吸烟是最危险致癌因素!大数据揭示:42%的癌症与可变外因有关
2017/11/23
11月初,美国临床肿瘤学会(ASCO)证实发布声明称,酒精是明确的致癌因素,一时引发大家普遍关注。现在,美国癌症协会(ACS)再次扩大范围:盘点分析了26种癌症类型、17种癌症风险因素,包括饮食、吸烟、喝酒、运动、超重……其中,吸烟被认为是“最危险分子”!


11月21日,影响因子高达187.04的神级期刊《CA: A Cancer Journal for Clinicians》最新发表一项研究,揭示了针对多种癌症风险因素的大数据分析结果,对通过改变生活方式预防癌症提供了一定的指示意义。

“大数据”分析

这次是美国癌症协会的Farhad Islami教授带领团队从美国疾病控制和预防中心(CDC)、国家癌症研究所(NCI)采集相关癌症病例和死亡数据,并对信息进行大规模的荟萃分析。研究团队共分析了26种癌症类型、17种风险因素,涉及1,570,975例癌症患者(其中587,521位患者因病去世)。

值得注意的是,这17种因素被认为是“可调整”的(即可以采取积极措施改变),包括饮酒、吸烟(一手、二手)、超重、纤维摄取量低、食用加工红肉、水果和蔬菜食用量低、紫外线辐射、钙含量低、缺乏体育锻炼以及6种癌症相关感染。


最危险因素:吸烟、超重、喝酒

结果显示:通过改变上述风险因素,42%的癌症、超45%的癌死亡是可以避免的。

而且,数据显示最危险的3个风险因素分别是吸烟、超重和饮酒——19%的癌症病例、约29%的死亡病例与吸烟有关;7.8%的癌症病例和6.5%的死亡病例源于体重超标;5.6%的癌症病例和4%的死亡病例归结于酒精。

此外,4.7%的癌症和1.5%的死亡是因为紫外线辐射;2.9%的癌症和2.2%的死亡与缺乏运动有关。

一些常见的癌症很大一部分归因于可改变的危险因素,例如85.8%的肺癌、超70%的肝癌、近55%的结直肠癌、约29%的乳腺癌都与可变因素有关,其中81.7%的肺癌可归结于吸烟。

具体而言,96%的黑色素瘤源于紫外线辐射,超60%的子宫癌与超重有关,50%的食道癌、47%的膀胱癌与吸烟有关。超10%的结直肠癌与低纤维饮食有关。

预防是关键

这些数据强调了通过改变风险因素的预防措施在降低癌症发生率和死亡率上的巨大潜力。

研究团队提醒大家,每个人都可以控制的4个关键因素分别是体重、饮酒、饮食和运动。这4个因素与14%的女性癌症风险、22%的男性癌症风险有关。

参考资料:

Cancer: 42 percent of cases down to risk factors you can change

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  • Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States

    Contemporary information on the fraction of cancers that potentially could be prevented is useful for priority setting in cancer prevention and control. Herein, the authors estimate the proportion and number of invasive cancer cases and deaths, overall (excluding nonmelanoma skin cancers) and for 26 cancer types, in adults aged 30 years and older in the United States in 2014, that were attributable to major, potentially modifiable exposures (cigarette smoking; secondhand smoke; excess body weight; alcohol intake; consumption of red and processed meat; low consumption of fruits/vegetables, dietary fiber, and dietary calcium; physical inactivity; ultraviolet radiation; and 6 cancer-associated infections). The numbers of cancer cases were obtained from the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute; the numbers of deaths were obtained from the CDC; risk factor prevalence estimates were obtained from nationally representative surveys; and associated relative risks of cancer were obtained from published, large-scale pooled analyses or meta-analyses. In the United States in 2014, an estimated 42.0% of all incident cancers (659,640 of 1570,975 cancers, excluding nonmelanoma skin cancers) and 45.1% of cancer deaths (265,150 of 587,521 deaths) were attributable to evaluated risk factors. Cigarette smoking accounted for the highest proportion of cancer cases (19.0%; 298,970 cases) and deaths (28.8%; 169,180 deaths), followed by excess body weight (7.8% and 6.5%, respectively) and alcohol intake (5.6% and 4.0%, respectively). Lung cancer had the highest number of cancers (184,970 cases) and deaths (132,960 deaths) attributable to evaluated risk factors, followed by colorectal cancer (76,910 cases and 28,290 deaths). These results, however, may underestimate the overall proportion of cancers attributable to modifiable factors, because the impact of all established risk factors could not be quantified, and many likely modifiable risk factors are not yet firmly established as causal. Nevertheless, these findings underscore the vast potential for reducing cancer morbidity and mortality through broad and equitable implementation of known preventive measures.

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