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. CA Cancer J Clin 2018;68:31‐54. © 2017 American Cancer Society.

中文翻译：

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美国可归因于潜在可改变风险因素的癌症病例和死亡的比例和数量


关于可以预防的癌症比例的当代信息对于确定癌症预防和控制的优先顺序很有用。在此，作者估计了 2014 年美国 30 岁及以上成年人中总体（不包括非黑色素瘤皮肤癌）和 26 种癌症类型的侵袭性癌症病例和死亡的比例和数量，这些癌症归因于主要的、潜在的可改变的暴露（吸烟；二手烟；体重超重；饮酒；食用红肉和加工肉类；水果/蔬菜、膳食纤维和膳食钙摄入量低；缺乏身体活动；紫外线辐射；以及 6 种癌症相关感染） 。癌症病例数来自疾病控制与预防中心 (CDC) 和国家癌症研究所；死亡人数是从疾病预防控制中心获得的；危险因素流行率估计值是从全国代表性调查中获得的；相关的癌症相对风险是从已发表的大规模汇总分析或荟萃分析中获得的。 2014 年，在美国，估计所有癌症发病率的 42.0%（1570,975 例癌症中的 659,640 例，不包括非黑色素瘤皮肤癌）和 45.1% 的癌症死亡（587,521 例死亡中的 265,150 例）可归因于评估的风险因素。吸烟在癌症病例（19.0%；298,970 例）和死亡（28.8%；169,180 例死亡）中所占比例最高，其次是体重过重（分别为 7.8% 和 6.5%）和饮酒（5.6% 和 4.0%） ， 分别）。根据评估的危险因素，肺癌的癌症数量（184,970 例）和死亡数（132,960 例死亡）最多，其次是结直肠癌（76,910 例和 28,290 例死亡）。 然而，这些结果可能低估了可归因于可改变因素的癌症的总体比例，因为所有已确定的风险因素的影响无法量化，而且许多可能的可改变风险因素尚未确定为因果关系。尽管如此，这些发现强调了通过广泛和公平地实施已知的预防措施来降低癌症发病率和死亡率的巨大潜力。加州癌症临床杂志 2018；68：31‐54。 © 2017 美国癌症协会。