Cancer incidence attributable to lifestyle and environmental factors in Alberta in 2012: summary of results

Grundy, Anne; Poirier, Abbey E.; Khandwala, Farah; Grevers, Xin; Friedenreich, Christine M.; Brenner, Darren R.

doi:10.9778/cmajo.20160045

Cited by 23 publications

(18 citation statements)

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“…The results reported here are overall in line with those from similar studies, though methodological differences—different groups of risk factors used, different time periods and different relative risk sources—preclude direct comparisons. For all modifiable risk factors and all cancers combined where the UK 2015 PAF was 37.7%, other reported PAFs include 42.0% in the US in 2014; 35 40.8% in Alberta, Canada in 2012; 36 and 31.9% in Australia in 2010. 37 In all these studies the preventable proportion was higher in males than in females, with the gap widest in Canada (3.7 percentage points) and smallest in the US (1.0 percentage points), in line with the 1.8 percentage point sex difference reported here.…”

Section: Discussionmentioning

confidence: 99%

The fraction of cancer attributable to modifiable risk factors in England, Wales, Scotland, Northern Ireland, and the United Kingdom in 2015

et al. 2018

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BackgroundChanging population-level exposure to modifiable risk factors is a key driver of changing cancer incidence. Understanding these changes is therefore vital when prioritising risk-reduction policies, in order to have the biggest impact on reducing cancer incidence. UK figures on the number of risk factor-attributable cancers are updated here to reflect changing behaviour as assessed in representative national surveys, and new epidemiological evidence. Figures are also presented by UK constituent country because prevalence of risk factor exposure varies between them.MethodsPopulation attributable fractions (PAFs) were calculated for combinations of risk factor and cancer type with sufficient/convincing evidence of a causal association. Relative risks (RRs) were drawn from meta-analyses of cohort studies where possible. Prevalence of exposure to risk factors was obtained from nationally representative population surveys. Cancer incidence data for 2015 were sourced from national data releases and, where needed, personal communications. PAF calculations were stratified by age, sex and risk factor exposure level and then combined to create summary PAFs by cancer type, sex and country.ResultsNearly four in ten (37.7%) cancer cases in 2015 in the UK were attributable to known risk factors. The proportion was around two percentage points higher in UK males (38.6%) than in UK females (36.8%). Comparing UK countries, the attributable proportion was highest in Scotland (41.5% for persons) and lowest in England (37.3% for persons). Tobacco smoking contributed by far the largest proportion of attributable cancer cases, followed by overweight/obesity, accounting for 15.1% and 6.3%, respectively, of all cases in the UK in 2015. For 10 cancer types, including two of the five most common cancer types in the UK (lung cancer and melanoma skin cancer), more than 70% of UK cancer cases were attributable to known risk factors.ConclusionTobacco and overweight/obesity remain the top contributors of attributable cancer cases. Tobacco smoking has the highest PAF because it greatly increases cancer risk and has a large number of cancer types associated with it. Overweight/obesity has the second-highest PAF because it affects a high proportion of the UK population and is also linked with many cancer types. Public health policy may seek to mitigate the level of harm associated with exposure or reduce exposure levels—both approaches may effectively impact cancer incidence. Differences in PAFs between countries and sexes are primarily due to varying prevalence of exposure to risk factors and varying proportions of specific cancer types. This variation in turn is affected by socio-demographic differences which drive differences in exposure to theoretically avoidable ‘lifestyle’ factors. PAFs at UK country level have not been available previously and they should be used by policymakers in devolved nations. PAFs are estimates based on the best available data, limitations in those data would generally bias toward underestimation of PAFs. R...

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Section: Discussionmentioning

confidence: 99%

The fraction of cancer attributable to modifiable risk factors in England, Wales, Scotland, Northern Ireland, and the United Kingdom in 2015

et al. 2018

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“…All of these PAFs were based on the use of early twentieth century birth cohorts, African Americans, or the general United Kingdom population to approximate unexposed populations. However, Grundy et al based their substantially lower PAF estimate of 12.5% for solar UV radiation in Alberta, Canada, on a minimum risk exposure level of no sunburn in lifetime [5]. Their approach implies a threshold for the carcinogenic effects of UV radiation.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, cancer prevalence in Canada is expected to increase substantially over the next decade due to the aging population [3]. A substantial proportion of cancer cases are attributable to avoidable risk factors [4,5], making prevention an important strategy for reducing the burden of cancer. Carcinogens in the environment comprise one potentially avoidable risk factor.…”

