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Goon S, Kim H, Giovannucci EL. Population attributable risk for colorectal and breast cancer in England, Wales, Scotland, Northern Ireland, and the United Kingdom. AMRC OPEN RESEARCH 2022; 3:11. [PMID: 38708073 PMCID: PMC11064977 DOI: 10.12688/amrcopenres.12980.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/04/2022] [Indexed: 05/07/2024]
Abstract
Background The population attributable risk (PAR) is a statistic commonly used for quantifying preventability of cancer. We report here PAR estimates for the United Kingdom (UK) along with its constituent countries for up-to-date risk factor-attributable colorectal cancer (CRC) and breast cancer (BC), focusing on diet and nutrition related factors and tobacco (CRC) using representative national surveys. Methods The PAR was calculated using established, modifiable risk factors by the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR): physical activity, body mass index (BMI), alcoholic drinks, red meat, processed meat, dietary fiber, dietary calcium, as well as cigarette smoking for CRC, and physical activity, BMI, alcoholic drinks, and fruits and vegetable consumption for BC. National prevalence estimates and relative risks (RRs) for CRC and BC were obtained from meta-analyses or large pooled analyses. Results Based on eight dietary and lifestyle risk factors, the estimates for attributable cases of CRC for males and females, respectively, were as follows: England: 67% and 60%; Scotland: 68% and 59%, Wales: 66% and 61%; Northern Ireland: 67% and 61%; and UK: 67% and 60%. Excluding smoking, the PAR for the UK was 61% for men and 52% for women. Based on four dietary and lifestyle risk factors, the estimates for BC were as follows: England: 26%, Scotland: 27%; Wales: 25%; Northern Ireland: 26%; and UK: 27%. Conclusion Up to 67% for CRC and 27% of BC were attributable to modifiable dietary and lifestyle factors in the UK. Moderate differences in PAR are observed between countries due to different prevalence of exposure to risk factors.
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Affiliation(s)
- Shatabdi Goon
- Department of Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA
- Florida Department of Health, Pasco, FL, 34652, USA
| | - Hanseul Kim
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Edward L. Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
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2
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Gudenkauf FJ, Thrift AP. Preventable causes of cancer in Texas by Race/Ethnicity: Inadequate diet. Prev Med Rep 2021; 24:101637. [PMID: 34976688 PMCID: PMC8684018 DOI: 10.1016/j.pmedr.2021.101637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 11/03/2021] [Accepted: 11/13/2021] [Indexed: 11/28/2022] Open
Abstract
We estimated the percentage and number of all incident cancer cases diagnosed in Texas in 2015 that were attributable to inadequate diet and examined for racial/ethnic differences. We calculated population attributable fractions for cancers with a causal relationship with red and processed meat consumption, insufficient fiber intake, and insufficient calcium intake, using prevalence estimates from the National Health and Nutrition Examination Survey and relative risk estimates from the World Cancer Research Fund/American Institute for Cancer Research 2018 Third Expert Report. Overall, 3.3% of all new cancers (3,428 cases) diagnosed in Texas in 2015 were attributable to inadequate diet. More diet-associated cancers were diagnosed in men (3.8%) than women (2.9%). Insufficient fiber intake (1.2%) contributed more cancers than processed meat consumption (1.0%), insufficient calcium intake (0.8%), and red meat consumption (0.4%). Non-Hispanic Blacks (4.4%) had a higher proportion of cancers attributable to inadequate diet than Hispanics (3.7%) and non-Hispanic Whites (3.1%). Considering only colorectal cancers, inadequate diet caused 39.6% of cases in non-Hispanic Blacks, compared to 33.6% in non-Hispanic Whites and 33.4% in Hispanics. Inadequate diet serves as an important but preventable source of cancer. In general, and for minority populations specifically, cancer prevention programs should continue to advocate for universal compliance with recommended dietary guidelines.
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Affiliation(s)
- Franciska J. Gudenkauf
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
- University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - Aaron P. Thrift
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
- Corresponding author at: Baylor College of Medicine, One Baylor Plaza, MS: BCM307, Room 621D, Houston, TX 77030-3498, USA.
