News US

Global and regional cancer burden attributable to modifiable risk factors to inform prevention

  • Bray, F. et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 74, 229–263 (2024).

    PubMed 

    Google Scholar 

  • Tran, K. B. et al. The global burden of cancer attributable to risk factors, 2010−19: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 400, 563–591 (2022).

    Article 

    Google Scholar 

  • Stein, C. J. & Colditz, G. A. Modifiable risk factors for cancer. Br. J. Cancer 90, 299–303 (2004).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Goddard, K. A. B. et al. Estimation of cancer deaths averted from prevention, screening, and treatment efforts, 1975−2020. JAMA Oncol. 11, 162–167 (2025).

    Article 
    PubMed 

    Google Scholar 

  • GBD 2023 Cancer Collaborators. The global, regional, and national burden of cancer, 1990−2023, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2023. Lancet 406, 1565−1586 (2025).

  • de Martel, C., Georges, D., Bray, F., Ferlay, J. & Clifford, G. M. Global burden of cancer attributable to infections in 2018: a worldwide incidence analysis. Lancet Glob. Health 8, e180–e190 (2020).

    Article 
    PubMed 

    Google Scholar 

  • Plummer, M. et al. Global burden of cancers attributable to infections in 2012: a synthetic analysis. Lancet Glob. Health 4, e609–e616 (2016).

    Article 
    PubMed 

    Google Scholar 

  • Whiteman, D. C. & Wilson, L. F. The fractions of cancer attributable to modifiable factors: a global review. Cancer Epidemiol. 44, 203–221 (2016).

    Article 
    PubMed 

    Google Scholar 

  • Azevedo, E. S. G. et al. The fraction of cancer attributable to ways of life, infections, occupation, and environmental agents in Brazil in 2020. PLoS ONE 11, e0148761 (2016).

    Article 

    Google Scholar 

  • Brown, K. F. et al. The fraction of cancer attributable to modifiable risk factors in England, Wales, Scotland, Northern Ireland, and the United Kingdom in 2015. Br. J. Cancer 118, 1130–1141 (2018).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Islami, F. et al. Cancer deaths and cases attributable to lifestyle factors and infections in China, 2013. Ann. Oncol. 28, 2567–2574 (2017).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Islami, F. et al. Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States, 2019. CA Cancer J. Clin. 74, 405–432 (2024).

    PubMed 

    Google Scholar 

  • Kulhánová, I. et al. Proportion of cancers attributable to major lifestyle and environmental risk factors in the Eastern Mediterranean region. Int. J. Cancer 146, 646–656 (2020).

    Article 
    PubMed 

    Google Scholar 

  • Nemati, S. et al. Population attributable proportion and number of cancer cases attributed to potentially modifiable risk factors in Iran in 2020. Int. J. Cancer 153, 1758–1765 (2023).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Soerjomataram, I. et al. Cancers related to lifestyle and environmental factors in France in 2015. Eur. J. Cancer 105, 103–113 (2018).

    Article 
    PubMed 

    Google Scholar 

  • Teh, H. S. & Woon, Y. L. Burden of cancers attributable to modifiable risk factors in Malaysia. BMC Public Health 21, 410 (2021).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Arnold, M. et al. Progress in cancer survival, mortality, and incidence in seven high-income countries 1995−2014 (ICBP SURVMARK-2): a population-based study. Lancet Oncol. 20, 1493–1505 (2019).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Shelton, J. et al. 25 year trends in cancer incidence and mortality among adults aged 35−69 years in the UK, 1993−2018: retrospective secondary analysis. BMJ 384, e076962 (2024).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • WHO global report on trends in prevalence of tobacco use 2000–2030. https://www.who.int/publications/i/item/9789240088283 (World Health Organization, 2024).

  • Manthey, J. et al. Global alcohol exposure between 1990 and 2017 and forecasts until 2030: a modelling study. Lancet 393, 2493–2502 (2019).

