title: Population Attributable and Preventable Fractions: Cancer Risk Factor Surveillance, and Cancer Policy Projection.
abstract: The proportions of new cancer cases and deaths that are caused by exposure to risk factors and that could be prevented are key statistics for public health policy and planning. This paper summarizes the methodologies for estimating, challenges in the analysis of, and utility of, population attributable and preventable fractions for cancers caused by major risk factors such as tobacco smoking, dietary factors, high body fat, physical inactivity, alcohol consumption, infectious agents, occupational exposure, air pollution, sun exposure, and insufficient breastfeeding. For population attributable and preventable fractions, evidence of a causal relationship between a risk factor and cancer, outcome (such as incidence and mortality), exposure distribution, relative risk, theoretical-minimum-risk, and counterfactual scenarios need to be clearly defined and congruent. Despite limitations of the methodology and the data used for estimations, the population attributable and preventable fractions are a useful tool for public health policy and planning.
authors.affiliation: Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France.
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Shield
authors.affiliation: Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, United Kingdom.
authors.forename: D Maxwell
authors.initials: DM
authors.lastname: Parkin
authors.affiliation: Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
authors.forename: David C
authors.initials: DC
authors.lastname: Whiteman
authors.affiliation: Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Canada.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rehm
authors.affiliation: Université de Lyon, Université Lyon 1, UMRESTTE IFSTTAR, UMRESTTE, Lyon, France.
authors.forename: Vivian
authors.initials: V
authors.lastname: Viallon
authors.affiliation: Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France.
authors.forename: Claire Marant
authors.initials: CM
authors.lastname: Micallef
authors.affiliation: HuGeF Foundation, Torino, Italy; MRC-PHE Center for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom.
authors.forename: Paolo
authors.initials: P
authors.lastname: Vineis
authors.affiliation: Faculty of Medicine, School of Public Health, Imperial College of London, London, United Kingdom.
authors.forename: Lesley
authors.initials: L
authors.lastname: Rushton
authors.affiliation: Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France.
authors.forename: Freddie
authors.initials: F
authors.lastname: Bray
authors.affiliation: Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Soerjomataram
keywords: Etiology; Incidence; Mortality; Neoplasms; Population Attributable Fraction; Prevention and control; Risk