Exploring Commercial Determinants of Cancer

February 19, 2021
Junk food and alcohol


February is National Cancer Awareness month -- an opportune time to showcase new developments in the fight against the second leading cause of death after cardiovascular disease. One sign of progress is a shift to cancer prevention efforts that focus on commercial determinants -- factors that arise from the power of the corporate sector and “profit-driven disease.”

Starting in the U.S. in the 1950s, industrial food manufacturing made commercial foods such as breads, canned foods, dairy products, confectionary, jams, soft drinks, cakes, biscuits, meat products and infant formula widely available at a relatively low cost to the consumer. These foods are generally highly palatable, high in energy, cheap, omnipresent and easy to keep.

There’s strong evidence, however, that diets of “fast foods” and other highly processed foods that are high in fat, starches or sugars are a cause of excess weight gain and obesity. Indeed, decades of research have demonstrated a strong link between obesity and cancer, and increased rates of obesity have been concurrent with the industrial revolution and the advent of food corporations.

In the same way, even though moderate drinking may be protective against heart disease, alcohol -- regardless of type and amount -- is causally associated with cancer. In fact, there’s convincing evidence of an alcohol-cancer link in humans, including for mouth, throat, larynx, esophagus, liver, colorectum, stomach, and pre- and post-menopausal breast cancer.

So it’s important to note that there is no safe level of alcohol for cancer. The more one drinks, the greater the risk, and abstinence offers the best possible protection. Alcohol increases the risk of cancer through several mechanisms: ethanol is metabolized to acetaldehyde, which is known to damage DNA and to disrupt cell repair mechanisms, and it may also raise levels of some hormones, such as estrogen.

Now is the time to consider the role of corporations in influencing our behaviors and to advocate for limiting the marketing of unhealthful products in order to combat the commercial drivers of non-communicable disease.

The Commercial Determinants of Health framework (access available through NYU Libraries), in fact, shifts the emphasis in research and policy from clinical management and behavioral change, which are limited in effect. This comprehensive approach may serve to amplify cancer risk reduction achieved by following the comprehensive guidelines and recommendations.


Niyati Parekh

Niyati Parekh, PhD
Executive Director of Doctoral Studies;
Associate Professor of Public Health Nutrition