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The Fraction of Cancer Attributable to Ways of Life,Infections, Occupation,and Environmental Agents in Brazil in 2020
Authors:Gulnar Azevedo e Silva  Lenildo de Moura  Maria Paula Curado  Fabio da Silva Gomes  Ubirani Otero  Leandro Fórnias Machado de Rezende  Regina Paiva Daumas  Raphael Mendon?a Guimar?es  Karina Cardoso Meira  Iuri da Costa Leite  Joaquim Gon?alves Valente  Ronaldo Ismério Moreira  Rosalina Koifman  Deborah Carvalho Malta  Marcia Sarpa de Campos Mello  Thiago Wagnos Guimar?es Guedes  Paolo Boffetta
Abstract:Many human cancers develop as a result of exposure to risk factors related to the environment and ways of life. The aim of this study was to estimate attributable fractions of 25 types of cancers resulting from exposure to modifiable risk factors in Brazil. The prevalence of exposure to selected risk factors among adults was obtained from population-based surveys conducted from 2000 to 2008. Risk estimates were based on data drawn from meta-analyses or large, high quality studies. Population-attributable fractions (PAF) for a combination of risk factors, as well as the number of preventable deaths and cancer cases, were calculated for 2020. The known preventable risk factors studied will account for 34% of cancer cases among men and 35% among women in 2020, and for 46% and 39% deaths, respectively. The highest attributable fractions were estimated for tobacco smoking, infections, low consumption of fruits and vegetables, excess weight, reproductive factors, and physical inactivity. This is the first study to systematically estimate the fraction of cancer attributable to potentially modifiable risk factors in Brazil. Strategies for primary prevention of tobacco smoking and control of infection and the promotion of a healthy diet and physical activity should be the main priorities in policies for cancer prevention in the country.
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