approaches
Modifying individual behaviors and social circumstances
could prevent up to half of all cancers in San Francisco.
These approaches hold particular promise in San Francisco. Task forces are working to leverage these approaches for each of the five cancers.
Cancer Screening
Evidence-based screening approaches can reduce the incidence and mortality of many cancers
Tobacco Use
Tobacco use contributes to numerous cancers, such as lung, breast, bladder, head and neck, pancreas, cervix, esophagus, and others.
Social Determinants
Underserved populations have higher rates of cancer occurrence and death from the disease.
Diet and Exercise
Regular physical activity and a healthy diet can decrease risk for some cancers, as well as improve quality of life after a cancer diagnosis.
screening
SF CAN aims to improve cancer screening to reduce preventable cancers, particularly among communities of color.
Evidence-based screening approaches can reduce the incidence and mortality of many cancers. Low awareness or poor access to screening mean more San Franciscans get preventable cancers.
Breast Cancer: Mammograms make a difference, yet almost a third of eligible women in San Francisco have not had a mammogram in the last two years. This is considerably lower than the rest of California and more common in non-Caucasian communities.
Colorectal cancer: When found early, colorectal cancer is highly treatable. However, at least 21% of San Franciscans over 50 do not undergo colorectal screening. In some systems and clinics, this rises to more than 60%.
Prostate Cancer: Due to confusion about changing guidelines, many men over 40 are not offered PSA testing to detect prostate cancer early. Yet many experts believe PSA screening with appropriate follow-up and targeted treatment can play an important role in deaths from prostate cancer.
SF CAN partners will implement culturally-sensitive, community education and outreach to improve screening rates for some of the city’s most devastating cancers.
Infectious Diseases Play a Part
Liver Cancer: Hepatitis B, Hepatitis C, Human Papilloma Virus (HPV) and Human Immunodeficiency Virus (HIV) are major causes of liver, cervical, anal, and other cancers.
Liver cancer is the fifth most common cause of cancer deaths in San Francisco. It is more common among foreign-born Asians and their children, with rates increasing among Latinos and African Americans in San Francisco.
We can do more to prevent and treat these viruses through public education, early detection screening, vaccination for hepatitis B and HPV, monitoring, and use of proven antiviral drugs.
Tobacco use is the single most important contributor to cancer, particularly in disadvantaged populations. Reducing tobacco use will reduce rates of lung and other tobacco-caused cancers.
SF CAN aims to dramatically reduce rates of lung cancer while also reducing other tobacco-caused cancers and diseases.
Tobacco Caused: Though identified primarily with lung cancer, tobacco use is linked to cancers of the bladder, pancreas, cervix, esophagus, breast and others. In San Francisco, 10% of the population smokes, a figure on par with the rest of the state (10.8%).
Breast Cancer and Colorectal Cancer: By engaging a full range of public and private partners in a coordinated effort to eliminate tobacco use, we could dramatically reduce rates of lung- and other tobacco-related cancers and diseases.
tobacco use
Social Determinants
Identifying social determinants of health can help improve outcomes for disadvantaged communities.
Most cancers occur more frequently in underserved populations, such as communities of color, disadvantaged groups, and LGBT populations. Mortality rates are also higher in those groups.
The majority of San Francisco residents are people of color. Our city's African American, Latino, and Asian populations tend to experience cancer's impact more deeply and widely than the city's white population.
Identifying social determinants of health can help improve outcomes for disadvantaged communities.
Social determinants of health are important factors in those disparities include:
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limited access to information on prevention
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limited access to screening and high quality cancer care
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adverse conditions in which people in these communities live and work
SF CAN aims to improve access to high quality care and to better understand why cancers affect some communities more.
SF CAN aims to use proven and emerging interventions to help San Franciscans increase and sustain physical activity.
Poor diet and lack of exercise can increase cancer risk and reduce the length and quality of life after cancer diagnosis. Small changes in exercise and diet can decrease risk factors for many cancers.
% of People Who Get More than 30 Minutes of Exercise Regularly:
22% San Francisco
27% California
Diet
Obesity has been linked to postmenopausal breast cancer and cancers of the endometrium, pancreas, colon and rectum, esophagus and kidney, among others. Red meat and processed meats have been linked to colorectal cancer. Alcohol consumption puts people at higher risk for a number of cancers including head and neck, esophageal, liver, breast, and colorectal cancer.
While improving the nation’s dietary habits is an ongoing challenge, there have been successful interventions. A citywide coalition such as SF CAN would coordinate proven approaches to encouraging healthier diets.
Exercise
Research increasingly cites physical activity as a tool in lowering risk for some cancers and an important factor in improving length and quality of life after diagnosis. Exercise also may play a role in reducing side effects from some cancer treatments.
Yet, San Franciscans generally exercise less than the rest of the state. Only 22.7% of San Francisco respondents in the California Health Interview Survey get more than 30 minutes of exercise a day for five days a week. This compares to 26.6 % of respondents statewide.
Intervention could include supporting the expansion of safe public spaces and the use of mobile apps.