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Risk Factors

Overview of Risk Factors

Percent of cancer deaths due to smoking:
Ezzati M, Henley SJ, Lopez AD, Thun MJ. Role of smoking in global and regional cancer epidemiology: current patterns and data needs. Int J Cancer. 2005;116(6):963-71.

Text:
Haenszel W, Kurihara M. Studies of Japanese migrants. I. Mortality from cancer and other diseases among Japanese in the United States. J Natl Cancer Inst. 1968;40(1):43-68.

International Agency for Research on Cancer. World Cancer Report 2014. Lyon: International Agency for Research on Cancer; 2014. Cogliano VJ, Baan R, Straif K, et al. Preventable exposures associated with human cancers. J Natl Cancer Inst. 2011;103(24):1827-39.

Ezzati M, Henley SJ, Lopez AD, Thun MJ. Role of smoking in global and regional cancer epidemiology: current patterns and data needs. Int J Cancer. 2005;116(6):963-71.

Thun MJ, Jemal A. How much of the decrease in cancer death rates in the United States is attributable to reductions in tobacco smoking? Tob Control. 2006;15(5):345-7.

Rushton L, Hutchings SJ, Fortunato L, et al. Occupational cancer burden in Great Britain. Br J Cancer. 2012;107 Suppl 1:S3-7.

Park J, Hisanaga N, Kim Y. Transfer of occupational health problems from a developed to a developing country: lessons from the Japan-South Korea experience. Am J Ind Med. 2009;52(8):625-32.

de Martel C, Ferlay J, Franceschi S, et al. Global burden
of cancers attributable to infections in 2008: a review and synthetic analysis. Lancet Oncol. 2012;13(6):607-15.

Vineis P, Xun W. The emerging epidemic of environmental cancers in developing countries. Ann Oncol. 2009;20(2):205-12.

Figure 1:
Waterhouse J, Muir CS, Correa P, Powell J (Eds). Cancer Incidence in Five Continents, Vol. III. IARC Scientific Publications, No. 15. Lyon: IARC; 1976.

Figure 2:
Cogliano VJ, Baan R, Straif K, et al. Preventable exposures associated with human cancers. J Natl Cancer Inst. 2011;103(24):1827-39.

Ezzati M, Henley SJ, Lopez AD, Thun MJ. Role of smoking in global and regional cancer epidemiology: current patterns and data needs. Int J Cancer. 2005;116(6):963-71.

Vineis P, Alavanja M, Buffler P, et al. Tobacco and cancer: recent epidemiological evidence. J Natl Cancer Inst. 2004;96(2):99-106.

Figure 3:
Case RAM, Hosker ME, McDonald DB, Pearson JT.

Tumours of the urinary bladder in workmen engaged in the manufacture and use of certain dyestuff intermediates in the British chemical industry. Part I. The role of aniline, benzidine, alpha-naphthylamine, and beta-naphthylamine. Br J Ind Med. 1954;11(2):75-104.

Figure 4:
Bruni L, Diaz M, Castellsagué X, et al. Cervical human papillomavirus prevalence in 5 continents: meta-analysis of 1 million women with normal cytological findings. J Infect Dis. 2010;202(12):1789-99.

Figure 5:
World Cancer Research Fund / American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington, DC: AICR; 2007.

Risks of Tobacco

Quote:
World Health Organization. Statement by the Director- General to the Intergovernmental Negotiating Body on the WHO framework convention on tobacco control at its fifth session. Available at: http://apps.who.int/gb/fctc/PDF/inb5/ einb5d7.pdf. Accessed July 11, 2014.

Deaths due to tobacco use in the 21st century:
Eriksen M, Mackay J, Ross H. The Tobacco Atlas. 4th edition. Atlanta: American Cancer Society; 2012.

Waterpipe use in young adults:
Akl EA, Gunukula SK, Aleem S, et al. The prevalence of waterpipe tobacco smoking among the general and specific populations: a systematic review. BMC Public Health. 2011;11:244.

Warren CW, Lea V, Lee J, et al. Change in tobacco use among 13-15 year olds between 1999 and 2008: findings from the Global Youth Tobacco Survey. Glob Health Promot. 2009;16(2 Suppl):38-90.

Text:
Eriksen M, Mackay J, Ross H. The Tobacco Atlas. 4th edition. Atlanta: American Cancer Society; 2012.