    Article 
    PubMed 

    Google Scholar 

  • Arndt, M. B. et al. Global, regional, and national progress towards the 2030 global nutrition targets and forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 404, 2543–2583 (2024).

    Article 

    Google Scholar 

  • WHO Report on the Global Tobacco Epidemic, 2023: Protect People From Tobacco Smoke (World Health Organization, 2023); https://www.who.int/publications/i/item/9789240077164

  • Bauman, A. et al. Impact of the first year of the ‘This girl can’ physical activity and sport mass media campaign in Australia. BMC Public Health 23, 333 (2023).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Ginsburg, O. & Horton, R. A Lancet Commission on women and cancer. Lancet 396, 11–13 (2020).

    Article 
    PubMed 

    Google Scholar 

  • WHO Framework Convention on Tobacco Control. Gender-responsive Tobacco Control: Evidence and Options for Policies and Programmes (World Health Organization, 2018); https://fctc.who.int/resources/publications/m/item/gender-responsive-tobacco-control-evidence-and-options-for-policies-and-programmes

  • Forman, D. et al. Global burden of human papillomavirus and related diseases. Vaccine 30, F12–F23 (2012).

    Article 
    PubMed 

    Google Scholar 

  • Lei, J. et al. HPV vaccination and the risk of invasive cervical cancer. N. Engl. J. Med. 383, 1340–1348 (2020).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Chen, Y. C. et al. Global prevalence of Helicobacter pylori Infection and incidence of gastric cancer between 1980 and 2022. Gastroenterology 166, 605–619 (2024).

    Article 
    PubMed 

    Google Scholar 

  • Malaty, H. M. et al. Age at acquisition of Helicobacter pylori infection: a follow-up study from infancy to adulthood. Lancet 359, 931–935 (2002).

    Article 
    PubMed 

    Google Scholar 

  • Bellack, N. R., Koehoorn, M. W., MacNab, Y. C. & Morshed, M. G. A conceptual model of water’s role as a reservoir in Helicobacter pylori transmission: a review of the evidence. Epidemiol. Infect. 134, 439–449 (2006).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Malfertheiner, P. et al. Helicobacter pylori infection. Nat. Rev. Dis. Primers 9, 19 (2023).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Chiang, T. H. et al. Mass eradication of Helicobacter pylori to reduce gastric cancer incidence and mortality: a long-term cohort study on Matsu Islands. Gut 70, 243–250 (2021).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Dorji, T. et al. Population-level cancer screening and cancer care in Bhutan, 2020−2023: a review. Lancet Reg. Health Southeast Asia 24, 100370 (2024).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Tsuda, M. et al. Effect on Helicobacter pylori eradication therapy against gastric cancer in Japan. Helicobacter 22, e12415 (2017).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Maucort-Boulch, D., de Martel, C., Franceschi, S. & Plummer, M. Fraction and incidence of liver cancer attributable to hepatitis B and C viruses worldwide. Int. J. Cancer 142, 2471–2477 (2018).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Schweitzer, A., Horn, J., Mikolajczyk, R. T., Krause, G. & Ott, J. J. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet 386, 1546–1555 (2015).

    Article 
    PubMed 

    Google Scholar 

  • Kandeel, A. et al. Evidence for the elimination of viral hepatitis B and C in Egypt: results of a nationwide survey in 2022. Liver Int. 44, 955–965 (2024).

    Article 
    PubMed 

    Google Scholar 

  • Salama, I. I. et al. Effectiveness of hepatitis B virus vaccination program in Egypt: multicenter national project. World J. Hepatol. 7, 2418–2426 (2015).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Thursz, M., Njie, R. & Lemoine, M. Global eradication of hepatitis B—feasible or fallacy? Nat. Rev. Gastroenterol. Hepatol. 9, 492–494 (2012).

