More than half of all cancers can be prevented or detected early by living a healthy life, taking part in organised screening programmes, and ensuring your children are vaccinated against both HPV and Hepatitis B.

Small changes now can make a big difference later!

Not smoking

One of the most important things we can do to reduce our risk of cancer and improve our wellbeing is to stop smoking. It is never too late to quit.

Second-hand smoking is breathing in someone else's tobacco smoke; this can also cause cancer.

By being smokefree, supporting people to quit and creating smoke-free places, together we can achieve the vision of a Smokefree Aotearoa by 2025.

There are ways you can help by not smoking around children, making your car and house smokefree, encouraging others to quit and encouraging your local marae to be smokefree.

If you are ready to quit, you don't have to do it alone. If you would like to talk to a support service as you start your quit journey visit Smokefree.org.nz or contact Quitline, Me Mutu on Quit.org.nz.

Information on vaping for those looking to stop smoking.

Eating well

We can reduce our chances of getting cancer and improve our wellbeing by eating a variety of healthy kai every day with our whānau.

Enjoy a variety of nutritious foods, including:

• vegetables and fruit (at least three servings of vegetables and at least two servings of fruit per day - these can be fresh, canned or frozen)
• grain foods, mostly wholegrain and those naturally high in fibre (e.g. brown rice, wheat and oats)
• some milk and milk products, mostly low and reduced fat
• some legumes (e.g. beans and lentils), nuts, seeds, fish and other kaimoana, eggs, poultry (e.g., chicken) and/or red meat* with the fat removed

*If choosing red meat, eat less than 500 g of cooked red meat a week.

Choose and/or prepare foods and drinks:

• with unsaturated fats (e.g. vegetable oils, nuts, some fish), instead of saturated fats (e.g. fatty lamb, beef, pork, butter, cheese, cream)
• that are low in salt (sodium)
• with little or no added sugar
• that are mostly 'whole' and less processed
• make plain water your first choice over other drinks.

For mothers, breastfeed your baby if you can.

After a cancer diagnosis, if you can, it is important that you follow the Ministry of Health Eating Well Guidelines. Check with your health professional about what is right for you.

You can find out more information about eating well by visiting some of the following helpful sites:

• Tips, guides and tools to get your family eating well (easy, fast and affordable recipes)
• Healthy eating advice from Health Navigator NZ.
• Reading Food Labels from Health Info.
• Using Food Labels from Health Navigator NZ.
• An explanation of the Health Star Rating system from Ministry for Primary Industries.
• World Cancer Research Fund International.

Avoid or limit alcohol

For cancer prevention and improving your health, it's best not to drink alcohol. If you do drink alcohol, reduce your long-term health risks by drinking no more than:

• two standard drinks a day for women and no more than ten standard drinks a week
• three standard drinks a day for men and no more than 15 standard drinks a week
• AND at least two alcohol-free days every week.

To improve your wellbeing, try not to drink and smoke together. Doing so raises the risk of developing some cancers many times more than drinking or smoking alone.

The more alcohol we drink, the higher our risk for cancer. For some types of cancer (especially breast cancer), drinking even small amounts can increase the risk.

You can find more information and advice on reducing the risk of drinking alcohol here.

Being active

We can reduce the likelihood of some cancers and improve wellbeing by being physically active every day.

Being active is doing any activity that gets our bodies moving, heart beating and breathing deeper. It includes housework, walking to work, doing the gardening, biking, playing sport and dancing. Being active doesn't mean we have to go to the gym (but this is good too).

It's not too late to start being more active.

Activity recommendations:

• Sit less, move more! Break up long periods of sitting
• Do at least two and a half hours of moderate or 90 minutes of vigorous physical activity spread throughout the week
• For extra health benefits, aim for five hours of moderate or two and a half hours of vigorous physical activity spread throughout the week
• Do muscle-strengthening activities on at least two days each week
• Doing some physical activity is better than doing none.

Physical activity is also important for people affected by cancer. It may help you to feel better mentally, sleep better, help to prevent pain and fatigue and may even help you live longer.

For fun, free and low-cost ideas to get your family moving visit Healthy Kids and Sport NZ. You can also find more information related to healthy activity guidelines on the Ministry of Health website.

Be SunSmart

Exposure to ultraviolet (UV) radiation in sunlight is the leading cause of skin cancers, including melanoma. The good news is that using sun protection will lower our risk at any age. It's also important to avoid sunbeds and check our skin regularly for any changes.

For skin cancer prevention, it's best to Slip, Slop, Slap and Wrap. Avoid tanning, sunbeds and getting sunburnt.

Protect yourself and your whānau all year round - even on cloudy days - when you are outdoors: in the mountains, out on the water or around reflective surfaces like snow and ice.

Make sure to Slip, Slop, Slap and Wrap.

