Reuters Health Information (2005-11-17): One third of cancer deaths due to modifiable risk factors
One third of cancer deaths due to modifiable risk factors
Last Updated: 2005-11-17 18:30:19 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Thirty-five percent of
cancer deaths worldwide can be attributed to the effect of nine
modifiable risk factors, according to results of a large collaborative
Although screening and treatment has reduced mortality from some
cancers, "primary prevention through lifestyle and environmental
interventions might offer the best option for reducing the large and
increasing burden of cancers worldwide," Dr. Majid Ezzati and
colleagues opine in their report, published in the November 19th issue
of The Lancet.
However, they add, "policies and programmes to implement such
interventions depend on reliable and comparable analyses of the effect
of risk factors for cancer at the population level."
To that end, Dr. Ezzati, from Harvard School of Public Health in
Boston, and his team systematically reviewed published studies,
government reports, and international databases to obtain data on risk
factor exposure and to estimate population attributable fractions.
Of 7 million global deaths from cancer in 2001, the authors estimate
that 2.43 million can be ascribed to the nine risk factors: overweight
and obesity, low fruit and vegetable consumption, physical inactivity,
smoking, alcohol consumption, unsafe sex, urban air pollution,
household use of solid fuels, and contaminated injections in
In high-income and low-income countries alike, smoking and alcohol
use were the most prevalent preventable causes of cancer deaths. In
low-and-middle-income countries, low fruit and vegetable intake were
also significant causes of cancer mortality, while in high-income
countries, overweight and obesity were among the most important causes.
"About a quarter of cancer deaths could be prevented by reducing
tobacco and alcohol use," Dr. Ezzati said in an interview with Reuters
Health. "Those are the ones for which there has been good experience
with interventions, such as taxation, prohibiting smoking in public
places, limiting advertising to minors, and reducing the initiation of
smoking and alcohol abuse."
For risk-factor attributable deaths, 37% were from lung cancer, 12%
from liver cancer, and 11% from esophageal cancer, the investigators
report, all of which have 5-year survival rates of < 25%.
Although high-income countries have only 15% of the world's
population, they accounted for 31% of deaths due to modifiable risk
factors. Except for cancer of the uterine cervix, joint population
attributable fractions were greater in high-income countries than in
low-and-middle-income countries for all other cancer sites.
"We hope that, given the huge interest society has in cancer
prevention, that this study will motivate policies to reduce risks,"
Dr. Ezzati concluded.