Cancer incidence attributable to lifestyle and environmental factors in Alberta in 2012: summary of results.
Cancer incidence attributable to lifestyle and environmental factors in Alberta in 2012: summary of results.
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DOI：
10.9778/cmajo.20160045
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发表时间：
2017-07-07
期刊：
影响因子：
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通讯作者：
Brenner, Darren R
中科院分区：
文献类型：
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作者：
Grundy, Anne;Poirier, Abbey E;Brenner, Darren R
背景技术背景：加拿大，更具体地说，阿尔伯塔，没有关于可归因于可改变的风险因素的癌症病例比例的估计数。本研究的目的是估计2012年阿尔伯塔癌症病例的总比例，这些病例可归因于一组24种可改变的生活方式和环境风险因素。我们估计了24个危险因素的总体人群归因风险估计值（吸烟[包括被动吸烟和主动吸烟]、超重和肥胖、体育活动不足、饮食[水果和蔬菜消费不足，纤维摄入不足、红肉和加工肉类摄入过量、盐摄入量、钙和维生素D摄入不足]、酒精、激素[口服避孕药和激素疗法]、感染[爱泼斯坦-巴尔病毒、肝炎B和C病毒、人乳头瘤病毒、幽门螺杆菌]、空气污染、天然和人工紫外线辐射，氡和水消毒副产品），结合人口归因风险估计的24个因素，以前估计。为了说明个体癌症病例是多种风险因素组合的结果的可能性，我们从100%中减去第一个因素的人群归因风险，然后将第二个因素的人群归因风险应用于剩余的比例，而不是归因于第一个因素。我们重复了这个过程中的顺序为所有相关exposition.RESULTS：总体而言，估计40.8%的癌症病例在阿尔伯塔在2012年可归因于可改变的生活方式和环境风险因素。据估计，最大比例的癌症可归因于吸烟、缺乏体育活动和体重过重。总结人群归因风险估计略高于妇女（42.4%）比男性（38.7%）。解释：约41%的癌症病例在阿尔伯塔可能是由于已知的可改变的生活方式和环境风险因素。降低这些因素在阿尔伯塔人口中的流行率有可能大幅降低该省的癌症负担。
BACKGROUND: Estimates of the proportion of cancer cases that can be attributed to modifiable risk factors are not available for Canada and, more specifically, Alberta. The purpose of this study was to estimate the total proportion of cancer cases in Alberta in 2012 that could be attributed to a set of 24 modifiable lifestyle and environmental risk factors.METHODS: We estimated summary population attributable risk estimates for 24 risk factors (smoking [both passive and active], overweight and obesity, inadequate physical activity, diet [inadequate fruit and vegetable consumption, inadequate fibre intake, excess red and processed meat consumption, salt consumption, inadequate calcium and vitamin D intake], alcohol, hormones [oral contraceptives and hormone therapy], infections [Epstein-Barr virus, hepatitis B and C viruses, human papillomavirus, Helicobacter pylori], air pollution, natural and artificial ultraviolet radiation, radon and water disinfection by-products) by combining population attributable risk estimates for each of the 24 factors that had been previously estimated. To account for the possibility that individual cancer cases were the result of a combination of multiple risk factors, we subtracted the population attributable risk for the first factor from 100% and then applied the population attributable risk for the second factor to the remaining proportion that was not attributable to the first factor. We repeated this process in sequential order for all relevant exposures.RESULTS: Overall, an estimated 40.8% of cancer cases in Alberta in 2012 were attributable to modifiable lifestyle and environmental risk factors. The largest proportion of cancers were estimated to be attributable to tobacco smoking, physical inactivity and excess body weight. The summary population attributable risk estimate was slightly higher among women (42.4%) than among men (38.7%).INTERPRETATION: About 41% of cancer cases in Alberta may be attributable to known modifiable lifestyle and environmental risk factors. Reducing the prevalence of these factors in the Alberta population has the potential to substantially reduce the provincial cancer burden.