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One-Third of Cancer Deaths Could Be Avoided

Of the seven million worldwide cancer deathsroles  in  all  income  levels  and  regions.
reported in 2001, 35 percent were
attributable to nine well-known behavioralWorldwide, the nine risk factors caused 1.6
and environmental risk factors, according tomillion cancer deaths among men and 830,000
an  analysis  published  in  The  Lancet.among women. Smoking alone is estimated to
have caused 21 percent of deaths from cancer
Researchers from the Harvard School of Publicworldwide.
Health (HSPH) and a network of collaborators
made the calculation by estimating mortalityIn high-income countries, these nine risks
for 12 types of cancer linked to the ninecaused 760,000 cancer deaths. Smoking,
risk factors in seven World Bank regions foralcohol, and overweight and obesity were the
that  year.most important causes of cancer in these
nations.
They also looked at how the risks, and the
cancers they cause, were distributed over theIn low- and middle-income regions, the nine
regions of the world. This is the firstrisks caused 1.67 million cancer deaths.
assessment of the role of health risks inSmoking, alcohol consumption, and low fruit
cancer  deaths  globally  and  regionally.and vegetable intake were the leading risk
factors  for  these  deaths.
Risk  Factor  Analysis
Sexual transmission of human papillomavirus
The researchers analyzed data from theis the leading risk factor for cervical
Comparative Risk Assessment project and Worldcancer in women in low- and middle-income
Health Organization databases to determinecountries, particularly in Sub-Saharan Africa
the level of risk factors in different worldand South Asia, where access to cervical
regions,  and  separately  for men and women.screening  is  also  limited.
They also considered how hazardous each riskAmong low- and middle-income regions, Europe
factor might be. The analysis covered alland Central Asia had the highest proportion
high-income countries together, and separatedof death from cancer from the nine risk
low-income and middle-income countries intofactors studied; 39 percent of 825,000 cancer
geographical regions: East Asia and Pacific,deaths in the low- and middle-income
South Asia, Europe and Central Asia, Latincountries of Europe and Central Asia were
America and Caribbean, Middle East and Northcaused  by  these  risks.
Africa,  and  Sub-Saharan  Africa.
The effects were even larger among men; one
The  nine  risk  factors:half of cancer deaths among men in the low-
and middle-income countries of Europe and
-  overweight  and  obesityCentral Asia were caused by these nine risks.
-  low  fruit  and  vegetable  intakeBehaviors  and  Environments
-  physical  inactivity"These results clearly show that many
globally important types of cancer are
-  smokingpreventable by changes in lifestyle behaviors
and environmental interventions," comments
-  alcohol  useMajid Ezzati, senior author of the study and
assistant professor of international health
-  unsafe  sexat  HSPH.
-  urban  air  pollution"To win the war against cancer, we must focus
not just on advances in biomedical
-  indoor  smoke  from  household use of coaltechnologies, but also on technologies and
policies that change the behaviors and
- contaminated injections in healthcareenvironments that cause those cancers," he
settingsadds.
Alcohol,  Smoking  Play  Large  RolesThe study, "Causes of cancer in the world:
comparative risk assessment of nine
More than one in every three of the sevenbehavioral and environmental risk factors,"
million deaths from cancer worldwide werewas funded by the National Institute on Aging
caused by these nine potentially modifiableand by the Disease Control Priorities
risk factors (2.43 million), the researchersProject.
found, with alcohol and smoking playing large



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