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3
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McFarlane M, Millard A, Hall H, Savage R, Constantinidou C, Arasaradnam R, Nwokolo C. Urinary volatile organic compounds and faecal microbiome profiles in colorectal cancer. Colorectal Dis 2019; 21:1259-1269. [PMID: 31282600 DOI: 10.1111/codi.14739] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 06/03/2019] [Indexed: 02/06/2023]
Abstract
AIM Volatile organic compounds (VOCs) are potential biomarkers for diagnosing colorectal cancer (CRC). We characterized urinary VOCs from CRC patients, their spouses/cohabitors (spouses) and first-degree relatives (relatives) to determine any differences. Correlation with stool-derived microbiomes was also undertaken. METHODS Urine from 56 CRC patients, 45 spouses and 37 relatives was assayed using liquid chromatography, field asymmetric ion mobility spectrometry (FAIMS), mass spectrometer technology. Analysis was performed using five-fold cross-validation and a random forest classifier. Faecal microbiome 16S rRNA was sequenced using Illumina MiSeq protocols and analysed using UPARSE and QIIME pipelines. VOC and microbiome profiles were also compared before and after cancer treatment. RESULTS Urinary VOC profiles of CRC patients were indistinguishable from either spouses or relatives. When spouses and relatives were grouped together to form a larger non-cancer control group (n = 82), their VOC profiles became distinguishable from those of CRC patients (n = 56) with 69% sensitivity and specificity, area under the curve 0.72 (P < 0.001). Microbiome analysis identified > 1300 operational taxonomic units across all groups. The analysis of similarity R value was 0.067 (P < 0.001), with significantly different bacterial abundances in 82 operational taxonomic units (6.2%) by Kruskal-Wallis testing. CRC patients' VOC or stool microbiome profiles were unchanged after treatment. CONCLUSION Although CRC patients' urinary VOC profiles cannot be differentiated from those of spouses or relatives they can be differentiated from a larger non-cancer control group. Comparison of the groups' microbiomes confirmed differences in bacterial species abundance. The current FAIMS-based assay can detect a unique, but modest, signal in CRC patients' urinary VOCs, which remains unaltered after treatment.
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Affiliation(s)
- M McFarlane
- Department of Gastroenterology, University Hospitals Coventry and Warwickshire, Coventry, UK
| | - A Millard
- Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - H Hall
- Department of Life Sciences, University of Warwick, Coventry, UK
| | - R Savage
- Warwick Systems Biology Centre, University of Warwick, Coventry, UK
| | - C Constantinidou
- Department of Life Sciences, University of Warwick, Coventry, UK
| | - R Arasaradnam
- Department of Gastroenterology, University Hospitals Coventry and Warwickshire, Coventry, UK.,Department of Life Sciences, University of Leicester, Leicester, UK
| | - C Nwokolo
- Department of Gastroenterology, University Hospitals Coventry and Warwickshire, Coventry, UK
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Behrens*1 G, Gredner*1 T, Stock C, F. Leitzmann M, Brenner*2 H, Mons*2 U. Cancers Due to Excess Weight, Low Physical Activity, and Unhealthy Diet. DEUTSCHES ARZTEBLATT INTERNATIONAL 2018; 115:578-585. [PMID: 30236216 PMCID: PMC6206246 DOI: 10.3238/arztebl.2018.0578] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 04/16/2018] [Accepted: 07/10/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Excess weight, low physical activity, low intakes of dietary fiber, fruits, and vegetables, and high meat and salt intake increase cancer risk. METHODS Numbers and proportions (population-attributable fractions, PAF) of incident cancer cases in Germany in 2018 attributable to these factors were estimated by sex and age groups for ages 35 to 84 years using population projections, national cancer incidence and exposure data, and published risk estimates. RESULTS Estimated numbers (percentages) of attributable cancers were 30 567 (7%) for excess weight, 27 081 (6%) for low physical activity, 14 474 (3%) for low dietary fiber intake, 9447 (2%) for low fruit and vegetable consumption, 9454 (2%) and 1687 (0.4%) for processed meat and high red meat consumption, respectively, and 1204 (0.3%) for high salt intake. Excess weight substantially contributed to endometrial, renal, and liver cancer (PAF = 24 to 35%). Low physical activity contributed to endometrial, renal, and lung cancer (PAF = 15 to 19%), and dietary factors mainly contributed to colorectal, breast, and lung cancer (PAF = 9 to 16%). CONCLUSION A considerable proportion of cancer cases are attributable to excess weight, physical inactivity, and unhealthy dietary habits. Major prevention efforts are needed to reduce the cancer incidence attributable to these avoidable factors.