Thun MJ, Carter BD, Feskanich D, et al. 50-year trends in smoking-related mortality in the United States. N Engl J Med. 2013;368(4):351-64.

International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Smokeless tobacco and some tobacco-specific N-nitrosamines. Vol. 89. Lyon: IARC; 2007.

International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Tobacco smoke and involuntary smoking. Vol. 83. Lyon: IARC; 2004.

Oberg M, Jaakkola MS, Woodward A, et al. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet. 2011;377(9760):139-46.

Main Maps: Male and female (>15 years) smoking prevalence, 2013
Data were provided by the Institute for Health Metrics and Evaluation, 2014.

Figure 1:
Global Burden of Disease Study 2010. Global Burden of Disease Study 2010 (GBD 2010) Results by Risk Factor 1990-2010. Seattle: Institute for Health Metrics and Evaluation (IHME); 2012.

Figure 2:
Giovino GA, Mirza SA, Samet JM, et al. Tobacco use in 3 billion individuals from 16 countries: an analysis of nationally representative cross-sectional household surveys. Lancet. 2012; 380(9842):668-79.

Figure 3:
Warren CW, Lea V, Lee J, et al. Change in tobacco use among 13-15 year olds between 1999 and 2008: findings from the Global Youth Tobacco Survey. Glob Health Promot. 2009; 16(2 Suppl):38-90.

Infection

Helicobacter pylori responsible for 90% of stomach cancers:
de Martel C, Forman D, Plummer M. Gastric cancer: epidemiology and risk factors. Gastroenterol Clin North Am. 2013;42(2):219-40.

Text:
de Martel C, Ferlay J, Franceschi S, et al. Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. Lancet Oncol. 2012;13(6):607-15.

de Martel C, Forman D, Plummer M. Gastric cancer: epidemiology and risk factors. Gastroenterol Clin North Am. 2013;42(2):219-40.

Forman D, de Martel C, Lacey CJ, et al. Global burden of human papillomavirus and related diseases. Vaccine. 2012;30 Suppl 5:F12-23.

International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Biological agents. Vol. 100B. Lyon: IARC; 2012.

Map:
de Martel C, Ferlay J, Franceschi S, et al. Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. Lancet Oncol. 2012;13(6):607-15.

Figure 1:
de Martel C, Ferlay J, Franceschi S, et al. Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. Lancet Oncol. 2012;13(6):607-15.

Diet, Body Mass, and Physical Activity

Quote:
Hippocrates. Hippocratic Writings. Chicago: Encyclopedia Britannica; 1955.

In some countries 60% of adults are overweight or obese:
World Health Organization. Global Health Observatory Data Repository, Overweight (Body Mass Index > 25) Data by Country, 2008 [online database]. Available from: http://apps. who.int/ghodata/, accessed November 9, 2012.

Text:
Baan R, Straif K, Grosse Y, et al. Carcinogenicity of alcoholic beverages. Lancet Oncol. 2007;8(4): 292-3.

Boffetta P, Hashibe M, La Vecchia C, et al. The burden of cancer attributable to alcohol drinking. Int J Cancer. 2006;119(4): 884-7.

Esposito K, Chiodini P, Colao A, Lenzi A, Giugliano D. Metabolic syndrome and risk of cancer: a systematic review and meta-analysis. Diabetes Care. 2012;35(11): 2402-11.

Esposito K, Ciardiello F, Giugliano D. Unhealthy diets: a common soil for the association of metabolic syndrome and cancer. Endocrine. Epub 2014 Jan 10.

International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Personal Habits and Indoor Combustions. Vol. 100E. Lyon, France: IARC; 2012.

Kushi LH, Doyle C, McCullough M, et al. American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin. 2012;62(1):30-67.

Rock CL, Doyle C, Demark-Wahnefried W, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62(4): 243-74.

World Cancer Research Fund / American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington, DC: AICR; 2007.

World Health Organization. Global Recommendations on Physical Activity for Health. Geneva: World Health Organization; 2010.

World Health Organization. Global Status Report on Noncommunicable Diseases. Geneva: World Health Organization; 2010.

Maps:
World Health Organization. Global Health Observatory Data Repository, Overweight (Body Mass Index > 25) Data by Country, 2008 [online database]. Available from: http://apps. who.int/ghodata/, accessed November 9, 2012.

