Proportion of cancer cases and deaths attributable to lifestyle risk factors in Brazil

• Published in: Cancer epidemiology Vol. 59; pp. 148 - 157
• Main Authors: Rezende, Leandro Fórnias Machado de, Lee, Dong Hoon, Louzada, Maria Laura da Costa, Song, Mingyang, Giovannucci, Edward, Eluf-Neto, José
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.04.2019; Elsevier Limited
• Subjects: Adult; Age; Aged; Alcohol; Alcohols; Body mass; Body mass index; Body size; Body weight; Brazil - epidemiology; Cancer; Dietary fiber; Disease prevention; Epidemiology; Esophagus; Exercise; Fatalities; Female; Fruits; Health risk assessment; Health Risk Behaviors; Health risks; Humans; Larynx; Life Style; Lifestyle risk factors; Lifestyles; Lungs; Male; Meat; Medical research; Middle Aged; Neoplasms - epidemiology; Neoplasms - etiology; Neoplasms - mortality; Oropharynx; Overweight; Physical activity; Population; Population attributable fraction; Prevention; Prospective Studies; Risk analysis; Risk Factors; Skin cancer; Smoking; Tobacco; Tobacco smoking; Vegetables; Young Adult; Brazil; United Kingdom > UK; Australia; United States > US; China; Lifestyle risk factors; Epidemiology; Population attributable fraction; Cancer
• ISSN: 1877-7821; 1877-783X
• DOI: 10.1016/j.canep.2019.01.021

•Lifestyle risk factors accounted for 27% of cancer cases and one-third of cancer deaths in Brazil.•Larynx, lung, oropharynx, esophagus and colorectum cancer cases and deaths could be at least halved.•Tobacco smoking was the single major cause of cancer, followed by high BMI and alcohol consumption. Lifestyle risk factors (tobacco smoking, alcohol consumption, overweight and obesity, unhealthy diet, and lack of physical activity) have been associated with increased risk of at least 20 types of cancer. We estimated the proportion of cancer cases and deaths that could be potentially avoided by eliminating or reducing lifestyle risk factors in Brazil. We obtained the distribution of lifestyle risk factors by sex and age groups from recent representative health surveys in Brazil; relative risks from pooled analyses of prospective studies and meta-analyses; and cancer cases and deaths in 2012 from GLOBOCAN. We found that 26.5% (114,497 cases) of all cancer cases and 33.6% (63,371 deaths) of all cancer deaths could be potentially avoided by eliminating lifestyle risk factors in Brazil. Plausible reductions in these exposures based on policy targets and cancer prevention recommendations could have potentially avoided 4.5% (19,731 cases) and 6.1% (11,480 deaths) of all cancer cases and deaths, respectively. Tobacco smoking accounted for most of the preventable cancer cases and deaths, followed by high body mass index and alcohol consumption. Larynx, lung, oropharynx, esophagus and colorectum cancer cases and deaths could be at least halved by eliminating these lifestyle risk factors. Findings from this study may be useful to inform strategies for cancer prevention and control across Brazil.