When it comes to cancer prevention, it feels like our focus has drifted toward smaller, more uncertain risks while the bigger ones don’t get as much attention.

I think a lot of that comes from social media. The things that show up in my feed tend to be the more controversial, emotionally charged topics. Pesticides, microplastics, other environmental toxins. I get a lot of questions about these in clinic, and they’re fair questions. I go down those rabbit holes sometimes too.

What I don’t hear about as much are things like obesity, being sedentary, or alcohol use.

When you step back and look at the bigger picture, the drivers of cancer risk haven’t really changed. Physical activity, body composition, diet quality, alcohol, smoking. These are the areas where we see pretty clear, dose-dependent relationships.

Some of the other concerns may matter, but the magnitude is harder to define and probably smaller.

In clinic, I usually try to bring it back to high yield and sustainable interventions. Cutting out ultra-processed foods, getting enough fiber, exercising more, sleeping better, and keeping alcohol in check. None of us is perfect, just trying to move towards getting the big things right — most of the time.