    Article 
    PubMed 

    Google Scholar 

  • Clougherty, J. E. A growing role for gender analysis in air pollution epidemiology. Environ. Health Perspect. 118, 167–176 (2010).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Okello, G., Devereux, G. & Semple, S. Women and girls in resource poor countries experience much greater exposure to household air pollutants than men: results from Uganda and Ethiopia. Environ. Int. 119, 429–437 (2018).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Shupler, M. et al. Global estimation of exposure to fine particulate matter (PM2.5) from household air pollution. Environ. Int. 120, 354–363 (2018).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Raimondi, S., Suppa, M. & Gandini, S. Melanoma epidemiology and sun exposure. Acta Derm. Venereol. 100, adv00136 (2020).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Iannacone, M. R. & Green, A. C. Towards skin cancer prevention and early detection: evolution of skin cancer awareness campaigns in Australia. Melanoma Manag. 1, 75–84 (2014).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Cumberbatch, M. G., Cox, A., Teare, D. & Catto, J. W. Contemporary occupational carcinogen exposure and bladder cancer: a systematic review and meta-analysis. JAMA Oncol. 1, 1282–1290 (2015).

    Article 
    PubMed 

    Google Scholar 

  • Cislaghi, B. et al. Gender norms and gender equality in full-time employment and health: a 97-country analysis of the world values survey. Front. Psychol. 13, 689815 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Santana, V. S. & Ribeiro, F. S. Occupational cancer burden in developing countries and the problem of informal workers. Environ. Health 10 Suppl 1, S10 (2011).

    Article 
    PubMed 

    Google Scholar 

  • Bray, F., Soerjomataram, I., Mery, L. & Ferlay, J. Improving the quality and coverage of cancer registries globally. Lancet 386, 1035–1036 (2015).

    Article 
    PubMed 

    Google Scholar 

  • Bray, F. et al. Cancer Incidence in Five Continents: inclusion criteria, highlights from Volume X and the global status of cancer registration. Int. J. Cancer 137, 2060–2071 (2015).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Moore, S. C. et al. Endogenous estrogens, estrogen metabolites, and breast cancer risk in postmenopausal Chinese women. J. Natl Cancer Inst. 108, djw103 (2016).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Freedman, N. D. et al. Impact of changing US cigarette smoking patterns on incident cancer: risks of 20 smoking-related cancers among the women and men of the NIH-AARP cohort. Int. J. Epidemiol. 45, 846–856 (2015).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Lee, C. H. et al. Independent and combined effects of alcohol intake, tobacco smoking and betel quid chewing on the risk of esophageal cancer in Taiwan. Int. J. Cancer 113, 475–482 (2005).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Ferlay, J. et al. Global Cancer Observatory: Cancer Today (version 1.1). International Agency for Research on Cancer https://gco.iarc.fr/today/en (2024).

  • International Statistical Classification of Diseases and Related Health Problems, 10th revision, Fifth edition, 2016 (World Health Organization, 2015); https://iris.who.int/handle/10665/246208

  • Fritz, A. et al. International Classification of Diseases for Oncology 3rd edn (World Health Organization, 2000); https://www.who.int/standards/classifications/other-classifications/international-classification-of-diseases-for-oncology

  • Bray, F. et al. Cancer Incidence in Five Continents, Vol. XII (IARC CancerBase No. 19). International Agency for Research on Cancer https://ci5.iarc.fr/ci5-xii/ (2023).

  • Crump, K. S. Risk of benzene-induced leukemia: a sensitivity analysis of the pliofilm cohort with additional follow-up and new exposure estimates. J. Toxicol. Environ. Health 42, 219–242 (1994).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Elliott, A. M., Aucott, L. S., Hannaford, P. C. & Smith, W. C. Weight change in adult life and health outcomes. Obes. Res. 13, 1784–1792 (2005).

    Article 
    PubMed 

    Google Scholar 

  • Grundy, A. et al. Cancer incidence attributable to alcohol consumption in Alberta in 2012. CMAJ Open 4, E507–E514 (2016).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Lanphear, B. P. & Buncher, C. R. Latent period for malignant mesothelioma of occupational origin. J. Occup. Med. 34, 718–721 (1992).