• Slip-on a shirt: slip on a shirt with long sleeves. Fabrics with a tighter weave and darker colours will give you better protection from the sun.
• Slip into the shade: slip into the shade of an umbrella or a leafy tree. Plan your outdoor activities for early or later in the day when the sun's UV levels are lower.
• Slop on sunscreen: slop on plenty of broad-spectrum, water-resistant sunscreen of at least SPF 30. Apply 20 minutes before going outside and reapply every two hours and especially after being in water or sweating.
• Slap on a hat: wear a hat with a wide brim or a cap with flaps. More people are sunburnt on the face and neck than any other part of the body.
• Wrap on sunglasses: choose close-fitting, wrap-around style sunglasses. Not all sunglasses protect against UV radiation, so always check the label for the sun protection rating.

More information on sun protection is available on the SunSmart and Cancer Society websites.

Check your body

It's important to check your entire body regularly to get to know your skin and what is normal for you. If you notice anything unusual which includes any new spots or spots that have changed in shape, size or colour, visit your GP.

Anywhere on your body, look out for:

• change in size, shape or colour of an existing mole or spot (apply the ABCDEFG rule):
  • asymmetry: one half is different from the other half
  • border irregularity: the mole or spot has uneven edges
  • colour: is not the same throughout
  • different: looks different from other moles, freckles or spots
  • evolving: any change in growth, elevated, or painful
  • firm: to the touch
  • growing: most are larger than 6mm and keep growing.
• a new mole
• a sore that does not heal
• itching, pain, oozing, bleeding in a mole.

The earlier we're able to identify a change in our skin, the more likely it is to be treated successfully.

Skin changes do not necessarily indicate skin cancer, but it is important to visit your GP to have them investigated further.

SunSmart provides helpful information on checking your skin on their website.

There is also guidance for children and parents on how to stay SunSmart on the SunSmart schools website.

For information on who is at higher risk for skin cancer visit the melanoma section of this website.

Get immunised

The HPV and Hepatitis B vaccines prevent viral infections that can cause cancer.

These vaccines are given to healthy people to protect them.

HPV immunisation programme

HPV vaccination is free for everyone aged 9 to 26. The vaccination programme is usually school-based and is offered in Year 8, at participating primary schools. The vaccine is given as two doses to those 14 years and under and three doses to those 15 years and older.

When you vaccinate your child on time, this gives them the best protection from HPV cancers.

If you are aged 26 or below and haven't received your HPV vaccine or if you think you haven't completed the vaccine series (2-3 doses), you can still receive free vaccination from your GP, health centre and some Family Planning centres.

The vaccine protects against HPV; a common virus passed from one person to another during sexual activity. Most people will get HPV at some point in their lives and it will cause no symptoms and go away on its own. But some types can cause cervical cancer in women and other less common cancers like cancers of the anus, penis, vagina, vulva and oropharynx.

The HPV vaccination can prevent more than 90% of HPV cancers when given at the recommended ages. It is safe, long-lasting and effective. The vaccine is most effective if given before becoming sexually active and exposed to HPV, but even if you're sexually active, you should still consider having the HPV vaccine. It can protect you against HPV types that you may not have been exposed to.

For people with a cervix who have been vaccinated, it is still important to have regular cervical smears. This is because the vaccine does not protect against all types of cervical cancer. For people with a cervix over 26 years, who have not been vaccinated, the best way to prevent cervical cancer is to continue to have regular cervical smears.

Hepatitis B immunisation

All children in New Zealand can be immunised against Hepatitis B as part of their free childhood immunisations at six weeks, three months and five months old. It's important to have all three doses.

If you have not received your Hepatitis B vaccine or you're not sure, visit your local health centre or call the Immunisation Advisory Centre free helpline 0800 IMMUNE (0800 466 863).

You can have a blood test to check if you need a vaccine. If you're aged 17 or under, catch up Hepatitis B immunisation is free.

Hepatitis B is a viral infection that can inflame or damage the liver. It can be a short-term (acute) illness in some people who may have few or no symptoms, and the virus may clear from your body without treatment. On rare occasions, it can become a long term (chronic) condition that can lead to serious health problems, such as liver damage, cirrhosis or liver cancer.

The younger a person is when infected with Hepatitis B virus, the higher the chance of developing a long-term/chronic infection. Most adults recover and do not become chronically infected. Hepatitis B is transmitted through sexual contact, sharing needles or syringes, or from mother to baby at birth. It is not spread through breastfeeding, sharing drinking glasses, sneezing, food or casual contact.

If you have questions, talk to your doctor or practice nurse or call the Immunisation Advisory Centre free helpline 0800 IMMUNE (0800 466 863).

Other helpful links:

Don't Assume You're Immune

Ministry of Health Hep B information

Fight infection

If you have one of the infections below and it is not treated, it may cause some cancers. Get treated for:

Hepatitis C

H. pylori

HIV

Hepatitis C

Hep C can cause short-term (acute) and long-term (chronic) infections. Most people who get infected will develop a chronic infection.

Most people with Hep C do not know that they are infected. The only way to know if you have Hep C is to have a blood test. Speak to your doctor or nurse if you have symptoms or if there's a risk you're infected.

