Dietary modification could result in a further 30 per cent reduction across the board. The problem is refining the educational message and getting it right in different communities.
Changing our current high-fat, low-fibre diet with a low fruit and vegetable intake is a common theme for cancer prevention. But many features of the modern Western diet are now being adapted globally as branded fast-food makers seek out new markets. Again, political will is necessary to reduce the costs to the public of healthy foods. We need to obtain more data so that we can make firmer recommendations.
The European Prospective Investigation into Cancer and Nutrition (EPIC) study currently in progress is a good example of how painstaking data and serum collection from 400000 Europeans could, over the years, provide a vast resource for investigating prospectively the complex inter-relationships between diet and cancer.
Cancer incidence varies enormously across Europe, providing an excellent natural laboratory for such studies.
Interventional epidemiology using rigorously controlled studies could produce the evidence that could lead to major changes. The current problem is the difficulty in making dietary advice specific and in some countries affordable. Although several groups have produced guidelines, there are so far few data about their uptake or significance in large populations.
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