Figure 1:
International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Personal Habits and Indoor Combustions. Vol. 100E. Lyon: IARC; 2012.

World Cancer Research Fund/American Institute for Cancer Research. Continuous Update Project Summary. Food, Nutrition, Physical Activity, and the Prevention of Pancreatic Cancer. Washington, DC: AICR; 2012.

World Cancer Research Fund/American Institute for Cancer Research. Continuous Update Project Report Summary. Food, Nutrition, Physical Activity, and the Prevention of Colorectal Cancer. Washington, DC: AICR; 2011.

World Cancer Research Fund/American Institute for Cancer Research. Continuous Update Project Report Summary. Food, Nutrition, Physical Activity, and the Prevention of Breast Cancer. Washington, DC: AICR; 2010.

World Cancer Research Fund/American Institute for
Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington, DC: AICR; 2007.

Figure 2:
Renehan AG, Soerjomataram I, Tyson M, et al. Incident cancer burden attributable to excess body mass index in 30 European countries. Int J Cancer. 2010; 126(3):692-702.

World Cancer Research Fund / American Institute for Cancer Research. Policy and action for cancer prevention. Food, nutrition, and physical activity: a Global Perspective. Washington, DC: AICR; 2009.

Figure 3:
Lee IM, Shiroma EJ, Lobelo F, et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219-29.

Ultraviolet Radiation

Quote:
Jorgensen CM. Scientific recommendations and human behaviour: sitting out in the sun. Lancet. 2002;360(9330):351-2.

Childhood sunburns increase skin cancer risk:
Green AC, Wallingford SC, McBride P. Childhood exposure to ultraviolet radiation and harmful skin effects: epidemiological evidence. Prog Biophys Mol Biol. 2011;107(3):349-55.

Text:
American Cancer Society. Skin Cancer: Basal and Squamous Cell. Available from: http://www.cancer.org/Cancer/SkinCancer -BasalandSquamousCell/DetailedGuide/skin-cancer-basal-and -squamous-cell-what-is-basal-and-squamous-cell, accessed October 4, 2012.

Baade PD, Green AC, Smithers BM, Aitken JF. Trends in melanoma incidence among children: possible influence of sun-protection programs. Expert Rev Anticancer Ther. 2011;11(5):661-4.

Douglass A, Fioletov V, Godin-Beekmann S, et al. Stratospheric ozone and surface ultraviolet radiation.
In: Scientific Assessment of Ozone Depletion, Global Ozone Research and Monitoring Project-Report No. 52. Geneva: World Meteorological Organization; 2010.

Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Available from: http://globocan. iarc.fr, accessed December 12, 2013.

Gallagher RP, Rivers JK, Lee TK, et al. Broad-spectrum sunscreen use and the development of new nevi in white children: A randomized controlled trial. JAMA. 2000;283(22):2955-60.

Green AC, Wallingford SC, McBride P. Childhood exposure to ultraviolet radiation and harmful skin effects: epidemiological evidence. Prog Biophys Mol Biol. 2011;107(3):349-55.

Green AC, Williams GM, Logan V, Strutton GM. Reduced melanoma after regular sunscreen use: randomized trial follow-up. J Clin Oncol. 2011;29(3):257-63.

International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Solar and Ultraviolet Radiation. Vol. 100D. Lyon, France: IARC; 2012.

Lucas R, McMichael T, Smith W, Armstrong B. Solar Ultraviolet Radiation: Global Burden of Disease from solar ultraviolet radiation. Environmental Burden of Disease Series, No. 13. Geneva: World Health Organization; 2006.

The International Agency for Research on Cancer Working Group on Artificial Ultraviolet (UV) Light and Skin Cancer. The association of use of sunbeds with cutaneous malignant melanoma and other skin cancers: A systematic review. Int J Cancer. 2007;120(5):1116-22.

Whiteman DC, Whiteman CA, Green AC. Childhood sun exposure as a risk factor for melanoma: A systematic review of epidemiologic studies. Cancer Causes Control. 2001;12(1):69-82.

Map:
Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Available from: http://globocan. iarc.fr, accessed December 12, 2013.

Figure 1:
Bentzen J, Kjellberg J, Thorgaard C, et al. Costs of illness for melanoma and nonmelanoma skin cancer in Denmark. Eur J Cancer Prev. 2013;22(6):569-76.