    CAS 
    PubMed 

    Google Scholar 

  • O’Reilly, K. M., McLaughlin, A. M., Beckett, W. S. & Sime, P. J. Asbestos-related lung disease. Am. Fam. Physician 75, 683–688 (2007).

    PubMed 

    Google Scholar 

  • Parker, E. D. & Folsom, A. R. Intentional weight loss and incidence of obesity-related cancers: the Iowa Women’s Health Study. Int. J. Obes. Relat. Metab. Disord. 27, 1447–1452 (2003).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Steenland, K., Stayner, L. & Deddens, J. Mortality analyses in a cohort of 18 235 ethylene oxide exposed workers: follow up extended from 1987 to 1998. Occup. Environ. Med. 61, 2–7 (2004).

    CAS 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Weiss, W. Cigarette smoking and lung cancer trends. A light at the end of the tunnel? Chest 111, 1414–1416 (1997).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • GBD 2019 Tobacco Collaborators. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990−2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet 397, 2337−2360 (2021).

  • World Health Organization. Global Information System on Alcohol and Health. https://www.who.int/data/gho/data/themes/global-information-system-on-alcohol-and-health

  • NCD Risk Factor Collaboration. National Adult Body-Mass Index – Data Downloads. https://www.ncdrisc.org/data-downloads-adiposity.html (2024).

  • World Health Organization. Insufficient physical activity – indicator group. https://www.who.int/data/gho/data/themes/topics/indicator-groups/insufficient-physical-activity-indicator-group (2024).

  • Rumgay, H. et al. Global burden of oral cancer in 2022 attributable to smokeless tobacco and areca nut consumption: a population attributable fraction analysis. Lancet Oncol. 25, 1413–1423 (2024).

    Article 
    PubMed 

    Google Scholar 

  • United Nations Children’s Fund (UNICEF). Breastfeeding. https://data.unicef.org/topic/nutrition/breastfeeding/ (UNICEF Data, 2025).

  • Air pollution: concentrations of fine particulate matter (PM2.5), SDG 11.6.2. World Health Organization https://www.who.int/data/gho/data/indicators/indicator-details/GHO/concentrations-of-fine-particulate-matter-(pm2-5) (2025).

  • Langselius, O. et al. Global burden of cutaneous melanoma incidence attributable to ultraviolet radiation in 2022. Int. J. Cancer 157, 1110–1119 (2025).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • WHO/ILO joint estimates of the work-related burden of disease and injury. World Health Organization https://www.who.int/teams/environment-climate-change-and-health/monitoring/who-ilo-joint-estimates (2021).

  • Kehoe, T., Gmel, G., Shield, K. D., Gmel, G. & Rehm, J. Determining the best population-level alcohol consumption model and its impact on estimates of alcohol-attributable harms. Popul. Health Metr. 10, 6 (2012).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Rehm, J. et al. Statistical modeling of volume of alcohol exposure for epidemiological studies of population health: the US example. Popul. Health Metr. 8, 3 (2010).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Shield, K. D. & Rehm, J. Difficulties with telephone-based surveys on alcohol consumption in high-income countries: the Canadian example. Int. J. Methods Psychiatr. Res. 21, 17–28 (2012).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. Lancet 403, 1027−1050 (2024).

  • Arnold, M. et al. Global burden of cancer attributable to high body-mass index in 2012: a population-based study. Lancet Oncol. 16, 36–46 (2015).

    Article 
    PubMed 

    Google Scholar 

  • Prevalence of insufficient physical activity among adults. World Health Organization https://www.who.int/data/gho/data/indicators/indicator-details/GHO/prevalence-of-insufficient-physical-activity-among-adults-aged-18-years-(age-standardized-estimate)-(-) (2017).

