Doctors Identify Six Immediate Steps to Lower Cancer Risk for People With a Family History

Doctors and researchers are urging people with a family history of cancer to take concrete steps now to reduce their personal risk, emphasizing lifestyle changes, targeted screening and genetic evaluation. While some cancer-related genetic changes are inherited, experts say a combination of prevention strategies and early detection can materially lower the chance of a future diagnosis.

Physician-scientists interviewed by the Daily Mail outlined six measures they recommend: regular physical activity, a healthy diet, avoiding environmental toxins such as tobacco smoke and radon, genetic counseling and testing when indicated, consideration of prophylactic surgery for high-risk individuals, and personalized screening schedules. They stressed that these actions do not eliminate risk but can reduce it and help detect disease earlier when treatment is more effective.

The experts explained that not all cancer is hereditary. The National Cancer Institute estimates that up to 10 percent of cancers may be caused by inherited genetic changes, meaning a minority are directly passed down through families. Still, certain patterns—such as multiple close relatives with the same cancer or early-onset disease in a parent or sibling—can indicate a familial cancer syndrome and warrant further evaluation.

"Any family history of cancer can be cause for concern," said Dr. Helen Messier, a physician-scientist who studies genomics, cancer prevention and precision medicine. She and Dr. Cedrek McFadden, a surgeon and associate professor at the University of South Carolina School of Medicine Greenville, recommended clinicians take a family history extending back at least three generations and to refer patients for genetic counseling when there are signs of increased hereditary risk.

For physical activity, both doctors recommended aiming for about 150 minutes per week of moderate exercise—roughly 20 to 30 minutes a day on most days. They noted that even brisk daily walks can yield benefits. Published research cited by the experts has linked higher levels of activity with reductions in colon and breast cancer risk; one 2022 study found up to a 23 percent lower risk of colon cancer among the most active groups compared with the least active, and a 2016 review associated higher activity with a 12 to 21 percent lower risk of breast cancer.

Dietary advice focused on patterns rather than single foods. Dr. Messier called a Mediterranean-style diet—rich in vegetables, legumes, whole grains, olive oil and lean proteins—"the gold standard," and recommended minimizing ultra-processed foods, added sugars and alcohol. For families affected by colorectal cancer, clinicians advised reducing processed and red meats and increasing fiber, which supports gut health and has been associated with lower colon cancer risk.

Avoiding toxins was the third pillar emphasized. Both doctors urged people to quit smoking and avoid secondhand smoke; exposure to secondhand smoke raises lung cancer risk by an estimated 20 to 30 percent. They also recommended testing homes for radon, a naturally occurring radioactive gas that the U.S. Environmental Protection Agency and other agencies identify as the second-leading cause of lung cancer after smoking and a contributor to roughly 21,000 U.S. deaths annually.

Genetic counseling and, where appropriate, genetic testing can clarify individualized risk and guide prevention and surveillance decisions. Tests can identify variants such as BRCA1 and BRCA2, which markedly increase the risk of breast and ovarian cancer, and mutations in the APC gene, which are linked to familial adenomatous polyposis and elevated colorectal cancer risk. "In some cases, a genetic test can tell us which screenings you actually need and when," Dr. McFadden said.

For people found to carry high-risk mutations, preventive surgery is an option that has been adopted in selected cases. Prophylactic procedures—such as mastectomy or oophorectomy for those with BRCA mutations, or colectomy for certain hereditary colorectal conditions—can substantially lower cancer risk. Public examples include high-profile cases in which patients opted for such surgeries after testing positive for high-risk genes.

Screening recommendations should be individualized rather than strictly age-based, the experts said. For instance, those with a first-degree relative diagnosed with colorectal cancer before age 50 may be advised to begin colonoscopy earlier than the standard starting age. Similarly, women with close relatives who had breast cancer may discuss earlier or more frequent mammography, and men with relevant family histories may consider earlier prostate screening.

The physicians cautioned that no single measure guarantees prevention. Instead, they framed the six steps as a layered approach that combines population-level evidence with individualized medical evaluation. They encouraged patients to bring detailed family histories to routine visits and to discuss risk-reduction options with primary care doctors, oncologists or genetic counselors.

Public health data cited by the doctors underscore the stakes: breast and colon cancers remain among the most commonly diagnosed malignancies, and lung cancer continues to account for a large share of cancer deaths. Early detection through screening and risk-reduction strategies can change outcomes, they said, which is why personalization—matching screening and prevention to family history and genetic findings—is central to contemporary cancer prevention efforts.

Clinicians reiterated that patients should not delay conversations with health professionals because of uncertainty. "Don’t guess—ask your doctor," Dr. McFadden said. "We’d much rather have that conversation now than after something shows up later."