Thanks to earlier detection and better treatment, breast cancer deaths nationally have fallen. Yet Native Hawaiian women continue to face a heavy burden.
Between 2014 to 2018, Native Hawaiian women had the highest rates of breast cancer and breast cancer deaths in Hawaiʻi – higher than Japanese, Filipino, or white women. Many cancers are still found at advanced stages, when treatment is harder and recovery slower.
Traditionally, breast cancer has been seen as a disease that mainly affects older women. Yet in recent years, doctors are seeing more cases in women under 50, with rates in younger women rising faster than in older age groups. This makes prevention and the adoption of healthy habits important early in life.
Studies worldwide show that 30-50% of breast-cancer cases could be prevented through healthy lifestyle choices. Lifestyle factors that increase cancer risk are:
- Excess body weight: Extra fat tissue raises estrogen, insulin, and inflammation, all of which increase breast cancer risk. Recent U.S. data show that excess weight accounts for about 30% of advanced-stage cases in postmenopausal women. In Hawaiʻi, 73% of Native Hawaiians are overweight or obese, the strongest modifiable risk factor women can change. For those already diagnosed, maintaining a healthy weight can help lower recurrence risk.
- High breast density: Dense breast tissue increases risk, explaining nearly 40% of advanced cases in younger women and up to 47% in Asian and Pacific Islander groups. Alcohol use and low physical activity raise density, on top of genetics.
- Alcohol intake: Every alcoholic drink per day raises breast cancer risk about 10%, with each additional drink increasing risk further. One drink equals one can of beer, ½ cup of wine, or one shot of liquor. In short, there’s no health benefit to drinking alcohol. Avoiding it is one of the simplest protective steps.
The following are lifestyle choices that lower cancer risk. Together, these everyday choices can prevent roughly one in three breast cancers:
- Physical activity: Regular exercise – about 150 minutes a week of brisk walking or equivalent – a lowers risk by 20-30% and improves hormone balance and immunity. Among those already diagnosed, it can reduce death from breast cancer by 48%. Yet about 24% of Native Hawaiians report no regular physical activity.
- Healthy diet: Eating more fruits, vegetables, soy, beans, and whole grains is linked to lower breast cancer risk. In contrast, higher intakes of red and processed meat, saturated fats, and processed foods are associated with more deaths and recurrences.
- Breastfeeding and limiting hormone therapy: Each 12 months of breastfeeding lowers risk about 4%; minimizing menopausal hormone therapy also helps.
- Regular mammograms: Screening can detect breast cancer early, often before symptoms appear, when treatment is most effective and survival rates are highest. Studies show that regular mammograms lower the chance of dying from breast cancer by 25-40%.
Lifestyle medicine isn’t a replacement for medical care, it’s a partner. Combined with timely screening and treatment, positive daily choices can protect, heal, and empower Hawaiʻi’s wāhine for generations to come.
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