There is no penalty for wrong answers. Religious hexes and curses for non-believing. Ingestion of contaminated water or food. The bite of infected insects. The crude death rate for cancer is increasing in the United States, but there is little change in the age-adjusted death rate for cancer.
Cigarette smoking over the past decades continues to be a major cause of cancer in the population.
Life expectancy is increasing in the United States. Childhood cancers have been substantially reduced by modern medical treatments. New medical treatments are causing people to live much longer once cancer has been diagnosed. Which is NOT an environmental factor related to disease risk. Biting insects such as mosquitos.