title: Social disparities, health risk behaviors, and cancer.
abstract: BACKGROUND
  Overall cancer incidence rates decreased in the most recent time period in both men and women, largely due to improvements in surgical therapeutic approaches (tertiary prevention) and screening programs (secondary prevention), but differences in cancer incidence and survival according to socioeconomic status are documented worldwide. Health risk behaviors, defined as habits or practices that increase an individual's likelihood of harmful health outcomes, are thought to mediate such inequalities.
  
  
  CONCLUSIONS
  Obesity has been related with increased cancer incidence and mortality due to imbalance of leptin and adiponectin which are connected to activation of PI3K, MAPK, and STAT3 pathways and decreasing insulin/insulin-like growth factor (IGF)-1 and mTOR signaling via activation of 5 AMP-activated protein kinase (AMPK), respectively. Physical activity has been associated to prevent cancer by the aforementioned obesity-related mechanisms, but also increasing level of circulating vitamin D, which has been related to lower risk of several cancers, and increasing prostaglandin F2a and reducing prostaglandin E2, which are both related with cancer prevention and promotion, respectively. A large number of different substances may induce themselves a direct cytotoxicity and mutagenic action on cells by smoking, whereas alcohol promote immune suppression, the delay of DNA repair, inhibition of the detoxification of carcinogens, the production of acetaldehyde, and the contribution to abnormal DNA methylation. The combined smoking and alcohol drinking habits have been shown to increase cancer risk by smoke action of increasing the acetaldehyde burden following alcohol consumption and alcohol action of enhancing the activation of various procarcinogens contained in tobacco smoke.
  
  
  CONCLUSIONS
  Interventions at the social level may be done to increase awareness about cancer risks and promote changing in unhealthy behaviors.
authors.forename: Stefania
authors.initials: S
authors.lastname: Rametta
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Grosso
authors.forename: Fabio
authors.initials: F
authors.lastname: Galvano
authors.forename: Antonio
authors.initials: A
authors.lastname: Mistretta
authors.forename: Stefano
authors.initials: S
authors.lastname: Marventano
authors.forename: Francesca
authors.initials: F
authors.lastname: Nolfo
authors.forename: Silvio
authors.initials: S
authors.lastname: Buscemi
authors.forename: Santi
authors.initials: S
authors.lastname: Gangi
authors.forename: Francesco
authors.initials: F
authors.lastname: Basile
authors.forename: Antonio
authors.initials: A
authors.lastname: Biondi
mesh_terms: D006801:Humans; D015994:Incidence; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D009765:Obesity / Q000150:complications; D012307:Risk Factors; D012309:Risk-Taking; D012959:Socioeconomic Factors