Bickers DR, Lim HW, Margolis D, et al. The burden of skin diseases: 2004 a joint project of the American Academy of Dermatology Association and the Society for Investigative Dermatology. J Am Acad Dermatol. 2006;55(3):490-500.

Fransen M, Karahalios A, Sharma N, et al. Non-melanoma skin cancer in Australia. Med J Aust. 2012;197(10):565-8.

Souza RJ, Mattedi AP, Correa MP, et al. An estimate of the cost of treating non-melanoma skin cancer in the state of Sao Paulo, Brazil. An Bras Dermatol. 2011;86(4):657-662.

Tinghog G, Carlsson P, Synnerstad I, Rosdahl I. Societal cost of skin cancer in Sweden in 2005. Acta Derm Venereol. 2008;88(5):467-73.

Figure 2:

Boldeman C, Jansson B, Dal H, Ullen H. Sunbed use among Swedish adolescents in the 1990s: A decline with an unchanged relationship to health risk behaviors. Scand J Public Health. 2003;31(3):233-7.

Guy GP Jr, Tai E, Richardson LC. Use of indoor tanning devices by high school students in the United States, 2009. Prev Chronic Dis. 2011;8(5):A116.

Koster B, Thorgaard C, Clemmensen IH, Philip A. Sunbed use in the Danish population in 2007: A cross-sectional study. Prev Med. 2009;48(3):288-90.

Ontario Sun Safety Working Group. National Sun Survey Highlights Report 2008. 2008. Available from: http://www.uvnetwork.ca/NationalSunSurveyHighlightsReport20080710.pdf, accessed October 9, 2012.

Figure 3:

Ferlay J, Bray F, Steliarova-Foucher E, Forman D. Cancer Incidence in Five Continents, CI5plus: IARC CancerBase [Internet]. Lyon, France: International Agency for Research on Cancer; 2014. Available from: http://ci5.iarc.fr, accessed December 12, 2013.

Reproductive and Hormonal Factors

Quote:

Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: Collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet. 2002; 360(9328):187–95.

Fertility rates have declined by 50% in some countries:

United Nations Department of Economic and Social Affairs Population Division. World Fertility Patterns 2009. 2010. Available from: http://www.un.org/esa/population/publications/ worldfertility2009/worldfertility2009.htm, accessed August 15, 2014.

Text:

Ma H, Bernstein L, Pike MC, et al. Age at first birth, parity and risk of breast cancer: A meta-analysis of 8 studies from the Nordic countries. Int J Cancer. 1990; 46(4):597–603.

Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: Collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50 302 women with breast cancer and 96 973 women without the disease. Lancet. 2002; 360(9328):187–95.

Pike MC, Wu AH, Spicer DV, et al. Estrogens, progestins, and risk of breast cancer. In: Ernst Shering Foundation Symposium Proceedings, Vol. 1. Berlin: Springer Verlag; 2007; pp. 127–50.

Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and hormonal contraceptives: Collaborative reanalysis of individual data on 53 297 women with breast cancer and 100 239 women without breast cancer from 54 epidemiological studies. Lancet. 1996; 347:1713–27.

Beral V. Breast cancer and hormone-replacement therapy in the Million Women Study. Lancet. 2003; 362(9382):419-27.

Grosse Y, Baan R, Straif K, et al. A review of human carcinogens—Part A: Pharmaceuticals. Lancet Oncol. 2009;10(1):13–4.

Maps:

United Nations Department of Economic and Social Affairs Population Division. World Fertility Patterns 2009. 2010. Available from: http://www.un.org/esa/population/publications/ worldfertility2009/worldfertility2009.htm, accessed August 15, 2012.

Figure 1:

Tanner JM. Trend towards earlier menarche in London, Oslo, Copenhagen, the Netherlands and Hungary. Nature. 1973; 243:95-6.

Zacharias L, Wurtman RJ. Age at menarche: Genetic and environmental influences. N Engl J Med. 1969; 280:868-75.

Figure 2:

Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and hormonal contraceptives: collaborative reanalysis of individual data on 53 297 women with breast cancer and 100 239 women without breast cancer from 54 epidemiological studies. Lancet. 1996; 347:1713–27.

Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and hormone replacement therapy: collaborative reanalysis of data from 51 epidemiological studies of 52 705 women with breast cancer and 108 411 women without breast cancer. Lancet. 1997;350(9084):1047-59.

Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: Collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50 302 women with breast cancer and 96 973 women without the disease. Lancet. 2002; 360(9328):187–95.

Ewertz M, Duffy SW, Adami HO, et al. Age at first birth, parity and risk of breast cancer: a meta-analysis of 8 studies from the Nordic countries. Int J Cancer. 1990; 46(4):597-603.

Environmental and Occupational Pollutants

Quote:

International Agency for Research on Cancer. Press Release: Outdoor air pollution a leading environmental cause of cancer deaths. 2013. Available from: http://www.iarc.fr/en/ media-centre/iarcnews/pdf/pr221_E.pdf, accessed August 18, 2014.

Text:

Benbrahim-Tallaa L, Baan RA, Grosse Y, et al. Carcinogenicity of diesel-engine and gasoline-engine exhausts and some nitroarenes. Lancet Oncol. 2012;13: 663–4.

Cantor KP, Lubin JH. Arsenic, internal cancers, and issues in inference from studies of low-level exposures in human populations. Toxicol Appl Pharmacol. 2007;222: 252–7.

Darby S, Hill D, Deo H, et al. Residential radon and lung cancer: Detailed results of a collaborative analysis of individual data on 7148 persons with lung cancer and 14,208 persons without lung cancer from 13 epidemiologic studies in Europe. Scand J Work Environ Health. 2006; 32(Suppl 1):1–83.

Field RW, Steck DJ, Smith BJ, et al. Residential radon gas exposure and lung cancer: The Iowa Radon Lung Cancer Study. Am J Epidemiol. 2000;151(11):1091–102. International Agency for Research on Cancer. IARC monographs on the evaluation of the carcinogenic risk of chemicals to humans: Indoor air pollution from heating and cooking: some solid fuels and cooking oil fumes. Vol. 95. Lyon, France: IARC; 2006.

Loomis D, Grosse Y, Lauby-Secretan B, et al. The carcinogenicity of outdoor air pollution. Lancet Oncol. 2013; 14: 1262–3.

Santana VS, Ribiero FSN. Occupational cancer burden in developing countries and the problem of informal workers. Environmental Health. 2011; 10(Suppl 1):S10.

Map: Mean annual PM2.5 levels

World Health Organization. Global Health Observatory Data Repository, Ambient air pollution database, May 2014 [online database]. Available from: http://apps.who.int/gho/data/ node.main.152?lang=en, accessed July 9, 2014.

Figure 1:

(Heading) World Health Organization. Household Air Pollution and Health. Available from: http://www.who.int/mediacentre/factsheets/fs292/en/, accessed August 19, 2014.

World Health Organization. Global Health Observatory Data Repository, Population using solid fuels (estimates), 2010, data by country [online database]. Available from: http://apps.who.int/gho/data/view.main.1701?lang=en, accessed July 9, 2014.

Figure 2:

Boffetta P, Kogevinas M, Saracci R, et al. Occupational carcinogens. In: Encyclopedia of occupational health and safety. Vol. 2, Cancer. Stellman JM (Ed). Geneva, Switzerland: International Labor Organization; 2011.

Figure 3:

Park EK, Takahashi K, Hoshuyama T, et al. Global magnitude of reported and unreported mesothelioma. Environ Health Perspect. 2011;119:514-8.

Figure 4:

Virta RL. Worldwide asbestos supply and consumption trends from 1900 through 2003: U.S. Geological Survey Circular 1298. Reston, VA; United States Geological Survey; 2006. Available from: http://pubs.usgs.gov/circ/2006/1298/ c1298.pdf, accessed July 25, 2014.

Human Carcinogens Identified by the IARC Monographs Program

Over 100 carcinogenic agents:

Cogliano VJ, Baan R, Straif K, et al. Preventable exposures associated with human cancers. J Natl. Cancer Inst. 2011;103:1827-39.

Text:

International Agency for Research on Cancer. IARC monographs for the evaluation of carcinogenic risks to humans. Available from: http://monographs.iarc.fr/, accessed July 25, 2014.

Figure:

Cogliano VJ, Baan R, Straif K, et al. Preventable exposures associated with human cancers. J Natl. Cancer Inst. 2011;103:1827-39.