The Guam Medical Association says high rates of smoking and binge drinking have led to a high prevalence of lung and liver cancer in Guam.
The Medical Association says cancer is the second most common cause of death in Guam, with lung cancer the biggest killer followed by liver cancer, which has a death rate about three times that of the United States mainland.
A Senior partner for health consulting services, Dr Annette David, says lifestyle changes need to take place to reduce the rate of cancer but says these are not easy unless certain policies are changed.
"So for instance our smokefree law, that the higher taxes on tobacco, that's the way to go. For alcohol use, in 2010 we raised our minimum legal drinking age from 18 to 21. And so far we've seen beginning declines in alcohol consumption among young people."
Dr Annette David says with Guam outside the framework convention on tobacco control it faces difficulties in pushing for advertising bans or graphic warnings on cigarette packets.