Section: Introductionmentioning

confidence: 99%

“…Understanding the comparative cancer burden from carcinogenic exposures may help decision-makers to prioritize carcinogens for additional policy interventions to reduce exposures and risks. There have been multiple recent efforts to estimate the cancer burden associated with lifestyle, behavioral, and environmental factors in the United States [6], the United Kingdom [7,8], Australia [9], and Alberta, Canada [5]. However, these studies restricted their examination of environmental carcinogens to air pollution, second-hand smoke, and radiation sources (e.g., radon and solar UV).…”

Section: Introductionmentioning

confidence: 99%

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An approach to estimating the environmental burden of cancer from known and probable carcinogens: application to Ontario, Canada

et al. 2020

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Background: Quantifying the potential cancer cases associated with environmental carcinogen exposure can help inform efforts to improve population health. This study developed an approach to estimate the environmental burden of cancer and applied it to Ontario, Canada. The purpose was to identify environmental carcinogens with the greatest impact on cancer burden to support evidence-based decision making. Methods: We conducted a probabilistic assessment of the environmental burden of cancer in Ontario. We selected 23 carcinogens that we defined as "environmental" (e.g., pollutants) and were relevant to the province, based on select classifications provided by the International Agency for Research on Cancer. We evaluated population exposure to the carcinogens through inhalation of indoor/outdoor air; ingestion of food, water, and dust; and exposure to radiation. We obtained or calculated concentration-response functions relating carcinogen exposure and the risk of developing cancer. Using both human health risk assessment and population attributable fraction models in a Monte Carlo simulation, we estimated the annual cancer cases associated with each environmental carcinogen, reporting the simulation summary (e.g., mean and percentiles). Results: We estimated between 3540 and 6510 annual cancer cases attributable to exposure to 23 environmental carcinogens in Ontario. Three carcinogens were responsible for over 90% of the environmental burden of cancer: solar ultraviolet (UV) radiation, radon in homes, and fine particulate matter (PM 2.5) in outdoor air. Eight other carcinogens had an estimated mean burden of at least 10 annual cancer cases: acrylamide, arsenic, asbestos, chromium, diesel engine exhaust particulate matter, dioxins, formaldehyde, and secondhand smoke. The remaining 12 carcinogens had an estimated mean burden of less than 10 annual cancer cases in Ontario.

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“…In addition, overall health (e.g., overweight) may also play a role in cancer development [2,3,4]. All combined exogenous factors are responsible for up to 55% of cancer cases [20,21,22,23].…”

Section: Introductionmentioning

confidence: 99%

Diet, Physical Activity, Obesity, and Breastfeeding: How French People Perceive Factors Associated with Cancer Risk

et al. 2019

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The French Cancer Barometer, a population-based-survey, is carried out every five years and is, to date, one of the few national studies conducted to investigate individual perception linked to cancer risk factors. The aims of the present study were to describe the perceptions of the French population in 2015 and to assess their evolution over a 5-year period (2010–2015). The French Cancer Barometer surveyed a randomly selected sample of participants aged 15–75 years (n = 3345 in 2010) and 15–85 years (n = 3764 in 2015), representative of the French population. Questions were on perception of diet, physical activity, obesity, and breastfeeding as cancer risk factors. In 2015, nutritional/activity factors were perceived as having an important role in cancer development for the majority of those surveyed (diet (90.8%), obesity (76%), and physical activity (70%)) with the exception being breastfeeding (34%). However, there was a moderate perception of the risks of red meat (43%) and salt or salty food (55%) consumption. Perceptions of nutritional risk factors were mostly associated with age and education level. Interestingly, there was a greater perception of nutritional risk factors in 2015 compared to 2010, and the participants’ opinions were also stronger. Efforts should be made on individuals with lower educational level and to promote the beneficial effects of breastfeeding. However, to impact food behavior, measures are needed at the environmental level and not only at the individual one.

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Cancer incidence attributable to lifestyle and environmental factors in Alberta in 2012: summary of results

Cited by 23 publications

References 28 publications

The fraction of cancer attributable to modifiable risk factors in England, Wales, Scotland, Northern Ireland, and the United Kingdom in 2015

The fraction of cancer attributable to modifiable risk factors in England, Wales, Scotland, Northern Ireland, and the United Kingdom in 2015

An approach to estimating the environmental burden of cancer from known and probable carcinogens: application to Ontario, Canada

Diet, Physical Activity, Obesity, and Breastfeeding: How French People Perceive Factors Associated with Cancer Risk

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