Infection can be spread by sharing unsterilised needles (especially needles used to inject recreational drugs), unsafe medical procedures, sharing razors or toothbrushes and very rarely, from an infected mother to her unborn baby.

There is no vaccine to prevent Hep C.

More info on Hep C

Helicobacter pylori (H.pylori)

H. pylori is a significant cause of stomach cancer.

The rate of H. pylori infection is a lot higher in Māori and Pacific peoples.

H. pylori is a common bacteria (germ) that grows in the lining of the stomach. It does not cause symptoms or illness in most infected people and may just live harmlessly in your stomach. People that do have symptoms may feel a burning pain in the upper part of their abdomen, indigestion, nausea vomiting, burping, loss of appetite, or feeling full after a small meal.

A few people infected by H. pylori may develop ulcers of the stomach and small intestine. In some rare cases, it may cause stomach cancer. Most people who are infected with H. pylori do not get stomach cancer.

The infection is usually acquired during childhood and will persist unless it is treated with antibiotics.

Who may be tested:

• people with ulcers (or a history of) and gastrointestinal pain
• people with repeated indigestion problems
• have a mother, father, brother, sister, or child with a history of stomach cancer
• are taking or about to take long term anti-inflammatory medications such as ibuprofen or aspirin
• have unexplained iron - deficiency anaemia
• your doctor may also test you if they think your chances of infection are high based on your ethnicity, place of birth (some areas have higher rates of H. Pylori), and other factors.

Tests may include a blood test, faecal (poo) sample or gastroscopy (sometimes called endoscopy – a small tube with a tiny camera is passed through your mouth and down to your stomach).

The bacteria are thought to spread through contact with the saliva or poo of an infected person, or by having contaminated food and water.

You may be able to reduce your chances of getting H. Pylori by washing your hands before preparing food and after you use the bathroom, avoiding water or food that is not clean (is from a safe source), and eating food that is washed and cooked thoroughly.

More info on helicobacter pylori

HIV

People with HIV are more likely to develop some types of cancer. Anti-retroviral therapy can help keep HIV under control and reduce the risk of cancer. There are also some other things you can do to reduce the risk or find cancer early.

What people with HIV can do to lower their risk of cancer or find cancer early

• Following HIV treatment guidelines can reduce the risk of some of these cancers.
• It's also important not to smoke. Help with quitting is available through Quitline Me Mutu quit.org.nz .
• Avoid or limit alcohol use as this increases the risk of some cancers.
• Know your Hepatitis status. Some types of Hepatitis can be prevented or treated.
• Don't share needles – this can increase the likelihood of getting Hep B or C, which increases the risks for liver cancer.
• Use condoms – these may protect against HPV cancers.
• Have a regular cervical smear if you have a cervix.
• Follow other cancer prevention recommendations [on this website].

Other helpful websites:

NZ AIDS Foundation

Body Positive NZ Tinana Ora

Reduce exposure to work-related carcinogens

By law, businesses must manage health risks caused by their work. If you are an employee, make sure to follow health and safety instructions.

Some of the more common cancers caused by workplace exposures include:

• work-related skin cancers
• asbestos-related mesotheliomas (a type of lung cancer)
• shift work-related cancers.

Simply being exposed does not necessarily mean that you will develop cancer. Many factors influence whether a person will develop cancer, including the amount and duration of the exposure and a person's genetic background.

WorkSafe is developing an action plan to reduce exposures to carcinogens at work. For more information on mitigating risks at work, visit the WorkSafe website .

For information on how workplaces can manage and monitor workplace UV exposure, visit the Wellplace NZ website.

Screening programmes

In New Zealand, there are three organised cancer screening programmes: BreastScreen Aotearoa, the National Cervical Screening Programme and the National Bowel Screening Programme.

Screening tests can detect changes in the body before they become cancer, or when the cancer is at an early stage. If changes are found early, it is usually easier to treat.

National Cervical Screening Programme

All people with a cervix between 25 and 69 years who have ever been sexually active should have a regular smear test every three years. These tests aim to identify changes in the cervix before they develop into cancer so regular cervical screening can prevent you developing cervical cancer. Most people are charged a fee for the test but some Māori and Pacific providers, community or primary health organisations offer a free or low-cost option.

For more information on cervical screening, visit the National Cervical Screening Programme website.

Bowel Screening Programme

The National Bowel Screening Programme is free for men and women aged 60 to 74 years, every two years. It aims to save lives by finding bowel cancer at an early stage when it can often be successfully treated. The test kit will arrive in the mail, and it is easy to do at home.

The National Bowel Cancer Screening Programme is currently being rolled out across NZ.

For more information on screening in your area, visit the National Bowel Screening Programme website.

BreastScreen Aotearoa (Breast Screening Programme)

Mammograms can save lives by finding breast cancer early before it spreads. New Zealand's free national breast screening programme is for people with breasts aged between 45 and 69, every two years.

For more information on breast screening, visit the National Breast Screening Programme website.