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Affiliation(s)
- Gundula Behrens*1
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg
| | - Thomas Gredner*1
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg
- Medical Faculty Heidelberg, University of Heidelberg, Heidelberg
| | - Christian Stock
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg
| | - Michael F. Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg
| | - Hermann Brenner*2
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg
| | - Ute Mons*2
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg
- Cancer Prevention Unit, German Cancer Research Center (DKFZ), Heidelberg
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Grundy A, Poirier AE, Khandwala F, Grevers X, Friedenreich CM, Brenner DR. Cancer incidence attributable to lifestyle and environmental factors in Alberta in 2012: summary of results. CMAJ Open 2017; 5:E540-E545. [PMID: 28687643 PMCID: PMC5621951 DOI: 10.9778/cmajo.20160045] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
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.
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Affiliation(s)
- Anne Grundy
- Affiliations: Department of Cancer Epidemiology and Prevention Research (Grundy, Poirier, Khandwala, Grevers, Friedenreich, Brenner), CancerControl Alberta, Alberta Health Services, Edmonton, Alta.; Department of Oncology (Friedenreich, Brenner) and Department of Community Health Sciences (Friedenreich, Brenner), Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Abbey E Poirier
- Affiliations: Department of Cancer Epidemiology and Prevention Research (Grundy, Poirier, Khandwala, Grevers, Friedenreich, Brenner), CancerControl Alberta, Alberta Health Services, Edmonton, Alta.; Department of Oncology (Friedenreich, Brenner) and Department of Community Health Sciences (Friedenreich, Brenner), Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Farah Khandwala
- Affiliations: Department of Cancer Epidemiology and Prevention Research (Grundy, Poirier, Khandwala, Grevers, Friedenreich, Brenner), CancerControl Alberta, Alberta Health Services, Edmonton, Alta.; Department of Oncology (Friedenreich, Brenner) and Department of Community Health Sciences (Friedenreich, Brenner), Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Xin Grevers
- Affiliations: Department of Cancer Epidemiology and Prevention Research (Grundy, Poirier, Khandwala, Grevers, Friedenreich, Brenner), CancerControl Alberta, Alberta Health Services, Edmonton, Alta.; Department of Oncology (Friedenreich, Brenner) and Department of Community Health Sciences (Friedenreich, Brenner), Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Christine M Friedenreich
- Affiliations: Department of Cancer Epidemiology and Prevention Research (Grundy, Poirier, Khandwala, Grevers, Friedenreich, Brenner), CancerControl Alberta, Alberta Health Services, Edmonton, Alta.; Department of Oncology (Friedenreich, Brenner) and Department of Community Health Sciences (Friedenreich, Brenner), Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Darren R Brenner
- Affiliations: Department of Cancer Epidemiology and Prevention Research (Grundy, Poirier, Khandwala, Grevers, Friedenreich, Brenner), CancerControl Alberta, Alberta Health Services, Edmonton, Alta.; Department of Oncology (Friedenreich, Brenner) and Department of Community Health Sciences (Friedenreich, Brenner), Cumming School of Medicine, University of Calgary, Calgary, Alta
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6
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Grundy A, Poirier AE, Khandwala F, McFadden A, Friedenreich CM, Brenner DR. Cancer incidence attributable to insufficient fibre consumption in Alberta in 2012. CMAJ Open 2017; 5:E7-E13. [PMID: 28401112 PMCID: PMC5378528 DOI: 10.9778/cmajo.20160043] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Insufficient fibre consumption has been associated with a increased risk of colorectal cancer. The purpose of this study was to estimate the proportion and absolute number of cancers in Alberta that could be attributed to insufficient fibre consumption in 2012. METHODS The number and proportion of colorectal cancers in Alberta attributable to insufficient fibre consumption were estimated using the population attributable risk. Relative risks were obtained from the World Cancer Research Fund's 2011 Continuous Update Project on colorectal cancer, and the prevalence of insufficient fibre consumption (< 23 g/d) was estimated using dietary data from Alberta's Tomorrow Project. Age- and sex-specific colorectal cancer incidence data for 2012 were obtained from the Alberta Cancer Registry. RESULTS Between 66% and 67% of men and between 73% and 78% of women reported a diet with insufficient fibre consumption. Population attributable risk estimates for colorectal cancer were marginally higher in men, ranging from 6.3% to 6.8% across age groups, whereas in women they ranged from 5.0% to 5.5%. Overall, 6.0% of colorectal cancers or 0.7% of all cancers in Alberta in 2012 were estimated to be attributable to insufficient fibre consumption. INTERPRETATION Insufficient fibre consumption accounted for 6.0% of colorectal cancers in Alberta in 2012. Increasing fibre consumption in Alberta has the potential to reduce to the future burden of colorectal cancer in the province.
