Diseases & Longevity · File 05

Cancer. The 50% medicine still does not fully explain.

Cancer is the 2nd global cause of death. The most important editorial figure: less than 50% of cancer is attributable to known factors (GBD 2019 Cancer Risk Factors Collaborators). Attributable — tobacco, alcohol, obesity, specific infections — defines the modifiable perimeter. The rest remains a field where early detection through biomarkers has growing space.

The honest ground of oncological prevention

Much of the public conversation about cancer pretends everything is preventable with 'healthy habits.' Indexed evidence says otherwise: GBD 2019 analysis (Tran et al., Lancet 2022) quantified that less than 50% of global cancer is attributable to known modifiable risk factors. Serious longevity medicine starts by recognizing that.

Attributable includes: smoking (~22% of global cancer deaths), alcohol, central obesity, low fruit/vegetable diet, physical inactivity, occupational exposure, air pollution, and specific infections (H. pylori → gastric, HPV → cervical and oropharyngeal, HBV/HCV → hepatocellular, EBV → lymphomas). The other 50% combines genetic susceptibility, uncharacterized environmental factors, and biological chance.

Serious longevity medicine does not promise to prevent cancer. It works with the 50% attributable — and with early detection of the rest.
Tobacco · global contribution · GBD 2019

The individual modifiable factor with greatest impact

Among all attributable factors, smoking remains the strongest — responsible for ~22% of global cancer deaths and most lung, head and neck, esophageal, and bladder cancers.

  • Smoking

    −3.20 / −3.74 años

    Danish cohort: active smoking = −3.20 years (men) / −3.74 years (women) of disease-free life. Responsible for ~22% of global cancer deaths.
    — Eriksen 2025; GBD 2019 Cancer

  • Central obesity

    13 tipos de cáncer

    IARC classified sufficient evidence for obesity-cancer association in 13 types: postmenopausal breast, colorectal, endometrium, esophagus, kidney, liver, gallbladder, pancreas, ovary, thyroid, gastric, myeloma, and meningioma.
    — Lauby-Secretan, NEJM 2016

  • Oncogenic infections

    ~13% global atribuible

    ~13% of global cancer is attributable to infections: H. pylori (gastric), HPV (cervical, oropharyngeal), HBV/HCV (hepatocellular), EBV (lymphomas), HHV-8 (Kaposi). Vaccination and screening change trajectory.
    — de Martel, Lancet Glob Health 2020

  • The non-attributable 50%

    Genética + azar + ambiente

    >50% of global cancer is not explained by known factors. Combines polygenic genetic susceptibility, uncharacterized environmental exposure, and biological chance in cellular replication (Tomasetti & Vogelstein, Science 2017).
    — Tran et al., Lancet 2022

Chap. 03 · 5-year survival · stage matters

Why early detection moves the trajectory

Stage at diagnosis is the most important predictor of survival for most cancers. Early detection is the most cost-effective intervention in preventive oncology.

  • Breast cancer

    >85% vs <30%

    5-year survival: >85% in early stages (I-II) vs <30% in stage IV. #1 cancer in women globally.
    — GBD 2019; SEER 2024

  • Colorectal cancer

    >90% vs <15%

    Detected by colonoscopy at premalignant polyp stage = effective prevention. Stage I: >90% survival; stage IV: <15%.
    — GBD 2019; SEER 2024

  • Lung cancer

    <20% supervivencia tardía

    5-year survival <20% in late stages. NLST (NEJM 2011): low-dose CT reduces lung cancer mortality 20% in high-risk smokers.
    — NLST NEJM 2011

  • Prostate cancer

    >95% localizado

    5-year: >95% survival in localized stages. Post-treatment urinary and sexual dysfunction is the largest QoL determinant post-survival.
    — GBD 2019; SEER 2024

What we don't do — and what we do

Wellness Care is not an oncology clinic. We do not do chemotherapy, we do not design oncological treatment protocols, we do not substitute the oncologist in patients with active diagnosis. Any 'longevity protocol' offering to treat active cancer with supplements, ozone, high-dose vitamin C, or unapproved interventions as a substitute for the oncological standard is dangerous and indefensible.

What we do: serious primary prevention. We evaluate modifiable attributable factors (tobacco, alcohol, central obesity, diet, physical activity, occupational exposure, treatable infections like H. pylori), coordinate age- and sex-appropriate screening (mammography, colonoscopy, cytology, PSA with shared decision, lung CT in smokers), measure inflammaging biomarkers, and build a general health protocol that reduces population risk.

We work with the 50% attributable and with early detection of the rest. No one serious promises more in preventive oncology.
How we measure it

The layers of oncological
risk assessment

Assessment combines attributable modifiable factors, guideline-based screening, and inflammaging biomarkers.

