the population, the annual number of cancer deaths in the Europe of Twelve between 1985 and 2000 should have risen from 850,000 to just over 1,000,000. An impact study carried out in 2003 by the International Agency for Research on Cancer (IARC) shows that the reduction in the number of deaths (in demographically-adjusted terms) was 9.2% over this period, slightly less than the 15% initially targeted. Thus, the Code prevented 92,500 cancer deaths in the year 2000 in the Europe of Twelve, including 18,300 in France.
The strength of this public health program, which was highly innovative at the time of its launch, is symbolized by its supervisory body. The European Commission, then chaired by Jacques Delors, placed it under the authority of Vice-President Manuel Marin, in charge of Social Affairs, and not under the aegis of the Research Commissioner, as was expected for a program with a strong medical dimension. This was a real paradigm shift, spurred on by the Chairman of the Committee of European Cancer Experts, Professor Maurice Tubiana - who passed away in 2013.
For the first time, all citizens of the Europe of Twelve were solemnly informed that they could themselves, through proactive behavior, reduce their risk of cancer - and the mortality linked to this disease - with an impact comparable to that of progress in care and biological research. The aim was to change attitudes in the population, while at the same time public authorities would adopt appropriate measures to prevent cancer and detect it early enough.

Recommendations still relevant 30 years later

It is remarkable that, 30 years on, the twelve recommendations have retained all their relevance and remain the bedrock not only of the fight against cancer, but also of the fight against chronic and degenerative diseases, which account for around two-thirds of healthcare expenditure in our country.
Let's look at the causes of cancer one by one, starting with tobacco, the leading cause of preventable cancer deaths. It was responsible for 47,000 (31.3%) of the 150,000 cancer deaths recorded in France in 2015, according to the French National Cancer Institute (Inca). It's never too late to stop smoking, and smoking others. Passive smoking is responsible for 1,000 cancer deaths every year in France.
Alcohol is the second leading preventable cause of cancer death. It causes 15,000 (10%) cancer deaths. If you drink alcoholic beverages, reduce the frequency to a few days a week, and limit the quantity consumed to a maximum of 2 glasses a day for men and 1 glass a day for women - some recommendations are even stricter.
Diet, too. 20-25% of cancers are thought to be due to our eating habits. Certain foods are proven risk factors if consumed in excess: red meat, cold meats, salt and high-calorie foods. On the other hand, other foods reduce the risk of cancer. For example, we recommend eating five fruits and vegetables a day, and other high-fiber foods such as wholegrain cereals (wholemeal bread, pasta, rice) and pulses (lentils, dried beans).

Thirty minutes of brisk walking, five days a week

Overweight and obesity are recognized risk factors, while regular physical activity reduces the risk of cancer. The equivalent of 30 minutes of brisk walking is recommended, 5 to 7 days a week.
In 2015, abusive exposure to UV rays, in the sun or in tanning booths, was responsible for 15,000 melanomas and 1,800 deaths. So protect yourself from the sun and avoid tanning equipment.
Radon is the second most common risk factor for lung cancer. This naturally-occurring radioactive gas, present in the soil of certain regions, can diffuse into dwellings. To find out how to measure radon levels in your home, contact your local health authority. To reduce the concentration of this gas, better soil insulation and ventilation are essential.
Occupational cancers account for 4-10% of cancer deaths. Compliance with handling instructions and vigilance on the part of occupational medicine are important in preventing them.

Hormonal menopause treatments to be limited

Breastfeeding reduces the risk of breast cancer. Hormonal menopause treatments, on the other hand, increase the risk, and should only be prescribed in the case of disorders that impair quality of life, and only for short periods, with regular medical supervision.
Finally, consulting your doctor can help you find out how to take part in the vaccination and screening programs offered by the health authorities.
Since 1988, the European Leagues Against Cancer have been working to raise awareness of these individual cancer prevention measures.
Even today, Inca estimates that 40% of cancers could be avoided if all citizens modified their lifestyles accordingly. Circ, for its part, puts the figure at 50% - the difference being explained by the fact that not all the causes of the disease are yet under control.
In the European Union, 24 countries have launched Cancer Plans since 2000. France adopted its own in 2003. Europe's fight against cancer continues under the EU's €450 million Health Programme for the period 2014-2020. Its objective: "To reduce the number of new cancers in the EU by 15% by 2020". Here again, the widest possible dissemination of the Code is one of the conditions for achieving this new objective.

Michel Richonnier, economist and former lecturer at Sciences Po and the College of Europe in Bruges (Belgium), contributed to this article.
Henri PujolHonorary Professor of Medicine at the University of Montpellier, University of Montpellier
Visit original version of this article was published on The Conversation.