Hamilton scores low at preventing cancer in a number of key areas flagged by a provincial report, including Ontario's worst air pollution.

"Downtown Hamilton has the highest rate of air pollution in the province," said Alice Peter, director of population health and prevention at Cancer Care Ontario. "It could be from industry or cars or anything that burns."

What more can be done to reduce the Number 1 killer in Ontario is outlined in the 2016 Prevention System Quality Index released this week by the agency that advises the province on cancer.

The report is particularly focused on policies and programs to help prevent as many as half of all cancers by eliminating lifestyle, occupational and environmental risks.

Concerns raised for Hamilton include high numbers of households struggling to pay for nutritious food because of poverty and low numbers of teachers with training in physical education.

In the case of fine particulate matter in outdoor air — or PM2.5 — Peter says Hamilton needs to do more to get residents walking, biking or bussing.

"If there are alternative approaches to transportation, fewer cars on the road, bike lanes or more public transportation that would reduce PM2.5," she says. "In some circumstances it relates to the emission standards for industry."

Monitoring the province's efforts in cancer prevention is a priority for CCO which says one in two Ontarians will develop cancer in their lifetime and one in four will die from the disease.

"I think one of the things that we're trying to get across is that cancer is preventable and there are things at various levels of government that can be done," says Peter. "It has been our feeling that it is probably much more efficient to make the healthy choice the easy choice, and you can have a much greater impact at the population level if you enact healthy public policies."

Cancer report Air pollution

Outdoor air pollution causes lung cancer with an estimated 560 new cases a year attributed to the inhalation of fine particulate matter, or PM2.5.

Average ambient PM2.5 concentrations (μg/m3) in 2014 sourced from Ontario's Ministry of the Environment and Climate Change:

Hamilton Downtown: 10.8 (worst in Ontario)

Hamilton Mountain: 9.4

Hamilton West: 9.9

Burlington: 9.6

Best result: 4.7 in Petawawa

Nutrition

Healthy eating can reduce the risk of certain cancers such as colorectal, stomach, oral, pharynx, larynx, esophagus and lung.

Households struggling to afford groceries tend to eat significantly less vegetables and fruit. Poverty influences the quality and quantity of food eaten.

Percentage of food insecure households for the period 2012-2014 sourced from the Canadian Community Health Survey done by Statistics Canada:

Hamilton: 14.5

Halton: 6.5 (best in Ontario)

Ontario: 12

Worst result: 16.5 in Peterborough

Exercise

Physical activity reduces the risk of colon cancer and likely post-menopausal breast and endometrial cancer.

Ontario's chief medical officer of health recommended in 2004 that physical education be taught in schools by teachers with specialized training.

Per cent of full- or part-time teachers with specialty training teaching health and physical education in the 2013-2014 school year sourced from the Ministry of Education:

Elementary

Hamilton: 2

Halton: 9.6

Ontario: 19.7

Best: 63.3 in York Region

Worst: 0 in Huron County and Perth District

Secondary

Hamilton: 6.5

Halton: 0 (tied for worst)

Ontario: 21.7

Best: 71.4 in Oxford County

Radon

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There are no known safe levels of exposure to radon, which is a cause of lung cancer.

The naturally occurring radioactive gas, released into the air when uranium in soil and rock decays, can accumulate to high concentrations indoors especially in basements and ground floors.

Percentage of tested homes with radon concentrations of 100 Bq/m3 or greater sourced from Health Canada:

Hamilton: 28.0

Halton: 12.4

Ontario: 25.2

Best: 4.2 in York and Durham regions

Worst: 44.1 in Windsor-Essex County

Alcohol

Drinking is a cause of oral, pharyngeal, esophageal, laryngeal, female breast, colorectal and liver cancers with an estimated 1,000 to 3,000 new cases in 2010 attributed to alcohol.

Privatization of retail alcohol outlets may result in increased consumption.

Per cent of alcohol retail stores that are privately owned in 2015-2016 sourced by the LCBO and the Alcohol and Gaming Commission of Ontario:

Hamilton: 83.3

Halton: 79.1

Ontario: 75.9

Best: 57.1 in Timiskaming and Porcupine

Worst: 91.2 in Niagara Region

Vaccines

Chronic infections are estimated to cause 7.4 per cent of cancers in developed countries.

Most are attributed to hepatitis B virus, hepatitis C virus, the human papillomavirus (HPV) family of viruses and Heliocobacter pylori.

Per cent of Grade 8 girls who got the HPV vaccine in the 2012-2013 school year:

Hamilton: 81.4

Halton: 70.7

Ontario: 80.2

Best: 87.4 in Wellington-Dufferin-Guelph

Worst: 68.2 in Lambton

Source: Cancer Care Ontario's Prevention System Quality Index