Causes of cancer in the world: comparative risk assessment of nine behavioural and environmental risk factors
Causes of cancer in the world: comparative risk assessment of nine behavioural and environmental risk factors
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DOI：
10.1016/s0140-6736(05)67725-2
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发表时间：
2005-11-19
期刊：
影响因子：
168.9
通讯作者：
Ezzati, M
中科院分区：
文献类型：
--
作者：
Danaei, G;Vander Hoorn, S;Ezzati, M
在降低死亡率方面，癌症治疗的进展不如其他慢性病有效；有效的筛查方法只适用于少数几种癌症。通过生活方式和环境干预进行初级预防仍然是减轻癌症负担的主要途径。在这份报告中，我们估计了2001年世界银行7个地区9种危险因素导致的12种癌症的死亡率。方法我们分析了来自比较风险评估项目和新来源的数据，以评估暴露于危险因素和按年龄、性别和地区的相对风险。我们将单个和多个危险因素的人群归因分数应用于世卫组织特定地点的癌症死亡率。2001年全球700万人死于癌症，估计有243万人(35%)可归因于9个潜在的可改变的危险因素。其中，76万人死于高收入国家，167万人死于低收入和中等收入国家。在低收入和中等收入地区中，欧洲和中亚的癌症死亡比例最高(39%)，可归因于所研究的风险因素。可归因于这些风险因素的死亡中，男性为160万人，女性为83万人。吸烟、饮酒以及水果和蔬菜摄入量低是全球和中低收入国家癌症死亡的主要风险因素。在高收入国家，吸烟、饮酒、超重和肥胖是导致癌症的最重要原因。人乳头瘤病毒的性传播是中低收入国家妇女宫颈癌的主要风险因素。解释说，减少对关键行为和环境风险因素的接触将防止相当大比例的癌症死亡。
Introduction With respect to reducing mortality, advances in cancer treatment have not been as effective as those for other chronic diseases; effective screening methods are available for only a few cancers. Primary prevention through lifestyle and environmental interventions remains the main way to reduce the burden of cancers. In this report, we estimate mortality from 12 types of cancer attributable to nine risk factors in seven World Bank regions for 2001.Methods We analysed data from the Comparative Risk Assessment project and from new sources to assess exposure to risk factors and relative risk by age, sex, and region. We applied population attributable fractions for individual and multiple risk factors to site-specific cancer mortality from WHO.Findings of the 7 million deaths from cancer worldwide in 2001, an estimated 2.43 million (35%) were attributable to nine potentially modifiable risk factors. Of these, 0.76 million deaths were in high-income countries and 1.67 million in low-and-middle-income nations. Among low-and-middle-income regions, Europe and Central Asia had the highest proportion (39%) of deaths from cancer attributable to the risk factors studied. 1.6 million of the deaths attributable to these risk factors were in men and 0.83 million in women. Smoking, alcohol use, and low fruit and vegetable intake were the leading risk factors for death from cancer worldwide and in low-and-middle-income countries. In high-income countries, smoking, alcohol use, and overweight and obesity were the most important causes of cancer. Sexual transmission of human papilloma virus is a leading risk factor for cervical cancer in women in low-and-middle-income countries.interpretation Reduction of exposure to key behavioural and environmental risk factors would prevent a substantial proportion of deaths from cancer.