title: The Fraction of Cancer Attributable to Ways of Life, Infections, Occupation, and Environmental Agents in Brazil in 2020.
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.
authors: Instituto de Medicina Social, University of Rio de Janeiro State, Rio de Janeiro, Rio de Janeiro State, Brazil.
authors: Gulnar
authors: G
authors: Azevedo E Silva
authors: Pan-Americana Health Organization, Brasília, Distrito Federal, Brazil.
authors: Lenildo
authors: L
authors: de Moura
authors: AC Camargo Cancer Center, Hospital AC Camargo, São Paulo, São Paulo State, Brazil.|International Prevention Research Institute, Lyon, France.
authors: Maria Paula
authors: MP
authors: Curado
authors: National Cancer Institute, Ministry of Health, Rio de Janeiro, Rio de Janeiro State, Brazil.
authors: Fabio da Silva
authors: Fda S
authors: Gomes
authors: National Cancer Institute, Ministry of Health, Rio de Janeiro, Rio de Janeiro State, Brazil.
authors: Ubirani
authors: U
authors: Otero
authors: Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, São Paulo State, Brazil.
authors: Leandro Fórnias Machado de
authors: LF
authors: Rezende
authors: National School of Public Health, Oswaldo Cruz Foundation, Ministry of Health, Rio de Janeiro, Rio de Janeiro State, Brazil.
authors: Regina Paiva
authors: RP
authors: Daumas
authors: Joaquim Venâncio Polytechnic School of Health, Oswaldo Cruz Foundation, Ministry of Health, Rio de Janeiro, Rio de Janeiro State, Brazil.
authors: Raphael Mendonça
authors: RM
authors: Guimarães
authors: Nursing School, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
authors: Karina Cardoso
authors: KC
authors: Meira
authors: National School of Public Health, Oswaldo Cruz Foundation, Ministry of Health, Rio de Janeiro, Rio de Janeiro State, Brazil.
authors: Iuri da Costa
authors: Ida C
authors: Leite
authors: National School of Public Health, Oswaldo Cruz Foundation, Ministry of Health, Rio de Janeiro, Rio de Janeiro State, Brazil.
authors: Joaquim Gonçalves
authors: JG
authors: Valente
authors: National Institute of Infectolgy, Oswaldo Cruz Foundation, Ministry of Health, Rio de Janeiro, Rio de Janeiro State, Brazil.
authors: Ronaldo Ismério
authors: RI
authors: Moreira
authors: Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, São Paulo State, Brazil.
authors: Rosalina
authors: R
authors: Koifman
authors: Health Surveillance Secretariat, Ministry of Health, Brasília, Federal District, Brazil.
authors: Deborah Carvalho
authors: DC
authors: Malta
authors: National Cancer Institute, Ministry of Health, Rio de Janeiro, Rio de Janeiro State, Brazil.
authors: Marcia Sarpa de Campos
authors: MS
authors: Mello
authors: Instituto de Medicina Social, University of Rio de Janeiro State, Rio de Janeiro, Rio de Janeiro State, Brazil.
authors: Thiago Wagnos Guimarães
authors: TW
authors: Guedes
authors: The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America.
authors: Paolo
authors: P
authors: Boffetta
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000453:epidemiology; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000453:epidemiology; D006505:Hepatitis / Q000150:complications / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008019:Life Style; D008297:Male; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D016273:Occupational Exposure / Q000706:statistics & numerical data; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013472:Sunlight / Q000009:adverse effects