Advanced biomarkers

21 specialized panels across 8 clinical categories — biological age, inflammaging, metabolic profile, functional hormonal, microbiota. The quantitative layer.

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Functional medicine

Shared root causes — mitochondrial dysfunction, inflammaging, neuroendocrine dysregulation — before organ pathology.

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Therapeutic plasma exchange

Spectra Optia, Buck Institute evidence (Fuentealba 2025), inflammaging modulation, and peripheral clearance.

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The Longevity Program

How this assessment integrates into the full program — from initial valuation to individualized protocol design under medical judgment.

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Featured evidence

The papers that structure
the honest oncological conversation

Three publications that quantify what proportion of cancer is modifiable and what is not.

"Globally in 2019, 4.45 million deaths and 105 million DALYs from cancer were attributable to risk factors evaluated — less than half of all cancer burden."
GBD 2019 · 204 países
Tran et al.
The Lancet · 2022
"Screening with low-dose CT reduced lung cancer mortality by 20% relative to chest radiography in high-risk smokers."
NLST · n=53,454
NLST Research Team
NEJM · 2011
"Approximately 13% of global cancers are attributable to infectious agents — H. pylori, HPV, HBV, HCV, EBV, HHV-8."
Estimación global IARC
de Martel et al.
Lancet Glob Health · 2020

Frequently asked questions about cancer and longevity

The most recurrent questions about what proportion of cancer is modifiable, which screenings work, and where longevity medicine ends and oncology begins.

01

How much of cancer is preventable with healthy habits?

Less than 50% per GBD 2019 Cancer Risk Factors Collaborators (Tran et al., Lancet 2022).

Attributable includes: tobacco (~22% global), alcohol, central obesity, diet and sedentarism, occupational exposure, specific infections.

The rest combines genetic susceptibility, uncharacterized environmental factors, and biological chance.

Tran et al. · Lancet · 2022
02

Which cancer screenings are proven to save lives?

Strongest-evidence screenings:

1. Mammography in women 40-74
2. Colonoscopy/fecal occult blood every 10/1-2 years from 45
3. Cytology/HPV in cervix
4. Low-dose CT in high-risk smokers (NLST NEJM 2011)

PSA is shared decision — modest benefit and overdiagnosis risk.

Developing areas: multi-cancer early detection (MCED).

03

Does Wellness Care treat cancer?

No. Wellness Care is not an oncology clinic.

Active cancer treatment belongs to the oncologist — surgery, chemotherapy, radiotherapy, immunotherapy.

Any 'longevity protocol' offering to treat active cancer with supplements, ozone, high-dose vitamin C, or unapproved interventions as a substitute for the oncological standard is dangerous and indefensible.

What we do: serious primary prevention, screening coordination, general health management during/after treatment (always coordinated with the oncologist).

04

Are tumor markers like CA 125 useful for early cancer detection?

In most cases, no in general asymptomatic population.

CA 125, CEA, CA 19-9, and AFP have low specificity for screening and generate many False positives.

Their correct use is post-treatment follow-up or targeted evaluation in symptomatic patients.

MCED tests based on cfDNA (Galleri) are a different class — still in evaluation but with promising preliminary results.

05

What is the link between inflammaging and cancer risk?

Chronic low-grade inflammation ('inflammaging') is a biological driver common to multiple chronic diseases — cardiovascular, dementia, T2D, and also some cancers.

Elevated hsCRP, IL-6, and TNF-α are associated with higher risk of colorectal, gastric, and lung cancer.

CANTOS (Ridker 2017 NEJM) demonstrated that inhibiting IL-1β (canakinumab) reduces lung cancer incidence in CV patients.

06

Is Helicobacter pylori detection really important?

Yes. H. pylori is the main etiological factor for gastric cancer, classified as Group 1 carcinogen by IARC since 1994.

In high-prevalence populations (Colombia, East Asia), eradication significantly reduces risk.

Urea-C13 breath test or fecal antigen are non-invasive methods.

It is one of the most cost-effective interventions in primary cancer prevention.

The honest ground

Cancer is not fully preventable. What can be worked on is the 50% attributable and early detection of the rest. The right promise is not 'avoid cancer' — it is 'be ready when it appears.'

Work on attributable factors, coordinate appropriate screening, measure inflammaging, and maintain general health as functional reserve — that is honest oncological prevention.

Family history of cancer?

Book a risk and early-detection assessment

We evaluate clinical history, attributable modifiable risk factors, age- and sex-appropriate screening, and inflammaging biomarkers. We do not do oncological treatment — that belongs to the oncologist. We do serious primary prevention and coordination.

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