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Affiliation(s)
- Anne Grundy
- Department of Cancer Epidemiology and Prevention Research (Grundy, Poirier, Khandwala, McFadden, Friedenreich, Brenner), CancerControl Alberta, Alberta Health Services; Department of Oncology, Cumming School of Medicine (Friedenreich, Brenner), University of Calgary; Department of Community Health Sciences (Friedenreich, Brenner), Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Abbey E Poirier
- Department of Cancer Epidemiology and Prevention Research (Grundy, Poirier, Khandwala, McFadden, Friedenreich, Brenner), CancerControl Alberta, Alberta Health Services; Department of Oncology, Cumming School of Medicine (Friedenreich, Brenner), University of Calgary; Department of Community Health Sciences (Friedenreich, Brenner), Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Farah Khandwala
- Department of Cancer Epidemiology and Prevention Research (Grundy, Poirier, Khandwala, McFadden, Friedenreich, Brenner), CancerControl Alberta, Alberta Health Services; Department of Oncology, Cumming School of Medicine (Friedenreich, Brenner), University of Calgary; Department of Community Health Sciences (Friedenreich, Brenner), Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Alison McFadden
- Department of Cancer Epidemiology and Prevention Research (Grundy, Poirier, Khandwala, McFadden, Friedenreich, Brenner), CancerControl Alberta, Alberta Health Services; Department of Oncology, Cumming School of Medicine (Friedenreich, Brenner), University of Calgary; Department of Community Health Sciences (Friedenreich, Brenner), Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research (Grundy, Poirier, Khandwala, McFadden, Friedenreich, Brenner), CancerControl Alberta, Alberta Health Services; Department of Oncology, Cumming School of Medicine (Friedenreich, Brenner), University of Calgary; Department of Community Health Sciences (Friedenreich, Brenner), Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Darren R Brenner
- Department of Cancer Epidemiology and Prevention Research (Grundy, Poirier, Khandwala, McFadden, Friedenreich, Brenner), CancerControl Alberta, Alberta Health Services; Department of Oncology, Cumming School of Medicine (Friedenreich, Brenner), University of Calgary; Department of Community Health Sciences (Friedenreich, Brenner), Cumming School of Medicine, University of Calgary, Calgary, Alta
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Whiteman DC, Wilson LF. The fractions of cancer attributable to modifiable factors: A global review. Cancer Epidemiol 2016; 44:203-221. [PMID: 27460784 DOI: 10.1016/j.canep.2016.06.013] [Citation(s) in RCA: 144] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 06/27/2016] [Accepted: 06/28/2016] [Indexed: 12/13/2022]
Abstract
Worldwide, the burden of cancer is rising, stimulating efforts to develop strategies to control these diseases. Primary prevention, a key control strategy, aims to reduce cancer incidence through programs directed towards reducing population exposure to known causal factors. Before enacting such strategies, it is necessary to estimate the likely effect on cancer incidence if exposures to known causal factors were reduced or eliminated. The population attributable fraction (PAF) is the epidemiological measure which quantifies this potential reduction in incidence. We surveyed the literature to document and summarise the proportions of cancers across the globe attributable to modifiable causes, specifically tobacco smoke, alcohol, overweight/obesity, insufficient physical activity, solar ultraviolet (UV) radiation and dietary factors (insufficient fruit, non-starchy vegetables and fibre; red/processed meat; salt). In total, we identified 55 articles that presented PAF estimates for one or more causes. Information coverage was not uniform, with many articles reporting cancer PAFs due to overweight/obesity, alcohol and tobacco, but fewer reporting PAFs for dietary factors or solar UV radiation. At all cancer sites attributable to tobacco and alcohol, median PAFs were markedly lower for women than men. Smoking contributed to very high median PAFs (>50%) for cancers of the lung and larynx. Median PAFs for men, attributable to alcohol, were high (25-50%) for cancers of the oesophagus, oral cavity/pharynx, larynx and liver. For cancers causally associated with overweight/obesity, high median PAFs were reported for oesophageal adenocarcinoma (men 29%, women 37%), gallbladder (men 11%, women 42%) and endometrium (36%). The cancer PAF literature is growing rapidly. Repeating this survey in the future should lead to more precise estimates of the potentially preventable fractions of cancer.
