BACKGROUND AND PURPOSE:

• Quantifying modifiable risk factors can help enable the design of cancer prevention programs
• GBD 2019 Cancer Risk Factors Collaborators (The Lancet, 2022) assessed the global cancer burden attributable to modifiable risk factors

METHODS:

• Comparative risk analysis
  • Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019
• Study design
  • Risk factors assessed
    • Behavioral | Environmental | Occupational | Metabolic
  • 82 risk–outcome pairs were included based on the World Cancer Research Fund criteria
• Primary outcome
  • Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019
  • Change in these measures between 2010 and 2019

RESULTS:

• In 2019, the risk factors included in this analysis accounted for a global total of
  • Deaths: 4.45 million (95% CI, 4.01 to 4.94)
    • Men: 2.88 million (95% CI, 2.60 to 3.18)
    • Women: 1.58 million (95% CI, 1.36 to 1.84)
  • DALYs: 105 million (95% CI, 95.0 to 116)
• Cancers attributable to modifiable risk factors in 2019 represented
  • 44.4% of all cancer deaths (95% CI, 41.3 to 48.4)
    • 50.6% of all cancer deaths in men (47.8 to 54.1)
    • 36.3% of all cancer deaths in women (32.5 to 41.3)
  • 42.0% of DALYs (95% CI, 39.1 to 45.6)
• The leading risk factors globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes were
  • Smoking
  • Alcohol use
  • High BMI
• Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI)
  • Leading risk factors for cancer DALYs in low SDI locations
    • Smoking
    • Unsafe sex
    • Alcohol use
  • Leading risk factors for cancer DALYs in high SDI locations
    • Smoking
    • Alcohol use
    • High BMI
• From 2010 to 2019, global risk-attributable cancer deaths and DALYs increased
  • Deaths: by 20.4% (95% CI, 12.6 to 28.4)
  • DALYs: by 16.8% (95% CI, 8.8 to 25.0)
• The greatest percentage increase was in metabolic risks
  • Deaths: by 34.7% (95% CI, 27.9 to 42.8)
  • DALYs: by 33.3% (95% CI, 25.8 to 42.0)

CONCLUSION:

• The top three risk factors contributing to the global cancer burden were smoking, alcohol use, and BMI
• Metabolic risk factors accounted for the greatest percent increase in deaths caused between 2010 and 2019
• The authors address the results including factors

However, from 2010 to 2019, age-standardised cancer DALY rates attributable to all risks combined declined in high, high-middle, and middle SDI countries, whereas these values increased in low-middle SDI countries or were approximately stable in low SDI countries

This increase was largely due to metabolic risks, which include risk factors such as high BMI

The growth in metabolic risk-attributable cancer burden might be the result of these countries experiencing an epidemiological transition in which improvements in country-level developmental status are related to increasing obesity levels

Learn More – Primary Sources:

The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

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