  • WHO/ILO joint estimates of the work-related burden of disease and injury, 2000−2016: global monitoring report (World Health Organization, 2021); https://www.who.int/publications/i/item/9789240034945

  • Pega, F., Hamzaoui, H., Náfrádi, B. & Momen, N. C. Global, regional and national burden of disease attributable to 19 selected occupational risk factors for 183 countries, 2000−2016: a systematic analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. Scand. J. Work Environ. Health 48, 158–168 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Reitsma, M. B. et al. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and initiation among young people in 204 countries and territories, 1990–2019. Lancet Public Health 6, e472–e481 (2021).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Jordan, S. J., Whiteman, D. C., Purdie, D. M., Green, A. C. & Webb, P. M. Does smoking increase risk of ovarian cancer? A systematic review. Gynecol. Oncol. 103, 1122–1129 (2006).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • World Cancer Research Fund/American Institute for Cancer Research. Diet, Nutrition, Physical Activity and Cancer: a Global Perspective (World Cancer Research Fund, 2018); https://www.wcrf.org/wp-content/uploads/2024/11/Summary-of-Third-Expert-Report-2018.pdf

  • Shield, K. et al. National, regional, and global burdens of disease from 2000 to 2016 attributable to alcohol use: a comparative risk assessment study. Lancet Public Health 5, e51–e61 (2020).

    Article 
    PubMed 

    Google Scholar 

  • Bagnardi, V. et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose−response meta-analysis. Br. J. Cancer 112, 580–593 (2015).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Abar, L. et al. Body size and obesity during adulthood, and risk of lympho-haematopoietic cancers: an update of the WCRF-AICR systematic review of published prospective studies. Ann. Oncol. 30, 528–541 (2019).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Wolin, K. Y., Yan, Y., Colditz, G. A. & Lee, I. M. Physical activity and colon cancer prevention: a meta-analysis. Br. J. Cancer 100, 611–616 (2009).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Friedenreich, C. M. & Cust, A. E. Physical activity and breast cancer risk: impact of timing, type and dose of activity and population subgroup effects. Br. J. Sports Med. 42, 636–647 (2008).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Schmid, D. et al. A systematic review and meta-analysis of physical activity and endometrial cancer risk. Eur. J. Epidemiol. 30, 397–412 (2015).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Renfrew, M. J., McCormick, F. M., Wade, A., Quinn, B. & Dowswell, T. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst. Rev. 5, CD001141 (2012).

    PubMed 

    Google Scholar 

  • Hamra, G. B. et al. Outdoor particulate matter exposure and lung cancer: a systematic review and meta-analysis. Environ. Health Perspect. 122, 906–911 (2014).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Plummer, M., Franceschi, S., Vignat, J., Forman, D. & de Martel, C. Global burden of gastric cancer attributable to Helicobacter pylori. Int. J. Cancer 136, 487–490 (2015).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • de Martel, C., Plummer, M., Vignat, J. & Franceschi, S. Worldwide burden of cancer attributable to HPV by site, country and HPV type. Int. J. Cancer 141, 664–670 (2017).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • GBD 2017 Risk Factor Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990−2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 392, 1923−1994 (2018).

  • Levin, M. L. The occurrence of lung cancer in man. Acta Unio Int. Contra Cancrum 9, 531–541 (1953).

    CAS 
    PubMed 

    Google Scholar 

  • Rumgay, H. et al. Global burden of cancer in 2020 attributable to alcohol consumption: a population-based study. Lancet Oncol. 22, 1071–1080 (2021).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Victora, C. G. et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet 387, 475–490 (2016).

    Article 
    PubMed 

    Google Scholar 

  • WHO global air quality guidelines: particulate matter (PM2.5 and PM10), ozone, nitrogen dioxide, sulfur dioxide and carbon monoxide (World Health Organization, 2021); https://www.who.int/publications/i/item/9789240034228

  • Arnold, M. et al. Global burden of cutaneous melanoma attributable to ultraviolet radiation in 2012. Int. J. Cancer 143, 1305–1314 (2018).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Related Articles

    Leave a Reply

    Your email address will not be published. Required fields are marked *

    Check Also
    Close
    Back to top button