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Affiliation(s)
- David C Whiteman
- QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Australia; The University of Queensland, School of Public Health, Herston Road, Herston, QLD 4006, Australia.
| | - Louise F Wilson
- QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Australia
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8
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Nagle CM, Wilson LF, Hughes MCB, Ibiebele TI, Miura K, Bain CJ, Whiteman DC, Webb PM. Cancers in Australia in 2010 attributable to inadequate consumption of fruit, non-starchy vegetables and dietary fibre. Aust N Z J Public Health 2016; 39:422-8. [PMID: 26437726 PMCID: PMC4606769 DOI: 10.1111/1753-6405.12449] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 04/01/2015] [Accepted: 05/01/2015] [Indexed: 12/01/2022] Open
Abstract
Objectives To estimate the number and proportion of cancers occurring in Australia in 2010 attributable to consumption deficits in fruit, non-starchy vegetables and dietary fibre. Methods We estimated the population attributable fraction (PAF) for cancers causally associated with inadequate intake of fruit and non-starchy vegetables (oral cavity, pharynx, oesophageal squamous cell carcinoma, stomach, larynx); inadequate intake of fruit (lung); and insufficient intake of fibre (colorectum). We used standard formulae incorporating prevalence of exposure (1995 National Nutrition Survey) and relative risks from independent studies. Results Overall, 1,555 (1.4% of all) and 311 (0.3% of all) cancers were attributable to inadequate intakes of fruit and non-starchy vegetables, respectively. A further 2,609 colorectal cancers (18% of colorectal) were attributable to insufficient fibre intake. If Australians increased their fibre intake by eating the recommended daily intakes of fruit and vegetables, an estimated 1,293 (8.8%) colorectal cancers could be prevented. Conclusions One in six colorectal cancer cases was attributable to inadequate intake of dietary fibre and about 1,800 cancers at other sites were attributable to insufficient fruit and non-starchy vegetable consumption. Implications Increasing the proportion of Australians who consume the recommended intake of fruit, vegetables and fibre could prevent up to 4% of all cancers.
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Affiliation(s)
- Christina M Nagle
- QIMR Berghofer Medical Research Institute, Queensland.,School of Public Health, The University of Queensland
| | | | | | | | - Kyoko Miura
- QIMR Berghofer Medical Research Institute, Queensland
| | - Christopher J Bain
- QIMR Berghofer Medical Research Institute, Queensland.,National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Australian Capital Territory
| | - David C Whiteman
- QIMR Berghofer Medical Research Institute, Queensland.,School of Public Health, The University of Queensland
| | - Penelope M Webb
- QIMR Berghofer Medical Research Institute, Queensland.,School of Public Health, The University of Queensland
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9
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Grundy A, Friedenreich CM, Poirier AE, Khandwala F, Brenner DR. A methodologic framework to evaluate the number of cancers attributable to lifestyle and environment in Alberta. CMAJ Open 2016; 4:E471-E478. [PMID: 27730111 PMCID: PMC5047844 DOI: 10.9778/cmajo.20150068] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Previous research to estimate population attributable risks for cancer in Alberta has been limited. Attributable burden estimates are important for planning and implementing population-based cancer prevention strategies. This article describes a methodologic framework to estimate the number of incident cancers attributable to modifiable lifestyle and environmental risk factors in Alberta. METHODS We estimated population attributable risks for cancer for exposures to 24 established cancer risk factors including tobacco consumption and environmental tobacco exposure, environmental factors, infectious agents, hormone therapies, dietary intake, obesity and physical inactivity. We used risk estimates to quantify the association between individual exposures and cancer sites as well as prevalence estimates for individual exposures in Alberta to estimate the proportion of cancer in Alberta that could be attributed to each exposure. These estimations were conducted in the context of a theoretical minimum risk principle, whereby exposures corresponding to the lowest levels of population risk were used as the comparisons for alternative exposure levels. INTE RPRETATION We outline the main methodologic principles for the protocol used in evaluating population attributable risks for modifiable lifestyle and environmental risk factors for cancer in Alberta. The data produced by this project will provide important information concerning which known cancer risk factors are responsible for the largest proportions of cancer in Alberta and could inform future cancer prevention strategies.
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Affiliation(s)
- Anne Grundy
- Department of Cancer Epidemiology and Prevention Research (Grundy, Friedenreich, Poirier, Khandwala, Brenner) Alberta Health Services-Cancer Control; Department of Oncology and Department of Community Health Sciences, Cumming School of Medicine (Friedenreich, Brenner), University of Calgary, Calgary, Alta
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research (Grundy, Friedenreich, Poirier, Khandwala, Brenner) Alberta Health Services-Cancer Control; Department of Oncology and Department of Community Health Sciences, Cumming School of Medicine (Friedenreich, Brenner), University of Calgary, Calgary, Alta
| | - Abbey E Poirier
- Department of Cancer Epidemiology and Prevention Research (Grundy, Friedenreich, Poirier, Khandwala, Brenner) Alberta Health Services-Cancer Control; Department of Oncology and Department of Community Health Sciences, Cumming School of Medicine (Friedenreich, Brenner), University of Calgary, Calgary, Alta
| | - Farah Khandwala
- Department of Cancer Epidemiology and Prevention Research (Grundy, Friedenreich, Poirier, Khandwala, Brenner) Alberta Health Services-Cancer Control; Department of Oncology and Department of Community Health Sciences, Cumming School of Medicine (Friedenreich, Brenner), University of Calgary, Calgary, Alta
| | - Darren R Brenner
- Department of Cancer Epidemiology and Prevention Research (Grundy, Friedenreich, Poirier, Khandwala, Brenner) Alberta Health Services-Cancer Control; Department of Oncology and Department of Community Health Sciences, Cumming School of Medicine (Friedenreich, Brenner), University of Calgary, Calgary, Alta
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10
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Kharazmi E, Fallah M, Sundquist K, Hemminki K. Familial risk of early and late onset cancer: nationwide prospective cohort study. BMJ 2012; 345:e8076. [PMID: 23257063 PMCID: PMC3527651 DOI: 10.1136/bmj.e8076] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To determine whether familial risk of cancer is limited to early onset cases. DESIGN Nationwide prospective cohort study. SETTING Nationwide Swedish Family-Cancer Database. PARTICIPANTS All Swedes born after 1931 and their biological parents, totalling >12.2 million individuals, including >1.1 million cases of first primary cancer. MAIN OUTCOME MEASURES Familial risks of the concordant cancers by age at diagnosis. RESULTS The highest familial risk was seen for offspring whose parents were diagnosed at an early age. Familial risks were significantly increased for colorectal, lung, breast, prostate, and urinary bladder cancer and melanoma, skin squamous cell carcinoma, and non-Hodgkin's lymphoma, even when parents were diagnosed at age 70-79 or 80-89. When parents were diagnosed at more advanced ages (≥ 90), the risk of concordant cancer in offspring was still significantly increased for skin squamous cell carcinoma (hazard ratio 1.9, 95% confidence interval 1.4 to 2.7), colorectal (1.6, 1.2 to 2.0), breast (1.3, 1.0 to 1.6), and prostate cancer (1.3, 1.1 to 1.6). For offspring with a cancer diagnosed at ages 60-76 whose parents were affected at age <50, familial risks were not significantly increased for nearly all cancers. CONCLUSION Though the highest familial risks of cancer are seen in offspring whose parents received a diagnosis of a concordant cancer at earlier ages, increased risks exist even in cancers of advanced ages. Familial cancers might not be early onset in people whose family members were affected at older ages and so familial cancers might have distinct early and late onset components.
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Affiliation(s)
- E Kharazmi
- Division of Molecular Genetic Epidemiology, German Cancer Research Centre, 69120 Heidelberg, Germany.
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